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

Jankauskaite, Lina; Grechukha, Yevgenii; Kjær, Kristin Avranden; Mamenko, Marina; Nakstad, Britt; Romankevych, Ivanna; Schnyder, Sara; Selvakumar, Joel; Trapani, Sandra; Daniliaviciene, Sandra; Valiulis, Arunas; Wyder, Corinne; Størdal, Ketil (2022). Overuse of medical care in paediatrics: A survey from five countries in the European Academy of Pediatrics. Frontiers in Pediatrics, 10, p. 945540. Frontiers 10.3389/fped.2022.945540

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Notfallzentrum für Kinder und Jugendliche
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Schnyder, Sara

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2296-2360

Publisher:

Frontiers

Language:

English

Submitter:

Anette van Dorland

Date Deposited:

03 Oct 2022 07:55

Last Modified:

05 Dec 2022 16:25

Publisher DOI:

10.3389/fped.2022.945540

PubMed ID:

36177454

Uncontrolled Keywords:

children choosing wisely over-testing overtreatment survey

BORIS DOI:

10.48350/173421

URI:

https://boris.unibe.ch/id/eprint/173421

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