Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 27
Filtrar
1.
BJGP Open ; 2024 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-39168498

RESUMEN

BACKGROUND: GPs can detect cognitive impairment at a very early stage, allowing early support for people and their caregivers. The early onset of cognitive impairment is between 50 and 60 years. Currently, in France, the Mini Mental State Examination remains the most used screening test, though it has a lower sensitivity and specificity than the Montreal Cognitive Assessment (MoCA) for detecting mild cognitive impairment, taking an average of 15 minutes to complete. AIM: To investigate the feasibility of the MoCA during routine consultations in general practice for the early detection of cognitive impairment and to determine prevalence of cognitive impairment in a primary care setting. DESIGN & SETTING: A quantitative, prospective feasibility study was carried out in real-life working condition during routine consultation. METHOD: GPs performed MoCA on adults aged 50 years and older, without suspected or confirmed cognitive impairment. RESULTS AND CONCLUSION: 61 GPs performed 221 MoCA with a mean duration of 8 minutes and detected mild neurocognitive impairment in 62% of patients. The MoCA is feasible and easy to perform during routine consultations in general practice by trained and experienced physicians.

2.
BJGP Open ; 2024 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-38964870

RESUMEN

BACKGROUND: In France, 40% of people aged over 16 (20 million) report having at least one chronic disease requiring long-term treatment. Compliance is estimated to be 50% on average. AIM: To study the practical management of oral treatments at home by people living with one or more chronic diseases. DESIGN & SETTING: Thirty general practitioners in France were invited by e-mail to enrol ten consecutive patients with chronic diseases. METHOD: A quantitative, descriptive, observational, cross-sectional study was carried out using standardised questionnaires to assess the socio-demographic profile of doctors and patients and the management of oral medication at home. RESULTS: Twenty general practitioners collected 180 questionnaires: 69.4% said they did not find taking their medication a problem; 42.8% used a pillbox; 79.4% said they knew 'all' their medications. 61% reported forgetting to take their medication. CONCLUSION: More than half of patients are non-adherent. Personalised reminders could reduce unintentional medication non-adherence.

3.
Sante Publique ; 34(HS2): 269-274, 2023.
Artículo en Francés | MEDLINE | ID: mdl-37336743

RESUMEN

Ten years ago, trans-gender people were looking for respectful and safe accompaniment. It was in this context of difficulty in finding answers that the Maison Dispersée de Santé de Lille began to set up a support service. The approach was immediately anchored in the gender transition pathway within primary care medicine, i.e. in access to local care. Caregivers and users, we build together our practice of health and care by meeting, debating, listening and sharing individual and collective expertise. Thus, we have gradually built a rigorous and non-rigid framework of a global, bio-psycho-social accompaniment that takes into account experiential learning. This framework must take into account the health of each individual in order to propose, follow and adapt a hormone replacement treatment. It allows for the accompaniment of physical changes, possible pre-existing psychological suffering or that which appears during the transition, as well as the upheaval of one's place in society. People with gender variations need medical support because they are part of a social reality that leads to this demand. The prevalence of transidentity has long been underestimated and this need has also been underestimated. Our experience of more than ten years of accompanying transitions of women and men in this context shows the feasibility of transitions in primary care within the French system of care and medico social support.


Asunto(s)
Cuidadores , Apoyo Social , Masculino , Humanos , Femenino , Retroalimentación , Estudios de Seguimiento , Cuidadores/psicología , Atención Primaria de Salud
4.
Sex Reprod Healthc ; 36: 100824, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36893521

RESUMEN

BACKGROUND: In France, women seeking abortion must do so before the maximum legal limit of 12 weeks of pregnancy (14 Gestational Weeks). Women seeking abortion after the 12-week limit tend to travel to the Netherlands, where the maximum legal limit is 22 weeks of pregnancy. The purpose of this study was to identify the profile and circumstances of women who travel from France to the Netherlands for a late abortion. METHODS: A descriptive, monocentric study was conducted in a Dutch abortion clinic, where a standardized, anonymous questionnaire was administered to women from France, holding an appointment for late abortion. Data was collected from July 2020 to December 2020. Data analysis was performed with R 4.0.3 software. RESULTS: Thirty-seven women participated in the study. Most of the women were young (15-25 y. o.), without any prior pregnancy, single, in paid employment, with an educational level less than or equal to a high school degree. Most of the women had regular gynaecological follow-up, used contraception, mostly birth control pills, and had already discussed emergency contraception or abortion with a healthcare professional. The women had delayed awareness of their pregnancy and visited the clinic at 18 weeks of pregnancy or later, beyond the 12-week French legal limit for abortion. CONCLUSION: Risk factors likely to lead to medical tourism for late abortion include young age (15-25 y. o.), first pregnancy, being insufficiently informed about available contraceptive methods.


