6 Overdiagnosis and overtreatment of infectious diseases in general practice. How and where to break the endless loop

Background Uncertainty about the origin of symptoms is a frequent challenge faced by health professionals working in general practice. This uncertainty is caused by a complex interaction of factors related to the use and interpretation of diagnostic information triggering overdiagnosis and subsequently overprescription of antibiotics. Unnecessary use of antibiotics is the main driver for development of antimicrobial resistance; hence it is crucial to identify and understand the determinants for overdiagnosis if we are to curb the overprescription of antibiotics in patients seeking care in general practice. Aim To facilitate discussion and advance understanding of the determinants for overdiagnosis in patients seeking care in general practice with suspected respiratory and urinary tract infection. Methodology The didactic methods used in the workshop will be Case-based learning and the fish bowl technique to promote discussion and gradual participation of all attendees. Program: Lecture: Welcome and explanation of key concepts of the diagnostic process in respiratory and urinary tract infections in general practice – 15 min. Clinical cases: this part will be divided into three sessions, in which a clinical case is presented, afterwards the fish–bowl technique is used to facilitate discussion – 60 min. Two moderators will guide the discussion to secure that at least the following three key question are debated for each case: What are the determinants of overdiagnosis or misdiagnosis in this case? Can we find a solution? Which knowledge is missing in order to find a solution to reduce overdiagnosis and the subsequent overtreatment? Cases: Diagnosis of urinary tract infections in the elderly Diagnosis of acute lower respiratory tract infections Diagnosis of sore throat as the main motive of consultation Plenary: Summary and final discussion – 15 min. Outcome After this workshop the participants will be able to identify: The challenges of the diagnostic process in the most common infectious diseases managed in general practice. The drivers for overdiagnosis and subsequent overtreatment. The potential solutions for reducing overdiagnosis.