RT Journal Article
SR Electronic
T1 Preventive health services implemented by family physicians in Portugal—a cross-sectional study based on two clinical scenarios
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e005162
DO 10.1136/bmjopen-2014-005162
VO 4
IS 5
A1 Martins, Carlos
A1 Azevedo, Luís Filipe
A1 Santos, Cristina
A1 Sá, Luísa
A1 Santos, Paulo
A1 Couto, Maria
A1 Pereira, Altamiro
A1 Hespanhol, Alberto
YR 2014
UL http://bmjopen.bmj.com/content/4/5/e005162.abstract
AB Objectives To assess whether Portuguese family physicians perform preventive health services in accordance with scientific evidence, based on the recommendations of the United States Preventive Services Task Force (USPSTF). Design Cross-sectional study. Setting Primary healthcare, Portuguese National Health Service. Participants 255 Portuguese family physicians selected by a stratified cluster sampling design were invited to participate in a computer-assisted telephone survey. Outcomes Prevalence of compliance with USPSTF recommendations for screening, given a male and female clinical scenario and a set of proposed medical interventions, including frequency of the intervention and performance in their own daily practice. Results A response rate of 95.7% was obtained (n=244). 98–100% of family physicians answered according to the USPSTF recommendations in most interventions. In the male scenario, the lowest concordance was observed in the evaluation of prostate-specific antigen with 37% of family physicians answering according to the USPSTF recommendations. In the female scenario, the lowest concordance was for cholesterol testing with 2% of family physicians complying. Family physicians younger than 50 years had significantly better compliance scores than older ones (mean 77% vs 72%; p<0.001). Conclusions We found a high degree of agreement with USPSTF recommendations among Portuguese family physicians. However, we also found results suggesting excessive use of some medical interventions, raising concerns related to possible harm associated with overdiagnosis and overtreatment.