"Routine" Laboratory Test Requests in Family Medicine: A Cross-Sectional Study Based on Clinical Practice in Portugal

Introduction: In Portugal, patients still believe they should perform a periodic check-up. The present study was designed to study the prescription pattern of "routine" laboratory tests in the Family practice in Portugal. Material and Methods: We performed a cross-sectional study in the Portuguese primary healthcare setting. We surveyed physicians on their "routine" laboratory test request pattern and the reasons for requesting or not requesting laboratory tests. The questions were based on the panel of the most prescribed tests in the of Central Lisbon health centre group. Results: Most of the inquired doctors said they requested "routine" laboratory tests (51.4%). There is a significant difference in the request of "routine" laboratory tests performed by trainees or specialists (p = 0.013). The most requested laboratory tests in adults are total cholesterol (92.2%) and blood glucose while the most requested laboratory tests in children are blood glucose, total cholesterol and full blood count. Many doctors (79.4%) that request "routine" laboratory tests do so to perform screening and the doctors that do not request routine" laboratory tests do so mainly (80.8%) because there's lack of scientific evidence. Discussion: We found differences in the prescription pattern of Family Physicians in Portugal, namely regarding the request of "routine" laboratory tests by doctors from different regions, degrees of specialization and age. We found that there is an association between prescribing "routine" laboratory tests and their request for screening. These physicians aparently want to track different types of pathology, even though patients have no symptoms or risks that could justify it. Most doctors, who do not prescribe "routine" laboratory tests, do not agree with screening for asymptomatic individuals, which is consistent with the evidence. Conclusion: Our results suggest that there is an excessive request of laboratory tests which can lead to overdiagnosis and overtreatment that requires global Social Marketing strategies to change the prevailing culture.