Workshop # 298

Quaternary prevention, addressing the limits of medical practice

Wonca world congress workshop # 298. Prague 2013. accepted abstract 

Marc Jamoulle, GP , researcher in Primary care , IRSS-UCL, Belgium

Gene Tsoi, Immediate Past President, Hong Kong College of Family Physicians, China

Iona Heath, President of the Royal College of General Practitioners, United Kingdom

Dee Mangin, Director, General Practice Research Group, Associate Professor, Otago university, New Zealand

Mohamad Pezeshki, Associate Professor, Department of Community Medicine, Tabriz Medical School, Iran

Miguel Pizzanelli Báez, head of the Primary care network, Florida, Uruguay

As stated in Wonca dictionary of family Medicine (Bentzen, 2003), quaternary prevention definition is “Action taken to identify a patient or a population at risk of overmedicalisation, to protect them from invasive medical interventions and provide for them care procedures which are scientifically and medically acceptable.” 

Quaternary prevention, first coined at Wonca world Hong Kong 1995 by M. Jamoulle& M.Roland, describes the protection of patients from diagnostic tests, interventions and treatments that offer no benefit for overall morbidity or mortality for the individual, and may cause physical or psychological harm.

The P4 concept pulls together all reflexive moves on the problems resulting from an excess of medical care, such as overscreening, overinvestigation, overprescription, and overtreatment.

Since the first workshop in Wonca Basel 2009, the P4 concept has spread throughout the world, and has provoked an intense exchange of ideas. The speakers gathered here from around the world intend to show how front line family physicians could analyze, understand, appropriate and use the P4 concept to examine, analyze and modify their practice.

The audience will be stimulated to share their concern about the limits of medicine exchange critical comments on the concept of P4.

At the end of the workshop attendees will be able to able to use and apply Quaternary prevention to improve both the health of individual patients and public policy.

More on http://www.ph3c.org rubric Quaternary prevention

Speakers

Marc Jamoulle : From Illitch to Moynihan , medicine can be dangerous for your health

Gene Tsoi ; Doctor-Patient Relationship - sharing of experience with a GP from Hong Kong

Iona Heath ; The ethical implications of excessive prevention

Dee Mangin : Mutimorbidity, ageing, and Quaternary Prevention

Mohammad Zakaria Pezeshki: Clinical Epidemiology and Quaternary Prevention

Miguel Pizanelli, Jorge Bernstein & André L. Silva: A South American move; the “Comision de Prevencion Cuaternaria”

Poster # 336

Quaternary prevention; from Wonca world Hong Kong 1995 to Wonca world Prague 2013

Wonca world congress Poster# 336. Prague 2013. Submitted abstract 

Marc Jamoulle & Michel Roland. General practitioners, Belgium

During the World Wonca congress in Hong Kong 1995, the Quaternary Prevention concept (P4), supported by the Wonca International Classification Committee in its Durham meeting, has been presented as a poster by the same authors.

As stated in Wonca dictionary of family Medicine (Bentzen, 2003), quaternary prevention definition is “Action taken to identify a patient or a population at risk of overmedicalisation, to protect them from invasive medical interventions and provide for them care procedures which are scientifically and medically acceptable.” 

18 years later, the concept has turned around the world and is now taught in many medicine schools. After a successful Wonca Europe Basel workshop, Wonca world Prague welcomes a workshop that provides speakers from 6 countries and 4 continents.

The draws used in various publications are shown on the poster in an attempt to explain visually the concept and refer to the corresponding quotes.

Links with the actual controversy about overscreening, overdiagnosis and overtreatment are indicated. Several mailing list addresses and websites related to Quaternary prevention are also displayed.

More about P4 on www.ph3c.org