A national intervention to reduce harm by combating overuse of medical services in Saudi Arabia.

Background: Choosing Wisely Saudi Arabia, a programme led by the Ministry of Health and Saudi Patient Safety Center, aims to reduce overuse of health care services, emphasizing patient safety, efficiency and patient-centred care.

Aim: To highlight the achievements of Choosing Wisely Saudi Arabia and make recommendations for more effective implementation.

Methods: Saudi Arabia began implementing Choosing Wisely as a pilot project in one hospital in January 2019 and later scaled up to other hospitals. To oversee the programme, we established a multistakeholder governance structure at the national and regional levels, which included a steering committee, a programme management office with a programme lead, a scientific committee, and regional and hospital champions. The steering committee developed the implementation guidelines, the Saudi Patient Safety Center developed the educational materials for patients, and the medical societies proposed the recommendations. The regional and hospital champions implemented the programme in the regions and at hospitals, respectively. The Saudi Ministry of Health funded the programme.

Results: During the first 4 years of implementation, 16 of the 20 health regions in Saudi Arabia implemented at least one Choosing Wisely initiative, leading to a reduction in the overuse of targeted medications and pharmacological agents, as well as laboratory and radiological services.

Conclusion: Choosing Wisely has been very helpful in reducing overuse of low-value health care services in Saudi Arabia. To make the programme sustainable and more effective, there is a need to adopt a comprehensive approach to implementation and involve more stakeholders from within and outside the Ministry of Health.