Effectiveness of clinician-directed default nudges on reducing overuse of tests and treatments in healthcare: a systematic review of randomised controlled trials (BMJ Quality and Safety, 18 July 2025)

Summary

Nudges are subtle changes to the way options are presented to guide choice. These have been employed in healthcare systems to improve clinical decisions. 

This systematic review analyses six randomised controlled trials investigating overuse of opiods, antibiotics, high-risk medicines for older patients and imaging during palliative radiotherapy, in order to examine the effect of clinician-directed default nudges on overuse of tests or treatments.

It was found that clinician-directed default nudges had inconsistent effects on overuse of healthcare, suggesting that high quality trials are required to determine whether default nudges reduce overuse or improve patient outcomes.