Sebastião Maria, Pesch Josefine, Kühlein Thomas, Hueber Susann
Institute of General Practice, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Bayern, Germany
Institute of General Practice, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Bayern, Germany.
BMJ Open. 2024 Jul 17;14(7):e084065. doi: 10.1136/bmjopen-2024-084065.
Medical overuse exposes patients to unnecessary risks of harm. It is an open question whether and how patients perceive the concept of medical overuse, its causes and negative consequences.
A qualitative study design, using elements of the Grounded Theory Approach by Strauss and Corbin.
Between May 2017 and January 2020, we recruited participants and conducted face-to-face interviews in the participants' homes. Data collection took place in Bavaria, Germany.
We recruited 16 participants (female=8, male=8) with various characteristics for the study. We used different strategies such as flyers in supermarkets, pharmacies, participants spreading information about the study or local multipliers (snowball sampling).
The participants mostly defined medical overuse as too much being done but understood the concept superficially. During the interviews, most participants could describe examples of medical overuse. They named a variety of direct and indirect drivers with economic factors suspected to be the main driver. As a consequence of medical overuse, participants named the physical and emotional harm (eg, side effects of medication). They found it difficult to formulate concrete solutions. In general, they saw themselves more in a passive role than being responsible for bringing about change and solutions themselves. Medical overuse is a 'problem of the others'. The participants emphasised that health education is important in reducing medical overuse.
Medical overuse was little discussed among participants, although many participants reported experiences of too much medicine. Health education and strengthening the patients' self-responsibility can play a vital role in reducing medical overuse.
医疗过度使用会使患者面临不必要的伤害风险。患者是否以及如何理解医疗过度使用的概念、其成因和负面后果仍是一个悬而未决的问题。
一项定性研究设计，采用施特劳斯和科尔宾的扎根理论方法的要素。
2017年5月至2020年1月期间，我们招募了参与者，并在参与者家中进行了面对面访谈。数据收集在德国巴伐利亚州进行。
我们招募了16名具有不同特征的参与者（女性=8名，男性=8名）参与该研究。我们采用了不同的策略，如在超市、药店发放传单，让参与者传播有关该研究的信息或通过当地的意见领袖（滚雪球抽样）。
参与者大多将医疗过度使用定义为做得太多，但只是表面上理解这个概念。在访谈中，大多数参与者能够描述医疗过度使用的例子。他们列举了各种直接和间接的驱动因素，怀疑经济因素是主要驱动因素。作为医疗过度使用的后果，参与者提到了身体和情感上的伤害（如药物副作用）。他们发现很难提出具体的解决方案。总体而言，他们认为自己更多地处于被动角色，而不是负责带来改变和解决方案。医疗过度使用是“他人的问题”。参与者强调健康教育在减少医疗过度使用方面很重要。
尽管许多参与者报告有用药过多的经历，但参与者之间很少讨论医疗过度使用问题。健康教育和增强患者的自我责任感在减少医疗过度使用方面可以发挥至关重要的作用。
