Overdose, Adverse Event
Conditions
Keywords
patient safety, quality assurance, overuse
Brief summary
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.
Detailed description
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.
Interventions
DRUGBenzodiazepines
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
DRUGparacetamol
paracetamol 1g for more than 3 days
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
DIAGNOSTIC_TESTProstate cancer
Screening for prostate cancer in asymptomatic patients
RADIATIONLumbago
image tests in non-specific lumbago
DRUGMucolytic
mucolytics, antitussives or antibiotics for upper respiratory infections (infants)
DRUGIbuprofen and paracetamol
treatment with ibuprofen and paracetamol (infants)
Sponsors
Osasunbidea
Servicio Madrileño de Salud, Madrid, Spain
Fondo de Investigacion Sanitaria
AQuAS
Agencia de Calidad Sanitaria de Andalucía
Ministerio de Sanidad, Servicios Sociales e Igualdad
Servicio Aragones De Salud
Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana
Generalitat Valenciana
MurciaSalud
Osakidetza
Castilla-La Mancha Health Service
Universidad Miguel Hernandez de Elche
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* All patients visiting GPs
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Medical overuse | Three years | Inadequate prescriptions of antimicrobials, mucolytics, lipid-lowering-drugs, ibuprofen or paracetamol in some specific cases defined as overuse |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Adverse events as consequence of inadequate clinical decision [Safety] | Three years | 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 |
Countries
Spain
Outcome results
None listed