Low-Value Clinical Practices: Knowledge and Beliefs of Spanish Surgeons and Anesthetists
Por:
Aranaz Andrés JM, Valencia-Martín JL, Vicente-Guijarro J, Díaz-Agero Pérez C, López-Fresneña N, Carrillo I, Mira Solves JJ and Working Group S
Publicada:
1 may 2020
Ahead of Print:
19 may 2020
Resumen:
OBJECTIVES: To know the frequency and causes of low value surgical practices, according to the opinion of surgeons and anesthetists, and to determine their degree of knowledge about the Spanish "Choosing wisely" initiative. METHODS: Cross-sectional observational study, based on a self-administered online questionnaire through an opportunistic sample of 370 surgeons and anesthetists from three Spanish regions, contacted through Scientific Societies. The survey took part between July and December 2017. RESULTS: A patient profile requesting unnecessary practices was identified (female, 51-65 years old and unaffiliated disease). The frequency of requests was weekly or daily for 50.0% of the professionals, of whom 15.1% acknowledged succumbing to these pressures. To dissuade the patient, clinical reasons (47%) were considered the most effective. To increase control and safety in the case was the main reason to indicate them. The greatest responsibility for overuse was attributed to physicians, defensive medicine and mass media. Assessing professionals' knowledge on unnecessary practices, an average of 5 correct answers out of 7 was obtained. Some 64.1% of the respondents were unaware of the Spanish "Choosing wisely" initiative. CONCLUSIONS: Low value surgical practices are perceived as a frequent problem, which requires an approach entailing intervention with patients and the media as well as professionals. Increase awareness on unnecessary surgical practices, and how to avoid them remain essential.
Filiaciones:
Aranaz Andrés JM:
Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, CIBER Epidemiología y Salud Pública (CIBERESP), 28034 Madrid, Spain
Valencia-Martín JL:
Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
Vicente-Guijarro J:
Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal. Departamento de Medicina y Especialidades Médicas, Facultad de Medicina, Universidad de Alcalá, IRYCIS, 28034 Madrid, Spain
Díaz-Agero Pérez C:
Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
López-Fresneña N:
Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
:
Miguel Hernández University of Elche, 03202 Elche, Spain
Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain
:
Miguel Hernández University of Elche, 03202 Elche, Spain
Alicante-Sant Joan Health District, Ministry of Health, 03550 Alicante, Spain
REDISSEC, Health Services Network Oriented to Chronic Diseases, Spain
Working Group S:
http://www.nohacer.es/, Spain
gold, Green Published
|