Identifying and de-implementing low-value care in primary care: the GP’s perspective—a cross-sectional survey Article Swipe
Rudolf B Kool
,
Eva W. Verkerk
,
Lieke JA Winnemuller
,
Tjerk Wiersma
,
Gert P. Westert
,
Jako Burgers
,
Simone A. van Dulmen
·
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.1136/bmjopen-2020-037019
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.1136/bmjopen-2020-037019
Objective General practitioners have an important role in reducing low-value care as gatekeepers of the health system. The aim of this study was to assess the experiences of Dutch general practitioners regarding low-value care and to identify their needs to decrease low-value primary care. Design We performed a cross-sectional study. Participants We sent a survey to 500 general practitioners. Setting Primary care in the Netherlands. Primary and secondary outcomes The survey contained questions about the provision of low-value care and on clinical cases about lumbosacral spine X-rays in patients with low back pain and vitamin B 12 laboratory tests without an evidence-based indication. We also asked general practitioners what they needed to reduce low-value care. Results A total of 182 general practitioners (37%) responded. 67% indicated that low-value care practices are regularly provided in general practice. 57% of the general practitioners have seen negative consequences of low-value care, in particular side effects of medication. The most provided low-value care practices are medication prescriptions such as antibiotics and laboratory tests such as vitamin B 12 tests. The most reported drivers are patient-related. General practitioners want to maintain a good relationship with their patients by offering their patients an intervention instead of watchful waiting. Lack of time also plays a major role. In order to reduce low-value care, general practitioners suggested that educating patients on the value of tests and treatments might help. Supporting general practitioners and other healthcare professionals with clear guidelines as well as having more time for consultation were also mentioned by general practitioners. Conclusion General practitioners are aware of providing unnecessary care despite their role as gatekeepers and have reasons for this. They need support in order to change their practice. This support might consist of better education of healthcare professionals and providing more time for consultation. Local and national media, such as websites and television, could be used to educate patients while guidelines could support professionals in reducing low-value care.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1136/bmjopen-2020-037019
- https://bmjopen.bmj.com/content/bmjopen/10/6/e037019.full.pdf
- OA Status
- gold
- Cited By
- 49
- References
- 27
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3033858483
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W3033858483Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1136/bmjopen-2020-037019Digital Object Identifier
- Title
-
Identifying and de-implementing low-value care in primary care: the GP’s perspective—a cross-sectional surveyWork title
- Type
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articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2020Year of publication
- Publication date
-
2020-06-01Full publication date if available
- Authors
-
Rudolf B Kool, Eva W. Verkerk, Lieke JA Winnemuller, Tjerk Wiersma, Gert P. Westert, Jako Burgers, Simone A. van DulmenList of authors in order
- Landing page
-
https://doi.org/10.1136/bmjopen-2020-037019Publisher landing page
- PDF URL
-
https://bmjopen.bmj.com/content/bmjopen/10/6/e037019.full.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://bmjopen.bmj.com/content/bmjopen/10/6/e037019.full.pdfDirect OA link when available
- Concepts
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Medicine, Medical prescription, Cross-sectional study, Family medicine, Health care, Value (mathematics), Primary care, General practice, Nursing, Computer science, Machine learning, Pathology, Economics, Economic growthTop concepts (fields/topics) attached by OpenAlex
- Cited by
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49Total citation count in OpenAlex
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2025: 5, 2024: 21, 2023: 8, 2022: 11, 2021: 4Per-year citation counts (last 5 years)
- References (count)
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27Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.general | 29, 57, 106, 120, 134, 139, 216, 232, 253 |
| abstract_inverted_index.instead | 198 |
| abstract_inverted_index.primary | 42 |
| abstract_inverted_index.reasons | 271 |
| abstract_inverted_index.support | 276, 284, 317 |
| abstract_inverted_index.system. | 16 |
| abstract_inverted_index.vitamin | 94, 171 |
| abstract_inverted_index.without | 99 |
| abstract_inverted_index.clinical | 81 |
| abstract_inverted_index.decrease | 40 |
| abstract_inverted_index.identify | 36 |
| abstract_inverted_index.maintain | 185 |
| abstract_inverted_index.national | 301 |
| abstract_inverted_index.negative | 143 |
| abstract_inverted_index.offering | 193 |
| abstract_inverted_index.outcomes | 68 |
| abstract_inverted_index.patients | 88, 191, 195, 221, 313 |
| abstract_inverted_index.provided | 132, 156 |
| abstract_inverted_index.reducing | 8, 320 |
| abstract_inverted_index.reported | 177 |
| abstract_inverted_index.waiting. | 201 |
| abstract_inverted_index.watchful | 200 |
| abstract_inverted_index.websites | 305 |
| abstract_inverted_index.Objective | 0 |
| abstract_inverted_index.contained | 71 |
| abstract_inverted_index.educating | 220 |
| abstract_inverted_index.education | 289 |
| abstract_inverted_index.important | 5 |
| abstract_inverted_index.indicated | 125 |
| abstract_inverted_index.low-value | 9, 32, 41, 77, 113, 127, 146, 157, 214, 321 |
| abstract_inverted_index.mentioned | 251 |
| abstract_inverted_index.performed | 46 |
| abstract_inverted_index.practice. | 135, 282 |
| abstract_inverted_index.practices | 129, 159 |
| abstract_inverted_index.providing | 261, 294 |
| abstract_inverted_index.provision | 75 |
| abstract_inverted_index.questions | 72 |
| abstract_inverted_index.regarding | 31 |
| abstract_inverted_index.regularly | 131 |
| abstract_inverted_index.secondary | 67 |
| abstract_inverted_index.suggested | 218 |
| abstract_inverted_index.Conclusion | 255 |
| abstract_inverted_index.Supporting | 231 |
| abstract_inverted_index.guidelines | 240, 315 |
| abstract_inverted_index.healthcare | 236, 291 |
| abstract_inverted_index.laboratory | 97, 167 |
| abstract_inverted_index.medication | 161 |
| abstract_inverted_index.particular | 149 |
| abstract_inverted_index.responded. | 123 |
| abstract_inverted_index.treatments | 228 |
| abstract_inverted_index.antibiotics | 165 |
| abstract_inverted_index.experiences | 26 |
| abstract_inverted_index.gatekeepers | 12, 268 |
| abstract_inverted_index.indication. | 102 |
| abstract_inverted_index.lumbosacral | 84 |
| abstract_inverted_index.medication. | 153 |
| abstract_inverted_index.television, | 307 |
| abstract_inverted_index.unnecessary | 262 |
| abstract_inverted_index.Netherlands. | 64 |
| abstract_inverted_index.Participants | 50 |
| abstract_inverted_index.consequences | 144 |
| abstract_inverted_index.consultation | 248 |
| abstract_inverted_index.intervention | 197 |
| abstract_inverted_index.relationship | 188 |
| abstract_inverted_index.consultation. | 298 |
| abstract_inverted_index.practitioners | 2, 30, 107, 121, 140, 182, 217, 233, 257 |
| abstract_inverted_index.prescriptions | 162 |
| abstract_inverted_index.professionals | 237, 292, 318 |
| abstract_inverted_index.evidence-based | 101 |
| abstract_inverted_index.practitioners. | 58, 254 |
| abstract_inverted_index.cross-sectional | 48 |
| abstract_inverted_index.patient-related. | 180 |
| cited_by_percentile_year.max | 100 |
| cited_by_percentile_year.min | 97 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 7 |
| citation_normalized_percentile.value | 0.96750607 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |