Patients' estimations of the importance of preventive health services: a nationwide, population-based cross-sectional study in Portugal

Abstract

ObjectivesTo determine, in the context of primary care preventive health services, the level of importance that Portuguese patients attribute to different preventive activities.DesignCross-sectional study.SettingPrimary Healthcare, Portugal.Participants1000 Portuguese adults selected by a stratified cluster sampling design were invited to participate in a computer-assisted telephone survey. Persons with a cognitive or physical disability that hampered the ability to complete a telephone interview and being a nursing home resident or resident in any other type of collective dwelling were excluded.OutcomesMean level of importance assigned to 20 different medical preventive activities, using a scale of 1–10, with 1 corresponding to ‘no importance for you and your health’ and 10 indicating ‘very important’.ResultsThe mean level of importance assigned to medical preventive activity was 7.70 (95% CI 7.60 to 7.80). Routine blood and urine tests were considered the most important, with an estimated mean of 9.15 (95% CI 9.07 to 9.24), followed by female-specific interventions (Pap smear, mammography and gynaecological and breast ultrasounds), with mean importance ranging from 8.45 (95% CI 8.23 to 8.63) for mammography to 8.56 (95% CI 8.36 to 8.76) for Pap smear. Advice regarding alcohol consumption (6.18; 95% CI 5.96 to 6.39) and tobacco consumption (5.99; 95% CI 5.75 to 6.23) were considered much less important.ConclusionsOur results reveal that Portuguese patients overestimate the importance of preventive medical activities, tend to give more importance to diagnostic and laboratory tests than to lifestyle measures, do not discriminate tests that are important and evidence-based, and seem not be aware of the individualisation of risk. Family physicians should be aware of these optimistic expectations, because these can influence the doctor–patient relationship when discussing these interventions and incorporating personalised risk.

Diagnostic and laboratory test ordering in Northern Portuguese Primary Health Care: a cross-sectional study

“…A similar pattern was found in test ordering in other general practice studies, 15 18 and the Eurosentinel Study Group showed that haemogram and glucose were the most frequently requested laboratory tests in eight countries. 1 These results are consistent with the expectations of Portuguese patients, who consider that ‘routine blood and urine tests’ are the most important preventive medical activities, 22 with a mean frequency interval of 12 months. 3 This test is popular among Portuguese people in their periodic health examinations or routine health check-ups.…”

Requisição de Análises de “Rotina” em Medicina Geral e Familiar: Um Estudo Observacional Transversal Analítico Baseado na Prática em Portugal

“…A maioria dos portugueses consideram que devem efetuar AR ao sangue e urina, com uma frequência média de 12 meses. 13 Com este estudo verificou-se que mais de metade dos médicos ainda prescreve AR, o que não está de acordo com as recomendações atuais que defendem não existir benefício (mas sim um potencial aumento do risco de causar dano) para o doente na requisição de AR. 6 Impôs-se a necessidade de realizar um estudo qualitativo para apurar os motivos que levam à manutenção desta má prática nomeadamente explorar se existe uma perversão da relação médico--doente na qual o médico não tenha poder para fazer face a questões culturalmente instituídas.…”

“…O desafio é lançado, para a criação de estratégias de marketing social para mudar a cultura vigente no sentido de reduzir o risco público associado a sobre-utilização, sobrediagnóstico e sobretratamento que a realização inapropriada de exames acarreta. 13…”

Choosing Wisely Portugal – Escolhas Criteriosas em Saúde

“…Miguel BIGOTTE VIEIRA* 1,2,3 , Guilherme FERREIRA-DOS-SANTOS* 2,3,4 , Catarina Reis de CARVALHO 2,5 , Catarina Viegas DIAS 2,6 , David Cordeiro SOUSA 2,7 , Inês LEAL 2,7 , João VALENTE JORGE 2,8 , Mariana ALVES 2,9 , Mariana MORGADO 2,10 , Rute Baeta BAPTISTA 2,11 , Paula FORTUNATO 12 , António VAZ-CARNEIRO 2,3 , Miguel GUIMARÃES 12,13 Acta Med Port 2018 Oct;31(10):521-523 ▪ https://doi.org/10.20344/amp.11138…”

“…Estas convicções conduzem à solicitação frequente destas intervenções ao profissional de saúde. 4 A implementação deste programa em Portugal pretende promover escolhas criteriosas em saúde e facilitar a comunicação entre profissionais de saúde e doentes.…”