[Sometimes less is more. Preventing overdiagnosis by sharing decisions].

In this article, we will define «quaternary prevention», which consists in minimizing the iatrogenic effects of medical interventions, and more specifically the notion of «overdiagnosis». We will then discuss how a poor appreciation of the risks, on the part of both patients and clinicians, seems to fuel the phenomenon. We will discuss the interest of placing quaternary prevention within the broader framework of Shared Decision Making.

[Functional disorders in primare care].

General practitioners frequently encounter patients with functional disorders. The authors discuss the specific aspects of the management of this population in general practice, through the lens of the five functions that define this discipline. A classification of functional disorders and the analysis of prognostic factors are of great value in deciding on therapeutic strategies.

Blended care to discontinue benzodiazepine receptor agonists use in patients with chronic insomnia disorder: a pragmatic cluster randomized controlled trial in primary care.

Study Objectives: International guidelines recommend using benzodiazepine receptor agonists (BZRA) for maximally four weeks. Nevertheless, long-term use for chronic insomnia disorder remains a common practice. This study aimed to test the effectiveness of blended care for discontinuing long-term BZRA use in general practice.

The Vienna self-assessment questionnaire: a usable tool towards more health-literate hospitals? Explorative case studies in three hospitals in Belgium.

Background: Strengthening the capacity of hospitals to take into account the level of health literacy of their public is a necessity to improve the quality of care. One way to develop adequate health literacy responsive policy and strategies in hospitals is the use of self-assessment tools to raise awareness, help prioritise action and mobilise stakeholders. The Vienna Health Literate Organisation (V-HLO) questionnaire, recently translated and adapted into French, is designed to meet this objective.

Effectiveness of a blended care programme for the discontinuation of benzodiazepine use for sleeping problems in primary care: study protocol of a cluster randomised trial, the Big Bird trial.

Introduction: Problematic benzodiazepine use is a global health issue. Although the adverse side effects of long-term use of benzodiazepines are well known, it remains difficult to implement interventions for discontinuation in primary care. Considering the success of blended care for the treatment of sleeping disorders and the support of substance use disorders, evidence suggests that a blended care approach, combining face-to-face consultations with the general practitioner with web-based self-learning by the patient, is beneficial for the discontinuation of chronic benzodiazepine use for primary insomnia in general practice.

Dealing with health literacy at the organisational level, French translation and adaptation of the Vienna health literate organisation self-assessment tool.

Background: Efforts to address health literacy should favour a system-based approach with the dual aim both of fostering the material conditions and creating a work culture inside health care organisations that makes it easier for people to use information. The Vienna Health Literate Organisation (V-HLO) self-assessment tool is a German-speaking questionnaire for quality managers of health care organisations. Its objective is to provide a diagnostic of the strengths and weaknesses of the organisation in terms of health literacy.

[Health literacy, a lever to make health care systems more equitable? Tools to support professionals and involve institutions].

This article briefly recalls why low levels of health literacy should be considered to constitute a public health issue. It then proposes the concept of health literacy as a possible lever to help health care systems to more effectively take social health inequalities into account. Finally, it provides concrete tools for field workers, both clinicians and quality of care managers, and emphasises the importance of an organizational approach to health literacy.

[From chronic disease to multimorbidity: Which impact on organization of health care].

Healthcare systems are concerned with the growing prevalence of chronic diseases. Single disease approach, based on the Chronic Care Model, is known to improve specific indicators for the targeted disease. However, the co-existence of several chronic disease, or multimorbidity, within a same patient is the most frequent situation.