Retrospective observational study in a random selection of 5% of digital records active between 2014 and 2017 to quantify the frequency of Do not do primary care recommendations, calculating the over-cost related to them and study reviewing a random selection of cases previously identified to determine whether patient suffered adverse events and their over-cost.
Basement: Overuse subjected patients to unnecessary risk without promoting a sufficient clinical benefit and over-cost. The Less is More Medicine movement has led to the identification of Do not do in different specialties, also in primary care. Objective: To analyze the impact of errors (overuse rates based in Do not do recommendations) in clinical practice. Method: Retrospective observational study in a random selection of 5% of digital records active between 2014 and 2017 to quantify the frequency of Do not do primary care recommendations, calculating the over-cost related to them. Retrospective study reviewing a random selection of cases previously identified to determine whether patient suffered adverse events and their over-cost. Setting. Primary care in Andalucía, Aragón, Castilla La Mancha, Comunidad Valenciana, Madrid, Murcia, Navarra y País Vasco, eight autonomous communities in Spain.
Study Type
OBSERVATIONAL
Enrollment
750,000
Benzodiazepines for insomnia, agitation or delirium in people older than 65
Non-steroidal anti-inflammatory drugs in patients with cardiovascular disease, chronic kidney disease, hypertension, heart failure or liver cirrhosis
paracetamol 1g for more than 3 days
FISABIO
Elche, Alicante, Spain
Universidad Miguel Hernández
Elche, Alicante, Spain
Medical overuse
Inadequate prescriptions of antimicrobials, mucolytics, lipid-lowering-drugs, ibuprofen or paracetamol in some specific cases defined as overuse
Time frame: Three years
Medical overuse
Inadequate test for lumbalgia or prostate cancer
Time frame: Three years
Adverse events as consequence of inadequate clinical decision [Safety]
Patients suffering hurt due to inadequate prescription or inadequate test. Inadequate prescriptions or tests as defined by Do-not-Do recommendations. These were defined by Spanish Primary Care Scientific Societies
Time frame: Three years
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antibiotic in acute bronchitis when the patient does not suffer from COPD, heart failure, diabetes or kidney disease or is undergoing active chemotherapy
Lipid-lowering drugs in patients older than 75 years without previous cardiovascular events
Screening for prostate cancer in asymptomatic patients
image tests in non-specific lumbago
antibiotics for pharyngitis (infants)
mucolytics, antitussives or antibiotics for upper respiratory infections (infants)
treatment with ibuprofen and paracetamol (infants)