Dosquet P, Charvet-Protat S, Pazart L, Frija G, Durieux P; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1994; Abstract No. 069.
ANDEM Paris, France.
BACKGROUND: Low osmolality CM (LOCM) are presented as safer and better tolerated than high osmolality CM (HOCM). However, severe secondary reactions and deaths have been described with LOCM. In France, LOCM are 3.6 times more expensive than HOCM. The additional cost of a systematic use of LOCM for intravenous administration is estimated at 250 millions FF (about 40 millions US$). Intravenous use represents about 75% of total CM consumption. Scientific elaboration of clinical guidelines (CG) for intravenous urography (IVU) and CT scan (CTS), defining what are the known advantages of LOCM and for what patients they can be useful, appeared necessary to the FSR. A survey was performed to evaluate the practice and the motivations of the radiologists. METHODS: A questionnaire was sent by post to a randomized sample of 1000 radiologists from a 6000 population. Two systematic mailings were dispatched, and a third if no response 1.5 month after the second. RESULTS: 456 questionnaires were returned (45.6% response rate). The respondent sample is representative of the types of radiology practice in France (50.4% of respondents have only private practice, 20.8% only public practice, and 28.8% both). 77% performed both IVU and CTS. LOCM are systematically used by 42% of respondents for CTS, and by 39% for IVU. When both LOCM and HOCM are used the mean use of LOCM is 32% (SD 24%) for CTS and 27% (SD 22%) for IVU. LOCM are more frequently used, systematically or not, by private radiologists. LOCM main advantages (less severe and mild adverse reactions, best comfort for patients) and disadvantages (higher cost) are equally quoted for both CTS and IVU. For CTS, higher cost does not appear as a disadvantage for private radiologists, which underlines the absence of real cost containment for them. Whatever their practice, the radiologists received information concerning CM principally from radiological reviews (87%) and directly from the CM producting firms (88%). Most of them (83%) think CG are necessary, and 89% are ready to change their prescription if CG established by professionals are published. CONCLUSION: This survey shows that 1) all the radiologists have nearly the same informations about CM, 2) the system of health care delivery influences the prescription rate for LOCM, 3) CG specifying the real known advantages of LOCM in term of mild, severe and fatal reaction are required, 4) radiological reviews and face-to-face information, if possible are the good media for CG diffusion.
Publication Types:
Keywords:
- Contrast Media
- Costs and Cost Analysis
- Data Collection
- France
- Guidelines as Topic
- Humans
- Osmolar Concentration
- Questionnaires
- Tomography, X-Ray Computed
- economics
- methods
- radiography
- hsrmtgs
Other ID:
UI: 102211807
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