Abstract

IntroductionThe 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.Materials and methodsThis 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.ResultsThe 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.ConclusionsThe 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.

Highlights

  • 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

  • The number of primary care requests without patient clinical question has decreased after the implementation of an automated requesting procedure

  • Laboratory requests are made through an electronic system, the Computerized Patient Order Entry (CPOE) that offers the General Practitioners (GPs) a field to be filled regarding the reason for the laboratory request through International Classification of Diseases, Ninth Revision, Clinical Modification (CIE-9-MC) codes [6]

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Summary

Introduction

The incidence of false positive results by the fact of being requested in a population with low prevalence of a certain disease could be significantly reduced [3]. It decreases the global request of laboratory tests; inappropriate over requesting may have contributed to the considerably increase in the volume of laboratory tests over the last years.

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