title: Patients' estimations of the importance of preventive health services: a nationwide, population-based cross-sectional study in Portugal.
abstract: To determine, in the context of primary care preventive health services, the level of importance that Portuguese patients attribute to different preventive activities.
  
  
  
  Cross-sectional study.
  
  
  
  Primary Healthcare, Portugal.
  
  
  
  1000 Portuguese adults selected by a stratified cluster sampling design were invited to participate in a computer-assisted telephone survey. Persons with a cognitive or physical disability that hampered the ability to complete a telephone interview and being a nursing home resident or resident in any other type of collective dwelling were excluded.
  
  
  
  Mean level of importance assigned to 20 different medical preventive activities, using a scale of 1-10, with 1 corresponding to 'no importance for you and your health' and 10 indicating 'very important'.
  
  
  
  The mean level of importance assigned to medical preventive activity was 7.70 (95% CI 7.60 to 7.80). Routine blood and urine tests were considered the most important, with an estimated mean of 9.15 (95% CI 9.07 to 9.24), followed by female-specific interventions (Pap smear, mammography and gynaecological and breast ultrasounds), with mean importance ranging from 8.45 (95% CI 8.23 to 8.63) for mammography to 8.56 (95% CI 8.36 to 8.76) for Pap smear. Advice regarding alcohol consumption (6.18; 95% CI 5.96 to 6.39) and tobacco consumption (5.99; 95% CI 5.75 to 6.23) were considered much less important.
  
  
  
  Our results reveal that Portuguese patients overestimate the importance of preventive medical activities, tend to give more importance to diagnostic and laboratory tests than to lifestyle measures, do not discriminate tests that are important and evidence-based, and seem not be aware of the individualisation of risk. Family physicians should be aware of these optimistic expectations, because these can influence the doctor-patient relationship when discussing these interventions and incorporating personalised risk.
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department, Faculty of Medicine, University of Porto, Porto, Portugal Family Health Unit Nova Via, Porto, Portugal.
authors.forename: Luísa
authors.initials: L
authors.lastname: Sá
authors.affiliation: Faculty of Medicine, Centre for Research in Health Technologies and Information Systems (CINTESIS) and Information Sciences and Decision on Health Department (CIDES), University of Porto, Porto, Portugal.
authors.forename: Orquídea
authors.initials: O
authors.lastname: Ribeiro
authors.affiliation: Faculty of Medicine, Centre for Research in Health Technologies and Information Systems (CINTESIS) and Information Sciences and Decision on Health Department (CIDES), University of Porto, Porto, Portugal.
authors.forename: Luís Filipe
authors.initials: LF
authors.lastname: Azevedo
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department, Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Luciana
authors.initials: L
authors.lastname: Couto
authors.affiliation: Faculty of Medicine, Centre for Research in Health Technologies and Information Systems (CINTESIS) and Information Sciences and Decision on Health Department (CIDES), University of Porto, Porto, Portugal.
authors.forename: Altamiro
authors.initials: A
authors.lastname: Costa-Pereira
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department, Faculty of Medicine, University of Porto, Porto, Portugal Faculty of Medicine, Centre for Research in Health Technologies and Information Systems (CINTESIS) and Information Sciences and Decision on Health Department (CIDES), University of Porto, Porto, Portugal.
authors.forename: Alberto
authors.initials: A
authors.lastname: Hespanhol
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department, Faculty of Medicine, University of Porto, Porto, Portugal Faculty of Medicine, Centre for Research in Health Technologies and Information Systems (CINTESIS) and Information Sciences and Decision on Health Department (CIDES), University of Porto, Porto, Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Santos
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department, Faculty of Medicine, University of Porto, Porto, Portugal Faculty of Medicine, Centre for Research in Health Technologies and Information Systems (CINTESIS) and Information Sciences and Decision on Health Department (CIDES), University of Porto, Porto, Portugal.
authors.forename: Carlos
authors.identifier: 0000-0001-8561-5167
authors.initials: C
authors.lastname: Martins
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D003955:Diagnostic Tests, Routine; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011174:Portugal; D011314:Preventive Health Services / Q000379:methods / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Patients values; Preventive services; family medicine; overdiagnosis; overtesting; prevention