Intervention to reduce C-reactive protein determination requests for acute infections at an emergency department

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author SANTOS, I. S. FMUSP-HC
BENSENOR, I. M. FMUSP-HC
MACHADO, J. B. A. FMUSP-HC
FEDELI, L. M. G. FMUSP-HC
LOTUFO, P. A. FMUSP-HC
dc.date.issued 2012
dc.identifier.citation EMERGENCY MEDICINE JOURNAL, v.29, n.12, p.965-968, 2012
dc.identifier.issn 1472-0205
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/432
dc.description.abstract Introduction C-reactive protein (CRP) levels rise during inflammatory processes and have been ordered for rheumatic disease follow-up since the 1950s. The number of tests ordered in the emergency setting has increased, but without evident improvement in medical care quality. Objective To determine the pattern of CRP determinations in the emergency department (ED) of a university hospital in Sao Paulo, Brazil, and to evaluate the effect of an intervention with staff and students about the best use of the test in the ED. Methods Data regarding CRP testing requests, related diagnoses and the number of monthly consultations in the hospital ED were analysed before and after the intervention. Because of an increase in CRP measurement requests from 2007 to 2009, the author started discussing the role of CRP determinations in the medical decision-making process in early 2010. Staff and faculty members openly discussed the pattern of requests in the hospital and related current medical literature. During 2010, the medical staff worked as multipliers to change the behaviour of new students and residents. The results of the first 4 months after the intervention were presented at another general meeting in July 2010. Results From 2007 to 2009, there were 11 786 CRP measurement requests with a clear exponential trend. After the intervention, during the calendar year 2010, there was a 48% reduction in adjusted annual CRP requests. Pneumonia, fever and urinary tract infections were the most common reasons for CRP requests. Discussion Inexpensive, well-directed, interactive educational interventions may affect professional behaviour and curb rates of laboratory tests.
dc.description.sponsorship · FAPESP
· Financiadora de Estudos e Projetos (FINEP)
· Eli-Lilly
· Daichi
· Novartis
dc.language.iso eng
dc.publisher BMJ PUBLISHING GROUP
dc.relation.ispartof Emergency Medicine Journal
dc.rights restrictedAccess
dc.subject.other prognostic value; procalcitonin; copeptin; disease
dc.title Intervention to reduce C-reactive protein determination requests for acute infections at an emergency department
dc.type article
dc.rights.holder Copyright BMJ PUBLISHING GROUP
dc.identifier.doi 10.1136/emermed-2011-200787
dc.identifier.pmid 22307925
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author SANTOS, I. S.:FM:MCM
hcfmusp.author BENSENOR, I. M.:FM:MCM
hcfmusp.author MACHADO, J. B. A.:HU:SVAULAB-62
hcfmusp.author FEDELI, L. M. G.:FM:
hcfmusp.author LOTUFO, P. A.:FM:MCM
hcfmusp.origem.id 2-s2.0-84870065642
hcfmusp.origem.id WOS:000311482000012
hcfmusp.publisher.city LONDON
hcfmusp.publisher.country ENGLAND
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dc.description.index MEDLINE
hcfmusp.citation.scopus 6
hcfmusp.citation.wos 6


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