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A top 5 list for French general practice

Authors
  • Hazard, Agnès1
  • Fournier, Lucie2
  • Rossignol, Louise2
  • Pelletier Fleury, Nathalie3
  • Hervé, Corentin2
  • Pitel, Thibaud2
  • Pino, Cécile2
  • Saint-Lary, Olivier1, 3
  • Hanslik, Thomas2, 4
  • Blanchon, Thierry2
  • François, Mathilde1, 3
  • 1 University Versailles-Saint-Quentin-en-Yvelines, Villejuif, Paris, France , Paris (France)
  • 2 Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Paris, France , Paris (France)
  • 3 University Versailles Saint-Quentin en Yvelines, University Paris-Sud, Villejuif, France , Villejuif (France)
  • 4 AP-HP, Service de Médecine Interne, Hôpital Ambroise Paré, Boulogne Billancourt, France , Boulogne Billancourt (France)
Type
Published Article
Journal
BMC Family Practice
Publisher
BioMed Central
Publication Date
Aug 09, 2020
Volume
21
Issue
1
Identifiers
DOI: 10.1186/s12875-020-01235-5
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundMedical overuse is an issue that has recently gained attention. The “Choosing Wisely” campaign invited each specialty in each country to create its own top five lists of care procedures with a negative benefit-risk balance to promote dialogue between patients and physicians.This study aims to create such a list for French general practice.MethodsA panel of general practitioners (GPs) suggested care procedures that they felt ought to be prescribed less. Using the Delphi method, a short list of those suggestions was selected. Systematic literature reviews were performed for each item on the short list. The results were presented to the panel to assist with the final selection of the top five list.ResultsThe panel included 40 GPs. The list includes: i/ antibiotics prescription for acute bronchitis, nasopharyngitis, otitis media with effusion, or uncomplicated influenza, ii/ systematic prostate specific antigen testing in men older than 50, iii/ prescription of cholinesterase inhibitors for mild cognitive impairment and for Alzheimer’s disease and memantine for Alzheimer’s disease, iv/ statins prescription in primary prevention of cardio-vascular risk in older patients, and v/ benzodiazepine or benzodiazepine-like agents prescription for generalised anxiety, insomnia, and for all indications in older patients.ConclusionsThis study resulted in a French top five list in general practice using a panel of GPs. All the items selected have a negative risk-benefit balance and are frequently prescribed by French general practitioners. This list differs from other top five lists for general practice, reflecting the local medical culture.

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