The Choosing Wisely campaign and shared decision-making with Māori

N Z Med J. 2021 Dec 17;134(1547):26-33.

Abstract

Aims: Choosing Wisely seeks to prevent harm by reducing the number of unnecessary tests, treatments and procedures, and by promoting shared decision-making. This article scopes perspectives of Māori patients/consumers and Māori health practitioners around Choosing Wisely and explores shared decision-making between Māori and their medical practitioners.

Methods: Eight Māori consumers and seven Māori health practitioners participated in a qualitative, semi-structured, in-depth interview study with an inductive thematic analysis.

Results: Participant feedback spanned issues from lack of Māori participation in programme governance through to practical issues like meaningful and literacy-appropriate health messaging, traversing consumer, practitioner, organisational and health-system aspects. Feedback further focused on the patient having trust in the practitioner, a sense of autonomy and the availability of advocacy and support in the consultation.

Conclusions: Despite a late campaign collaboration with Māori, Choosing Wisely New Zealand is the first of the international programmes to acknowledge the possibility that their initiative might increase inequity for Indigenous populations. This enquiry highlights the need to consult Māori early and to infuse Treaty principles and Māori knowledge and custom at every stage of the programme.

MeSH terms

  • Culture
  • Decision Making, Shared*
  • Humans
  • Native Hawaiian or Other Pacific Islander*
  • New Zealand
  • Qualitative Research