Preventive health services implemented by family physicians in Portugal—a cross-sectional study based on two clinical scenarios
- Carlos Martins1,
- Luís Filipe Azevedo2,
- Cristina Santos2,
- Luísa Sá1,
- Paulo Santos1,
- Maria Couto1,
- Altamiro Pereira2,
- Alberto Hespanhol1
- 1Family Medicine Unit, Social Sciences and Health Department of the Faculty of Medicine of Porto, Porto, Portugal
- 2Information Sciences and Decision on Health Department (CIDES), Faculty of Medicine, Centre for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal
- Correspondence to Dr Carlos Manuel Martins;
- Received 3 March 2014
- Revised 24 April 2014
- Accepted 28 April 2014
- Published 26 May 2014
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.
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