Avoidable Adverse Events Related to Ignoring the Do-Not-Do Recommendations: A Retrospective Cohort Study Conducted in the Spanish Primary Care Setting

Mira, J.J. ; Carrillo, I. ; Perez-Perez, P. ; Astier-Pena, M.P. (Universidad de Zaragoza) ; Caro-Mendivelso, J. ; Olivera, G. ; Silvestre, C. ; Nuin, M.A. ; Aranaz-Andres, J.M.

Resumen: Objective This study aimed to measure the frequency and severity of avoidable adverse events (AAEs) related to ignoring do-not-do recommendations (DNDs) in primary care. Methods A retrospective cohort study analyzing the frequency and severity of AAEs related to ignoring DNDs (7 from family medicine and 3 from pediatrics) was conducted in Spain. Data were randomly extracted from computerized electronic medical records by a total of 20 general practitioners and 5 pediatricians acting as reviewers; data between February 2018 and September 2019 were analyzed. Results A total of 2557 records of adult and pediatric patients were reviewed. There were 1859 (72.7%) of 2557 (95% confidence interval [CI], 71.0%-74.4%) DNDs actions in 1307 patients (1507 were performed by general practitioners and 352 by pediatricians). Do-not-do recommendations were ignored more often in female patients (P < 0.0001). Sixty-nine AAEs were linked to ignoring DNDs (69/1307 [5.3%]; 95% CI, 4.1%-6.5%). Of those, 54 (5.1%) of 1062 were in adult patients (95% CI, 3.8%-6.4%) and 15 (6.1%) of 245 in pediatric patients (95% CI, 3.1%-9.1%). In adult patients, the majority of AAEs (51/901 [5.7%]; 95% CI, 4.2%-7.2%) occurred in patients 65 years or older. Most AAEs were characterized by temporary minor harm both in adult patients (28/54 [51.9%]; 95% CI, 38.5%-65.2%) and pediatric patients (15/15 [100%]). Conclusions These findings provide a new perspective about the consequences of low-value practices for the patients and the health care systems. Ignoring DNDs could place patients at risk, and their safety might be unnecessarily compromised.

Idioma: Inglés

DOI: 10.1097/PTS.0000000000000830

Año: 2021

Publicado en: Journal of patient safety 17, 8 (2021), e858-e865
ISSN: 1549-8417

Factor impacto JCR: 2.243 (2021)

Categ. JCR: HEALTH POLICY & SERVICES rank: 62 / 88 = 0.705 (2021) - Q3 - T3
Categ. JCR: HEALTH CARE SCIENCES & SERVICES rank: 82 / 109 = 0.752 (2021) - Q4 - T3

Factor impacto CITESCORE: 3.1 - Nursing (Q2) - Medicine (Q2)

Factor impacto SCIMAGO: 0.447 - Public Health, Environmental and Occupational Health (Q2) - Leadership and Management (Q2)

Financiación: info:eu-repo/grantAgreement/ES/ISCIII-FEDER/PI16-00816

Tipo y forma: Article (Published version)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)