Indications for laboratory tests in primary care: assessment of the most frequent indications and requests with blank clinical information.
BACKGROUND
The aim of this work is twofold. Firstly, to study the temporal evolution in the number of laboratory requests from primary care without clinical indication, and to analyse the number of such requests before and after the implementation of an automated requesting procedure. Secondly, to investigate what are the most frequent clinical indications that prompted laboratory testing.


METHODS
This is a retrospective observational study conducted from January 2009 to December 2015. We counted the requests without clinical question, calculated the number of such requests per total number of requests and listed the most frequent indications.


RESULTS
The number of tests requests with a blank clinical indication was significantly higher in 2009 when compared to 2015 (80% vs. 20%; P < 0.001). For every year in this 7-year period, dyslipidemia, essential hypertension and diabetes were the most prevalent diagnoses that prompted a laboratory test in primary care, accounting for more than 20% of all indications.


CONCLUSIONS
The number of primary care requests without patient clinical question has decreased after the implementation of an automated requesting procedure. Disorders of lipid metabolism, essential hypertension and diabetes mellitus were the most prevalent diagnoses that prompted a laboratory test in primary care.
Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain; Department of Biochemistry and Molecular Pathology, Universidad Miguel Hernandez, Elche, Spain.
Maria
M
Salinas
Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain.
Maite
M
López-Garrigós
Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain; Department of Clinical Medicine, Universidad Miguel Hernandez, Elche, Spain.
Emilio
E
Flores
Department of Biochemistry and Molecular Pathology, Universidad Miguel Hernandez, Elche, Spain.
Maria
M
Leiva-Salinas
Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain.
Patricia
P
Esteban
Department of Clinical Medicine, Universidad Miguel Hernandez, Elche, Spain.
Miguel
M
Ahumada
Department of Radiology, University of Virginia, Charlottesville, USA.
Carlos
C
Leiva-Salinas
D019411:Clinical Laboratory Techniques / Q000706:statistics & numerical data*; D006801:Humans; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration*
clinical laboratory; pre-analytical phase; primary care; quality indicators; test request