context, culture, and the complexity of de-implementing low-value care; comment on “key factors that promote low-value care: views of experts from the united states, canada, and the netherlands”

Low-value care contributes to poor quality of care and wasteful spending in healthcare systems. in verkerk and colleagues’ recent qualitative study, interviews with low-value care experts from canada, the united states, and the netherlands identified a broad range of nationally relevant social, system, and knowledge factors that promote ongoing use of low-value care. these factors highlight the complexity of the problem that is persistent use of low-value care and how it is heavily influenced by public and medical culture as well as healthcare system features. this commentary discusses how these findings integrate within current low-value care and de-implementation literature and uses specific low-value care examples to highlight the importance of considering context, culture, and clinical setting when considering how to apply these factors to future de-implementation initiatives.