61 ‘Practicing wisely’: a hands-on workshop to decrease overuse at the level of the consultation in primary care

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Abstract

Method

For each workshop, the participants filled a questionnaire before and immediately after the workshop. They also had to choose two practices they would change and after 6 and 12 weeks, they were asked to provide us with feedback using structured and semi-structured questions on their successes or challenges.

Method

We analyzed the responses to these questionnaires. We used quantitative measures when appropriate and analysed recurrent themes on answers asking them to describe how they were successful and/or the difficulties encountered in changing practices.

Results

Feedback was in general very favourable to this workshop, and most participants reported having used the tools and concepts that were discussed during the workshop. Many themes that can lead to overuse are discussed through the workshop. We have seen that deprescribing PPIs, shared decision making for statins in primary prevention and cancer screening counselling seem to be the practice change chosen the most often by participants. Some logistical issues are viewed as barriers but also, contradicting opinions by specialist colleagues can sometimes make applying what was learned difficult. It seems though, as per the participant’s feedback, that patients appreciate these changes.

Conclusions

We present Québec’s experience with ‘Practicing Wisely’ a hands-on workshop aimed at decreasing overuse. We opted, which is different than in other provinces, to ask about practice changes in a descriptive manner, trying to better qualify successes and identify barriers. Our future goal is to prepare tools and material to address issues raised, so we can make the next version of the workshop even more relevant and useful. We believe such an interactive workshop, based on small and large group discussions, simple but common clinical scenarios, and use while in session of different resources is one possible (albeit one of many) way to help change in practice at the consultation level.

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