Preventing Overdiagnosis in Primary Care (PRO PRICARE)
PRO PRICARE is the acronym for “PReventing Overdiagnosis in Primary Care”. Our project is carrying out the development and implementation of measures to prevent overtreatment in health care. Our network PRO PRICARE and the three research projects included are funded by the Germany Federal Ministry for Education and Research (BMBF) with a 2,1 million Euro grant.
Further information on our sub-projects you can find here:
ICF - Development of a core set of the “International Classification of Functioning, Disability and Health” for geriatric patients in primary care
ICE - Investigation of the impact of doctor-patient communication on primary care services and the development of support tools for improving of communication within the practice.
ACE – Investigation of undesirable cascade effects in case of thyroid anomalies.
Aim
We will start by identifying patient-clusters threatened by overtreatment and over-medication as well as medical interventions with low or non-existing benefit. The next step will be to find ways to reduce unnecessary treatment and medication. As a generalist and first contact person the general practitioner is normally the entry point for most patients in the health system. One of the main roles and responsibilities of a family doctor is the prevention of miss- and over-treatment as he is the one providing the long-term supervision of the patient´s health.
Prozedure
What is overtreatment?
Medical overtreatment is defined as „patient treatment without clear medical indication and if the risks of the prescribed therapy excel its positive effects”. The blurring of distinctions between risk-factors, early stages of illness and the actual disease as well as the progress in medical technology, spirit of entrepreneurship and increasing health-craze include the risk for an inflation of disease in the society. Overtreatment in health care also includes unnecessary diagnostic and therapeutic treatments. This contains additional and unnecessary risk for the patient.
An example
One example is the regular prescription of imaging methods in the case of back pain although numerous studies show that these examinations have limited impact. Nearly every middle-aged person in the western world shows changes especially in the lumbar vertebrae area. These are normal average signs of wear not necessarily connected to the pain. In addition the patient is exposed to needless radiation by being treating with CT and other imaging measures. These methods should only be implemented in case they are indicated by evidence based official guidelines.