SIG Quaternary Prevention and Overmedicalization update

Miguel Pizzanelli, (Uruguay) convenor of WONCA Special Interest Group on Quaternary Prevention and Overmedicalization (QP&O) reports on the period August 2018 to March 2019.

Leadership and Team Building level:
The Iberoamericana and Europe regions have active QP&O groups. The strategy to spread Quaternary prevention interest and focus in a global way is developing strongly in these two regions. However, to achieve a global impact it is necessary to promote leadership and interest in other regions. The activities performed during the WONCA World conference in Seoul were important to promote quaternary prevention in Asia.

Collaborative Network level:

An international team established the coordination of Quaternary Prevention activities during the WONCA World Conference in Seoul successfully. Regions involved in this coordination: Asia Pacific, Europe, Iberoamericana.

Ongoing projects:
Collaborative Database on Quaternary Prevention Resources and References. Editorial board is Miguel Pizzanelli, Ricardo Lavalle, Marc Jamoulle. The project aims to collect, share and retrieve bibliographic references, papers and material on the topic of quaternary prevention, with education or research purposes. Up to time 120 entries exist in the database. Proposal available form:

Exchange Level:

QP&O members participated in the proposal of a manuscript submitted to the BMJ “Reforming Disease Definitions: a new primary care led, people-centred approach"

Main Publications and Communications
Jamoulle M, Roland M, Bae J-M, Heleno B, Visentin G, Gusso GDF, et al. Ethical, pedagogical, socio-political and anthropological implications of quaternary prevention. Implicações éticas, pedagógicas, sócio-políticas e antropológicas da prevenção quaternária. Rev Bras Med Fam Comunidade [Internet]. 2018 Oct 10 [cited 2018 Oct 29];13(40):1–14. Available from:

Martins C, Godycki-Cwirko M, Heleno B, Brodersen J. Quaternary prevention: an evidence-based concept that aims to protect patients from medical harm. Status: submitted and accepted by British Journal of General Practice.
Norman AH, Tesser CD. Quaternary prevention: a balanced approach to demedicalisation. Br J Gen Pract [Internet]. 2019 Jan 1 [cited 2019 Mar 6];69(678):28–9. Available from:

Jamoulle M, Lavalle R. The Quaternary Prevention concept and the social responsibility in medicine schools. (French).Le concept de prévention quaternaire et la responsabilité sociétale des facultés de médecine. Dictionnaire francophone de responsabilité sociale en santé. Avril 2018. Available from:

Quaternary Prevention at the WONCA World Conference:

Our SIG presented at the WONCA World Conference. Korea, October, 17 and 19, 2018. Chairs: Monica Nivelo, University of Chile. Faculty of Medicine, Chile; Daniel Widmer, Institut Universitaire de Médecine de Famille, Switzerland; and Jong-Myon Bae, Jeju National University School of Medicine, Korea. Speakers: Monica Nivelo, Daniel Widmer, Marc Jamoulle, Jong-Myon Bae., Patrick Ouvrard. Participation of EUROPREV members.
Complete report with all publications and activities is available here.

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Contact Miguel
[email protected]