Asunto(s)
Aborto Inducido , Turismo Médico , Embarazo , Femenino , Humanos , Anticoncepción , Europa (Continente) , Anticonceptivos Orales , Aborto Legal
5.
Patient Educ Couns ; 105(11): 3306-3312, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-35995685

RESUMEN

OBJECTIVES: To explore possible forms of domestic violence suffered by men with Parkinson's disease (PD). METHODS: A qualitative study was conducted through face-to face interviews, followed by a conceptual content analysis. Forms of violence were predetermined as code categories according to a classification of mistreatment and a lack within Maslow's hierarchy of needs. Data triangulation was performed by two researchers using the "long table" method according to Krueger & Casey. RESULTS: Eleven men with PD were interviewed to identify experienced forms of domestic violence. Since PD, the men felt neglected by their partners, lived in the fear of the partner's reactions, described a mutual sexual and physical distance, suffered from mockeries, humiliations, physical violence, and had a feeling of abandon while facing and managing PD. CONCLUSIONS: Domestic violence against men with PD exists and should be screened during communication with healthcare professionals. PRACTICE IMPLICATIONS: Domestic violence has different faces and is not always identified by the victims themselves. Spouses with profiles at risk for domestic violence against men with PD should be identified. Domestic violence can be triggered by female gender, alcoholism, anxiety and depression, a low educational level, low interest in and low knowledge about PD.


Asunto(s)
Violencia Doméstica , Enfermedad de Parkinson , Escolaridad , Femenino , Humanos , Masculino , Investigación Cualitativa , Esposos
6.
JMIR Hum Factors ; 9(1): e30258, 2022 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-35333180

RESUMEN

BACKGROUND: A major factor in the success of any search engine is the relevance of the search results; a tool should sort the search results to present the most relevant documents first. Assessing the performance of the ranking formula is an important part of search engine evaluation. However, the methods currently used to evaluate ranking formulae mainly collect quantitative data and do not gather qualitative data, which help to understand what needs to be improved to tailor the formulae to their end users. OBJECTIVE: This study aims to evaluate 2 different parameter settings of the ranking formula of LiSSa (the French acronym for scientific literature in health care; Department of Medical Informatics and Information), a tool that provides access to health scientific literature in French, to adapt the formula to the needs of the end users. METHODS: To collect quantitative and qualitative data, user tests were carried out with representative end users of LiSSa: 10 general practitioners and 10 registrars. Participants first assessed the relevance of the search results and then rated the ranking criteria used in the 2 formulae. Verbalizations were analyzed to characterize each criterion. RESULTS: A formula that prioritized articles representing a consensus in the field was preferred. When users assess an article's relevance, they judge its topic, methods, and value in clinical practice. CONCLUSIONS: Following the evaluation, several improvements were implemented to give more weight to articles that match the search topic and to downgrade articles that have less informative or scientific value for the reader. Applying a qualitative methodology generates valuable user inputs to improve the ranking formula and move toward a highly usable search engine.

7.
Health Soc Care Community ; 30(1): 1-10, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-33825299

RESUMEN

The COVID-19 pandemic has focused health systems on supporting patients affected by this virus. Meanwhile in the community, many other contained patients could only use self-care strategies, especially in countries that have set up a long and strict containment such as France. The study aimed to compare coping strategies deployed by patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS; a poorly recognised syndrome) to those with better known and referenced chronic conditions. An online flash survey was conducted during the containment period in partnership with French Patients Organizations including ME/CFS national association. Therefore, 'Brief COPE' version of Lazarus and Folkman's Ways of Coping Check List has been adapted to the specificity of the containment. The survey was e-distributed in France from 15 April to 11 May 2020. Differences of coping strategies were analyzed using Wilcoxon-Mann-Withney test. Amongst 637 responses, 192 were complete, presenting a wide variety of diseases, including 93 ME/CFS. The latter have significantly different coping strategies than recognised diagnosed diseases patients: similar uses of emotion focused coping but less uses of seek social support and problem-focused copings. In conclusion, coping strategies are different for those who deal with the daily experience of ME/CFS, highly disabling chronic condition with diagnostic ambiguity, low degree of medical and social recognition and without treatment. Better understanding of those strategies is needed to provide the means for health promotion researchers, managers and clinicians, to accompany those patients.


Asunto(s)
COVID-19 , Síndrome de Fatiga Crónica , Adaptación Psicológica , Síndrome de Fatiga Crónica/epidemiología , Humanos , Pandemias , SARS-CoV-2
8.
Eur J Gen Pract ; 27(1): 77-82, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33978533

