ArticleInternational journal for quality in health care : journal of the International Society for Quality in Health Care2018
Limit, lean or listen? A typology of low-value care that gives direction in de-implementation.
Article in International journal for quality in health care : journal of the International Society for Quality in Health Care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 1 of them a synthesis that pooled it.
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Who cites it
64 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Reducing Peripheral Intravenous Catheter Use in Adult Acute Care: A Systematic Review.Emergency medicine Australasia : EMA · 2026Pooled it
- Randomized Trial of the Choosing Wisely Consumer Questions and a Shared Decision-Making Video Intervention on Decision-Making Outcomes.Medical decision making : an international journal of the Society for Medical Decision Making · 2023Trial
- Prevalence of Low-Value Care and Its Associations with Patient-Centered Outcomes in Dementia.Journal of Alzheimer's disease : JAD · 2021Trial
- Economic evaluation of the NET intervention versus guideline dissemination for management of mild head injury in hospital emergency departments.Implementation science : IS · 2018Trial
- Co-Design of a Theory-Informed, Multicomponent, Intervention for Diagnostic Stewardship in a Major-Referral Emergency Department: A Qualitative Descriptive Study.Emergency medicine Australasia : EMA · 2026Article
- De-implementation of low-value care: contrasting theories, models, and frameworks to generate methodological guidance.Implementation science communications · 2026Article
- From CXR to ultrasound: a multi-framework approach to advancing De-implementation in acute care.Implementation science communications · 2026Article
- Cost-Effectiveness of Anticoagulation Treatment for Subclinical Device-Detected Atrial Fibrillation.JAMA network open · 2026Article
- Comparative effectiveness of non-reflective and reflective strategies to favor de-implementation of low-value prescribing for the primary prevention of cardiovascular disease in primary care: the DE-imFAR cluster randomized implementation trial.Implementation science communications · 2026Article
- Risk assessment reasoning and decision-making by ambulance professionals in patients with a transient loss of consciousness: a qualitative study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- 'Communication Is Crucial': A Qualitative Study of Patient Expectations of Diagnostic Tests in Emergency Medicine Practice.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- New perspectives from evidence to action - patient-centered evidence transformation in evidence-based nursing: a narrative review.Frontiers in public health · 2026Review
- The role of electronic health records systems in de-implementing low-value care in primary care: a scoping review.Implementation science communications · 2025Review
- Article
- Nurses' Attitudes and Clinical Judgment on Skin Disinfection Before Subcutaneous Injection: Impact of Setting, Experience, and Normative Beliefs.Nursing reports (Pavia, Italy) · 2025Article
- Barriers and facilitators for reducing low-value home-based nursing care: A qualitative exploratory study among homecare professionals.Journal of advanced nursing · 2025Article
- A Tailored De-Implementation Strategy to Reduce Low-Value Home-Based Nursing Care: A Mixed-Methods Feasibility Study.Journal of advanced nursing · 2025Article
- De-implementation of inappropriate inhaled corticosteroid use in patients with COPD in general practice, results of a mixed methods study.NPJ primary care respiratory medicine · 2025Article
- Low-value clinical practices in pressure injury management: a scoping review.BMC health services research · 2025Article
- De-implementation of low-value home-based nursing care: an effect and process evaluation.Implementation science communications · 2025Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOveruse of unnecessary care is widespread around the world. This so-called low-value care provides no benefit for the patient, wastes resources and can cause harm. The concept of low-value care is broad and there are different reasons for care to be of low-value. Hence, different strategies might be necessary to reduce it and awareness of this may help in designing a de-implementation strategy. Based on a literature scan and discussions with experts, we identified three types of low-value care.
resultsThe type ineffective care is proven ineffective, such as antibiotics for a viral infection. Inefficient care is in essence effective, but is of low-value through inefficient provision or inappropriate intensity, such as chronic benzodiazepine use. Unwanted care is in essence appropriate for the clinical condition it targets, but is low-value since it does not fit the patients' preferences, such as a treatment aimed to cure a patient that prefers palliative care. In this paper, we argue that these three types differ in their most promising strategy for de-implementation and that our typology gives direction in choosing whether to limit, lean or listen.
conclusionWe developed a typology that provides insight in the different reasons for care to be of low-value. We believe that this typology is helpful in designing a tailor-made strategy for reducing low-value care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.