Abstract No. 1276 (Workshop) : EVIDENCE BASED NON-PHARMACOLOGICAL INTERVENTION PRESCRIBED IN PRIMARY CARE

Conference: 
Author(s): 
Gómez de la Cámara A, Navarro Gil A, Grandes Velasco E, Ortega Fraile P, Jurado Valenzuela S, Gómez Medina M Research Unit. Area 11 National Institute of Health. Madrid. Spain
Text: 
Objective:
To estimate the proportion of evidence based non-pharmacological medical interventions in the clinical practice of Primary Care. Setting: Three primary care practices from urban neighbourhoods. Subjects: Medical interventions present in 150 medical records were review from a systematic sample
Type of Study: Cross-sectional.
Measurements:
Interventions were defined as the treatment or manoeuvre that represented the practitioner's attempt to cure, alleviate or care for the patient in respect to the primary diagnosis based in non-pharmacological resources. The evidence for the interventions was searched in Medline (1986-1997). They were classified according the presence of supporting experimental evidence for each of the intervention in i) present, ii) dubious and iii) absent.
Results: We found 92 different primary diagnosis. A 32% had two different interventions, and a 14% more than three. A 19,5% were non-pharmacological interventions and the rest mostly pharmacological. The most frequent non-pharmacological interventions were those related to cardiovascular disease (diet, physical exercise, etc), followed by upper respiratory tract infections (hydration), low back pain (physical therapy, rest or both), constipation (diet, exercise) and gastroenteritis (diet). Only hydration of the respiratory tract lacks experimental based evidence.
Conclusions:
Non-pharmacological interventions are a frequent and coherent part of the treatment plan of the primary care physician. In our study almost all had experimental evidence easily found in Medline.