Unnecessary overuse. Study of "inadvisable practices" for patients with atrial fibrillation.

Abstract:

OBJECTIVE:To identify overuse (diagnostic, therapeutic and self-care practices that represent risks that outweigh the potential benefits) in patients with atrial fibrillation. METHOD:The study was based on qualitative research techniques. Using the "Metaplan" technique, we identified and ordered potentially inappropriate, ineffective and inefficient practices. By means of a consensus conference, we then established a number of "inadvisable practice" measures (relatively common practices that should be eliminated based on the scientific evidence or clinical experience). Professionals from the specialties of cardiology, haematology, neurology, internal medicine, family medicine and nursing participated in the consensus. RESULTS:We developed a catalogue of 19 "inadvisable practices" related to the diagnosis, treatment and care of anticoagulated patients that were inappropriate, had questionable effectiveness or were ineffective, as well as 13 beliefs or behaviours for anticoagulated patients that could result in injury or were useless or inefficient. CONCLUSION:The "inadvisable practices" approach helps identify practices that represent greater risks than benefits for patients. It seems appropriate to include algorithms in the clinical decision-making support systems that consider this information for the diagnosis, treatment and for home care. For this last case, recommendations have also been prepared that define specific contents for the healthcare education of these patients.

journal_name

Rev Clin Esp

journal_title

Revista clinica espanola

authors

Ortiz MM,Llamas P,Sanmartín M,Egido JA,Del Toro J,Egocheaga MI,Estévez MS,Navarro IM,Mira JJ

doi

10.1016/j.rce.2017.02.014

subject

Has Abstract

pub_date

2017-05-01 00:00:00

pages

181-187

issue

4

eissn

0014-2565

issn

1578-1860

pii

S0014-2565(17)30077-2

journal_volume

217

pub_type

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