title: Preventive health services implemented by family physicians in Portugal-a cross-sectional study based on two clinical scenarios.
abstract: OBJECTIVE
  To assess whether Portuguese family physicians perform preventive health services in accordance with scientific evidence, based on the recommendations of the United States Preventive Services Task Force (USPSTF).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Primary healthcare, Portuguese National Health Service.
  
  
  METHODS
  255 Portuguese family physicians selected by a stratified cluster sampling design were invited to participate in a computer-assisted telephone survey.
  
  
  RESULTS
  Prevalence of compliance with USPSTF recommendations for screening, given a male and female clinical scenario and a set of proposed medical interventions, including frequency of the intervention and performance in their own daily practice.
  
  
  RESULTS
  A response rate of 95.7% was obtained (n=244). 98-100% of family physicians answered according to the USPSTF recommendations in most interventions. In the male scenario, the lowest concordance was observed in the evaluation of prostate-specific antigen with 37% of family physicians answering according to the USPSTF recommendations. In the female scenario, the lowest concordance was for cholesterol testing with 2% of family physicians complying. Family physicians younger than 50 years had significantly better compliance scores than older ones (mean 77% vs 72%; p<0.001).
  
  
  CONCLUSIONS
  We found a high degree of agreement with USPSTF recommendations among Portuguese family physicians. However, we also found results suggesting excessive use of some medical interventions, raising concerns related to possible harm associated with overdiagnosis and overtreatment.
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department of the Faculty of Medicine of Porto, Porto, Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Martins
authors.affiliation: Information Sciences and Decision on Health Department (CIDES), Faculty of Medicine, Centre for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal.
authors.forename: Luís Filipe
authors.initials: LF
authors.lastname: Azevedo
authors.affiliation: Information Sciences and Decision on Health Department (CIDES), Faculty of Medicine, Centre for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Santos
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department of the Faculty of Medicine of Porto, Porto, Portugal.
authors.forename: Luísa
authors.initials: L
authors.lastname: Sá
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department of the Faculty of Medicine of Porto, Porto, Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Santos
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department of the Faculty of Medicine of Porto, Porto, Portugal.
authors.forename: Maria
authors.initials: M
authors.lastname: Couto
authors.affiliation: Information Sciences and Decision on Health Department (CIDES), Faculty of Medicine, Centre for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal.
authors.forename: Altamiro
authors.initials: A
authors.lastname: Pereira
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department of the Faculty of Medicine of Porto, Porto, Portugal.
authors.forename: Alberto
authors.initials: A
authors.lastname: Hespanhol
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration*; D010821:Physicians, Family / Q000592:standards*; D011174:Portugal; D010818:Practice Patterns, Physicians'; D011314:Preventive Health Services; D011320:Primary Health Care / Q000458:organization & administration*; D012189:Retrospective Studies; D000078329:Workforce; D055815:Young Adult
keywords: Preventive Medicine; Primary Care