Identifying and de-implementing low-value care in primary care: the GP's perspective-a cross-sectional survey

Area of Science:

• Primary Care Research
• Health Services Research
• Medical Practice Management

Background:

• General practitioners (GPs) act as gatekeepers in healthcare systems.
• Reducing low-value care is crucial for healthcare efficiency and patient safety.
• Understanding GP experiences is key to addressing low-value primary care.

Purpose of the Study:

• To assess Dutch GPs' experiences with low-value care.
• To identify needs and strategies for decreasing low-value primary care.

Main Methods:

• Cross-sectional study involving a survey.
• Survey distributed to 500 GPs in the Netherlands.
• Questions covered low-value care provision, clinical cases (e.g., unnecessary X-rays, B12 tests), and perceived needs for reduction.

Main Results:

• 182 GPs responded (37% participation).
• 67% reported regular provision of low-value care; 57% observed negative consequences (e.g., medication side effects).
• Common low-value practices include antibiotic prescriptions and B12 tests; patient-related factors and time constraints are key drivers.

Conclusions:

• GPs are aware of providing unnecessary care and cite patient relationship maintenance and time as reasons.
• Support is needed, including patient education (via media) and professional guidance (clear guidelines).
• Increased consultation time and better professional education are essential for reducing low-value care.