Overuse of medical care in paediatrics: A survey from five countries in the European Academy of Pediatrics.

Autor:	Jankauskaite L; Department of Paediatrics, Lithuanian University of Health Sciences, Kaunas, Lithuania.; Institute of Physiology and Pharmacology, Lithuanian University of Health Sciences, Kaunas, Lithuania.; European Academy of Paediatrics, Brussels, Belgium., Grechukha Y; European Academy of Paediatrics, Brussels, Belgium.; Department of Paediatric Infectious Diseases and Paediatric Immunology, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine., Kjær KA; Faculty of Medicine, University of Oslo, Oslo, Norway., Mamenko M; European Academy of Paediatrics, Brussels, Belgium.; Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine.; Ukrainian Academy of Paediatric Specialties, Kyiv, Ukraine., Nakstad B; Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana., Romankevych I; European Academy of Paediatrics, Brussels, Belgium.; Ukrainian Academy of Paediatric Specialties, Kyiv, Ukraine.; Miller School of Medicine, Jackson Memorial Hospital, University of Miami, Coral Gables, FL, United States., Schnyder S; European Academy of Paediatrics, Brussels, Belgium.; Division of Paediatric Emergency Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Selvakumar J; Department of Paediatric and Adolescent Health, Akershus University Hospital, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Trapani S; European Academy of Paediatrics, Brussels, Belgium.; Paediatric Unit, Department of Health Sciences, Meyer Children's Hospital, University of Florence, Florence, Italy., Daniliaviciene S; Karoliniskiu Policlinic, Vilnius, Lithuania.; Clinic of Children's Diseases, Institute of Clinical Medicine, Medical Faculty of Vilnius University, Vilnius, Lithuania., Valiulis A; European Academy of Paediatrics, Brussels, Belgium.; Clinic of Children's Diseases, Institute of Clinical Medicine, Medical Faculty of Vilnius University, Vilnius, Lithuania.; Human Ecology Research Group, Department of Public Health, Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania., Wyder C; European Academy of Paediatrics, Brussels, Belgium.; Paediatric Praxis Kurwerk, Burgdorf, Switzerland., Størdal K; European Academy of Paediatrics, Brussels, Belgium.; Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.; Department of Paediatric Research, University of Oslo, Oslo, Norway.
Jazyk:	angličtina
Zdroj:	Frontiers in pediatrics [Front Pediatr] 2022 Sep 13; Vol. 10, pp. 945540. Date of Electronic Publication: 2022 Sep 13 (Print Publication: 2022).
DOI:	10.3389/fped.2022.945540
Abstrakt:	Studies and initiatives such as the "Choosing wisely" (CW) campaign emphasise evidence-based investigations and treatment to avoid overdiagnosis and overtreatment. The perception of the extent of medical overactivity among professionals and drivers behind are not well studied in the paediatric field. Aim: We aimed to investigate the physicians' opinion and clarify the main drivers regarding medical overactivity in member countries of the European Academy of Paediatrics (EAP). Methods: In this study, paediatricians, paediatric residents, primary care paediatricians, and family doctors treating children were surveyed in Norway, Lithuania, Ukraine, Italy, and Switzerland. Over-investigation was defined as "diagnostic work-up or referral that is unlikely to provide information which is relevant for a patient" and overtreatment was defined as "treatment that does not benefit or can harm more than benefit the patient." The original questionnaire was developed in 2018 by a working group from the Norwegian Paediatric Association. Results: Overall, 1,416 medical doctors participated in the survey, ranging from 144 in Lithuania to 337 in Switzerland. 83% stated that they experienced over-investigation/overtreatment, and 81% perceived this as a problem. The majority (83%) perceived expectations from family and patients as the most important driver for overtreatment in their country. Other drivers for overuse were use of national guidelines/recommendations, worry for reactions, and reduction of uncertainty. Conclusion: This is the first study investigating knowledge and attitude toward medical overactivity in European countries. Despite different cultural and economic environments, the patterns and drivers of increased investigations and medicalisation are similar. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Jankauskaite, Grechukha, Kjær, Mamenko, Nakstad, Romankevych, Schnyder, Selvakumar, Trapani, Daniliaviciene, Valiulis, Wyder and Størdal.)
Databáze:	MEDLINE
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