RESUMEN
INTRODUCTION: The qualities of primary healthcare (PHC) make it a very relevant environment for research; however, there is still work to be done to enhance the research capabilities of family physicians in healthcare units. Considering there is no ongoing review that specifically addresses this objective, the proposed goal of this scoping review is to determine the depth of the literature on the current strategies that support research capacity building among family physicians in the context of PHC. METHODS AND ANALYSIS: The scoping review will include studies from PubMed, Scopus, Web of Science, Cochrane Library and grey literature, published from 2008 to 2023, that address strategies to promote research capacity building among family physicians in the context of PHC. Only studies published in English, Portuguese or Spanish will be considered. All study designs, including quantitative, qualitative and mixed-methods studies, will be eligible for inclusion. The literature search will be performed from January to March of 2024 and data charting will employ a descriptive-analytical method, systematically summarising study objectives, methodologies, findings and implications. This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols and the review will employ the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. ETHICS AND DISSEMINATION: This review does not need ethical approval. Peer-reviewed publications, policy summaries, presentations at conferences and involvement with pertinent stakeholders are all part of our outreach approach.
Asunto(s)
Creación de Capacidad , Médicos de Familia , Humanos , Exactitud de los Datos , Etnicidad , Proyectos de Investigación , Atención Primaria de Salud , Revisiones Sistemáticas como Asunto , Literatura de Revisión como AsuntoRESUMEN
INTRODUCTION: In Portugal, patients still believe they should perform a periodic check-up. The present study was designed to study the prescription pattern of "routine" laboratory tests in the Family practice in Portugal. MATERIAL AND METHODS: We performed a cross-sectional study in the Portuguese primary healthcare setting. We surveyed physicians on their "routine" laboratory test request pattern and the reasons for requesting or not requesting laboratory tests. The questions were based on the panel of the most prescribed tests in the of Central Lisbon health centre group. RESULTS: Most of the inquired doctors said they requested "routine" laboratory tests (51.4%). There is a significant difference in the request of "routine" laboratory tests performed by trainees or specialists (p = 0.013). The most requested laboratory tests in adults are total cholesterol (92.2%) and blood glucose while the most requested laboratory tests in children are blood glucose, total cholesterol and full blood count. Many doctors (79.4%) that request "routine" laboratory tests do so to perform screening and the doctors that do not request routine" laboratory tests do so mainly (80.8%) because there's lack of scientific evidence. DISCUSSION: We found differences in the prescription pattern of Family Physicians in Portugal, namely regarding the request of "routine" laboratory tests by doctors from different regions, degrees of specialization and age. We found that there is an association between prescribing "routine" laboratory tests and their request for screening. These physicians aparently want to track different types of pathology, even though patients have no symptoms or risks that could justify it. Most doctors, who do not prescribe "routine" laboratory tests, do not agree with screening for asymptomatic individuals, which is consistent with the evidence. CONCLUSION: Our results suggest that there is an excessive request of laboratory tests which can lead to overdiagnosis and overtreatment that requires global Social Marketing strategies to change the prevailing culture.
Introdução: Em Portugal os utentes têm a convicção de que devem realizar análises laboratoriais mesmo na ausência de fatores de risco, nomeadamente história familiar. Estas são designadas análises de "rotina". O presente estudo pretendeu analisar o padrão de requisição de análises de "rotina" em Medicina Geral e Familiar em Portugal.Material e Métodos: Desenvolvemos um estudo observacional transversal analítico que teve como população alvo os médicos pertencentes aos cuidados de saúde primários em Portugal. Os médicos foram questionados quanto ao seu padrão de requisição e sobre quais os motivos da requisição ou não de análises de "rotina". As questões tiveram por base as análises clínicas mais prescritas pelos médicos do Agrupamento de Centros de Saúde Lisboa Central.Resultados: A maioria dos médicos afirmou prescrever análises de "rotina" (51,4%). Verificou-se uma relação estatisticamente significativa entre ser especialista e a requisição de análises de "rotina" (p = 0,013). As análises clínicas mais prescritas na idade adulta foram a determinação de colesterol total (92,2%) e de glicemia. Na idade pediátrica foram a determinação de glicemia, de colesterol total e o hemograma. A maioria dos médicos (79,4%) que prescreve análises de "rotina" fá-lo como forma de rastreio e os não prescritores não realizam análises maioritariamente (80,8%) porque não se encontra de acordo com a evidência científica.Discussão: No nosso estudo observámos diferenças na prática de Medicina Geral e Familiar em Portugal, nomeadamente no que diz respeito à requisição de análises de "rotina" por médicos de diferentes regiões, graus de especialização e idade. Verificámos que existe uma associação entre prescrever análises de rotina e o pedido das mesmas para realização de rastreio o que parece demonstrar que os médicos que referem prescrever análises de "rotina" têm a intenção, com as mesmas, de rastrear diversos tipos de patologia, embora os doentes não apresentem sintomatologia ou riscos que o justifiquem. A maior parte dos médicos que não prescreve análises de "rotina", não concordam com o rastreio de indivíduos assintomáticos o que está de acordo com a evidência.Conclusão: Os nossos resultados sugerem que existe um pedido excessivo de análises de "rotina" que pode levar a sobrediagnóstico e sobretratamento sendo para isso necessária a criação de estratégias globais de marketing social para mudar a cultura vigente.