• Bmc Fam Pract · Aug 2020

    A top 5 list for French general practice.

    • Agnès Hazard, Lucie Fournier, Louise Rossignol, Nathalie Pelletier Fleury, Corentin Hervé, Thibaud Pitel, Cécile Pino, Olivier Saint-Lary, Thomas Hanslik, Thierry Blanchon, and Mathilde François.
    • Department of Family Medicine, Faculty of Health Sciences Simone Veil, University Versailles-Saint-Quentin-en-Yvelines, Villejuif, Paris, France. agneshazard@hotmail.com.
    • Bmc Fam Pract. 2020 Aug 9; 21 (1): 161.

    BackgroundMedical overuse is an issue that has recently gained attention. The "Choosing Wisely" campaign invited each specialty in each country to create its own top five lists of care procedures with a negative benefit-risk balance to promote dialogue between patients and physicians. This study aims to create such a list for French general practice.MethodsA panel of general practitioners (GPs) suggested care procedures that they felt ought to be prescribed less. Using the Delphi method, a short list of those suggestions was selected. Systematic literature reviews were performed for each item on the short list. The results were presented to the panel to assist with the final selection of the top five list.ResultsThe panel included 40 GPs. The list includes: i/ antibiotics prescription for acute bronchitis, nasopharyngitis, otitis media with effusion, or uncomplicated influenza, ii/ systematic prostate specific antigen testing in men older than 50, iii/ prescription of cholinesterase inhibitors for mild cognitive impairment and for Alzheimer's disease and memantine for Alzheimer's disease, iv/ statins prescription in primary prevention of cardio-vascular risk in older patients, and v/ benzodiazepine or benzodiazepine-like agents prescription for generalised anxiety, insomnia, and for all indications in older patients.ConclusionsThis study resulted in a French top five list in general practice using a panel of GPs. All the items selected have a negative risk-benefit balance and are frequently prescribed by French general practitioners. This list differs from other top five lists for general practice, reflecting the local medical culture.

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