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| Name | Class |
|---|---|
| Osasunbidea | UNKNOWN |
| Servicio Madrileño de Salud, Madrid, Spain | OTHER |
| Fondo de Investigacion Sanitaria | OTHER |
| AQuAS |
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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 AndalucÃa, Aragón, Castilla La Mancha, Comunidad Valenciana, Madrid, Murcia, Navarra y PaÃs Vasco, eight autonomous communities in Spain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients visiting GP | All patients visiting GP. The frequency of some drugs and diagnosis tests include in the Do-Not-Do recommendations will be analyzed. |
| |
| Patient visiting pediatricians | All patients visiting pediatricians (0 to 14 years old). The frequency of some drugs and diagnosis tests include in the Do-Not-Do recommendations will be analyzed. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Benzodiazepines | Drug | Benzodiazepines for insomnia, agitation or delirium in people older than 65 |
|
| Measure | Description | Time Frame |
|---|---|---|
| Medical overuse | Inadequate prescriptions of antimicrobials, mucolytics, lipid-lowering-drugs, ibuprofen or paracetamol in some specific cases defined as overuse | Three years |
| Medical overuse | Inadequate test for lumbalgia or prostate cancer | Three years |
| Measure | Description | Time Frame |
|---|---|---|
| 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 | Three years |
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Inclusion Criteria:
Exclusion Criteria:
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All patients data codified in the primary care databases (BDCAP and BIFAP)
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| Name | Affiliation | Role |
|---|---|---|
| JOSE J MIRA, PhD | UNIVERSIDAD MIGUEL HERNANDEZ | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| FISABIO | Elche | Alicante | 03202 | Spain | ||
| Universidad Miguel Hernández |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24803401 | Background | Gibson R. The human cost of overuse. BMJ. 2014 May 6;348:g2975. doi: 10.1136/bmj.g2975. No abstract available. | |
| 28077234 | Background | Brownlee S, Chalkidou K, Doust J, Elshaug AG, Glasziou P, Heath I, Nagpal S, Saini V, Srivastava D, Chalmers K, Korenstein D. Evidence for overuse of medical services around the world. Lancet. 2017 Jul 8;390(10090):156-168. doi: 10.1016/S0140-6736(16)32585-5. Epub 2017 Jan 9. |
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Public and safety patient researchers
December 2019
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| UNKNOWN |
| Agencia de Calidad Sanitaria de AndalucÃa | UNKNOWN |
| Ministerio de Sanidad, Servicios Sociales e Igualdad | OTHER_GOV |
| Servicio Aragones De Salud | OTHER |
| Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana | OTHER |
| Generalitat Valenciana | OTHER |
| MurciaSalud | OTHER_GOV |
| Osakidetza | OTHER |
| Castilla-La Mancha Health Service | OTHER |
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| Non-steroidal anti-inflammatory drugs | Drug | Non-steroidal anti-inflammatory drugs in patients with cardiovascular disease, chronic kidney disease, hypertension, heart failure or liver cirrhosis |
|
| paracetamol | Drug | paracetamol 1g for more than 3 days |
|
| Antimicrobial agent | Drug | 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 drug | Drug | Lipid-lowering drugs in patients older than 75 years without previous cardiovascular events |
|
| Prostate cancer | Diagnostic Test | Screening for prostate cancer in asymptomatic patients |
|
| Lumbago | Radiation | image tests in non-specific lumbago |
|
| Antimicrobial agent | Drug | antibiotics for pharyngitis (infants) |
|
|
| Mucolytic | Drug | mucolytics, antitussives or antibiotics for upper respiratory infections (infants) |
|
|
| Ibuprofen and paracetamol | Drug | treatment with ibuprofen and paracetamol (infants) |
|
| Elche |
| Alicante |
| 03202 |
| Spain |
| 24374418 | Background | Segal JB, Bridges JF, Chang HY, Chang E, Nassery N, Weiner J, Chan KS. Identifying possible indicators of systematic overuse of health care procedures with claims data. Med Care. 2014 Feb;52(2):157-63. doi: 10.1097/MLR.0000000000000052. |
| 26457643 | Background | Rosenberg A, Agiro A, Gottlieb M, Barron J, Brady P, Liu Y, Li C, DeVries A. Early Trends Among Seven Recommendations From the Choosing Wisely Campaign. JAMA Intern Med. 2015 Dec;175(12):1913-20. doi: 10.1001/jamainternmed.2015.5441. |
| 20458080 | Background | Grady D, Redberg RF. Less is more: how less health care can result in better health. Arch Intern Med. 2010 May 10;170(9):749-50. doi: 10.1001/archinternmed.2010.90. No abstract available. |
| 23180803 | Background | Aranaz-Andres JM, Aibar C, Limon R, Mira JJ, Vitaller J, Agra Y, Terol E. A study of the prevalence of adverse events in primary healthcare in Spain. Eur J Public Health. 2012 Dec;22(6):921-5. doi: 10.1093/eurpub/ckr168. Epub 2011 Nov 29. |
| 26258406 | Background | Newton EH, Zazzera EA, Van Moorsel G, Sirovich BE. Undermeasuring Overuse--An Examination of National Clinical Performance Measures. JAMA Intern Med. 2015 Oct;175(10):1709-11. doi: 10.1001/jamainternmed.2015.4025. No abstract available. |
| 34009877 | Derived | Mira JJ, Carrillo I, Perez-Perez P, Astier-Pena MP, Caro-Mendivelso J, Olivera G, Silvestre C, Nuin MA, Aranaz-Andres JM; on behalf the SOBRINA Research Team. Avoidable Adverse Events Related to Ignoring the Do-Not-Do Recommendations: A Retrospective Cohort Study Conducted in the Spanish Primary Care Setting. J Patient Saf. 2021 Dec 1;17(8):e858-e865. doi: 10.1097/PTS.0000000000000830. |
| 30837247 | Derived | Mira JJ, Carrillo I, Gea Velazquez de Castro MT, Silvestre C, Olivera G, Caro-Mendivelso J, Perez-Perez P, Agra Y, Fernandez AM, Aranaz-Andres JM; SOBRINA Research Team. SOBRINA Spanish study-analysing the frequency, cost and adverse events associated with overuse in primary care: protocol for a retrospective cohort study. BMJ Open. 2019 Mar 4;9(3):e023399. doi: 10.1136/bmjopen-2018-023399. |
| ID | Term |
|---|---|
| D062787 | Drug Overdose |
| ID | Term |
|---|---|
| D063487 | Prescription Drug Misuse |
| D000076064 | Drug Misuse |
| D019966 | Substance-Related Disorders |
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D001569 | Benzodiazepines |
| D000082 | Acetaminophen |
| D000890 | Anti-Infective Agents |
| D000900 | Anti-Bacterial Agents |
| D000960 | Hypolipidemic Agents |
| D005100 | Expectorants |
| D007052 | Ibuprofen |
| ID | Term |
|---|---|
| D001552 | Benzazepines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D000083 | Acetanilides |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
| D045506 | Therapeutic Uses |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
| D000963 | Antimetabolites |
| D045504 | Molecular Mechanisms of Pharmacological Action |
| D057847 | Lipid Regulating Agents |
| D019141 | Respiratory System Agents |
| D010666 | Phenylpropionates |
| D000146 | Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
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