RESUMEN

BACKGROUND: Substance use disorders (SUDs) are based on pathophysiological mechanisms common to all psychoactive substances. However, general practitioners (GPs) hold different views depending on the substance in question. OBJECTIVES: To determine whether the perceptions that teaching GPs and final-year residents in general practice have of patients with a SUD vary according to the substance involved and explore their professional responsibility and management experiences. METHODS: A cross-sectional observational study was carried out by asking residents and teaching GPs from eight faculties of medicine about their perceptions, professional responsibility and management experience of patients with tobacco, alcohol and opioid use disorders, using an online questionnaire between June and September 2017. RESULTS: The responses of 238 teaching GPs (mean age 50 years SD 3.5; 58% men) and 327 residents (mean age 28 years SD 9.9; 67% women) were analysed (response rates: 9 and 15% respectively). Tobacco smokers were considered to be more responsible for their acts than the other users. Teaching GPs and residents considered that it was their responsibility to discuss substance use. They did not feel able to manage alcohol and opioid use disorders. Tobacco cessation was mainly managed alone (78%). The results were quite similar among teaching GPs and residents. CONCLUSION: The majority of practitioners had no difficulty managing smoking cessation. During the management of alcohol and particularly opioid use disorders, practitioners did not feel competent. The gap between their perceived responsibility and competencies should be addressed by training and promoting collaborative care.


Asunto(s)
Medicina General , Médicos Generales , Trastornos Relacionados con Opioides , Adulto , Actitud del Personal de Salud , Estudios Transversales , Humanos , Persona de Mediana Edad , Percepción , Nicotiana
9.
Patient Educ Couns ; 104(8): 2060-2066, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33551207

RESUMEN

OBJECTIVES: To assess the users' characteristics, discussion contents, and the atmosphere of virtual peer communities. METHODS: A qualitative, prospective study was conducted using the Netnography method. The most popular, publicly accessible French discussion forums were investigated. The web users' quotes were collected from May to October 2018. Data analysis triangulation was performed by two researchers using the NVivo 12® software. RESULTS: The users discussed their experience with Parkinson's disease (PD) in a warm atmosphere. 23 discussion threads were analysed: 302 messages posted by 70 users (70% were females; the average illness duration was 6 years); 115 encoded nodes were created. Five user profiles appeared: leader, follower, expert, mixed, and undetermined. Common preoccupations were a lack of time and listening from the physicians' side. Three themes emerged: managing symptoms, living with PD, and sharing illness experiences. Users sought actively for a cure to limit or stop disease evolution, using alternative and complementary therapies to optimize their daily condition. CONCLUSIONS: Online forums foster person's informal learnings about coping with PD. Healthcare professionals can use these learnings to optimize person-centred support. PRACTICE IMPLICATIONS: During consultations, healthcare professionals should invite persons to discuss their online activity, informal learnings, beliefs and expectations towards therapeutic strategies.


Asunto(s)
Enfermedad de Parkinson , Femenino , Personal de Salud , Humanos , Internet , Enfermedad de Parkinson/terapia , Grupo Paritario , Estudios Prospectivos , Investigación Cualitativa
10.
BMC Fam Pract ; 22(1): 20, 2021 01 14.
Artículo en Inglés | MEDLINE | ID: mdl-33446099

RESUMEN

BACKGROUND: The purpose of this study is to forward the implementation of an operational evidence-based state screening program of common diseases in Ukraine, where currently no state-based and evidence-based screening (EBS) exists. EBS should be performed by Family Doctors in a primary care setting and concern prevalent diseases in adults, such as: obesity (BMI), hypertension (BP measurement), diabetes (glycaemia), dyslipidemia (cholesterol/lipids), colon cancer (FOBT/colonoscopy), breast cancer (mammography), STIs (chlamydia, syphilis), HIV, HBV, HCV (i.e. serology or other rapid tests), HPV (swabs), cervical cancer (test Pap). depression (i.e., PHQ-9), and smoking (i.e., Fagerstrom). METHODS: Four needs-based research actions were led among citizens and healthcare professionals, based on multidimensional empowerment. Internal Strengths and Weaknesses of the ongoing implementation process were identified through these studies, whereas external Opportunities and Threats were determined by the present socio-cultural and political context. This SWOT analysis is likely to guide future state-based initiatives to accomplish EBS implementation in Ukraine. RESULTS: Internal Strengths are the bottom-up multidimensional empowerment approach, teaching of EBS and the development of an internet-based platform "Screening adviser" to assist shared decision making for person-centred EBS programs. Internal Weaknesses identified for the Family Doctors are a heterogeneous screening and the risk of decreasing motivation to screen. External Opportunities include the ongoing PHC reform, the existent WONCA and WHO support, and the existence of EBS programs in Europe. External Threats are the lack of national guidelines, not fully introduced gate keeping system, the vulnerable socio-economic situation, the war situation in the East of Ukraine and the Covid-19 pandemic. CONCLUSIONS: We started EBS implementation through research actions, based on a multidimensional empowerment of citizens, HCP and in EBS pathways involved stakeholder teams, to foster a sustainable operational human resource to get involved in that new EBS pathway to implement. The presented SWOT-analysis of this ongoing implementation process allows to plan and optimize future steps towards a state based and supports EBS program in Ukraine.


Asunto(s)
Medicina Basada en la Evidencia , Medicina Familiar y Comunitaria , Tamizaje Masivo/organización & administración , Medicina Estatal , Conflictos Armados , COVID-19 , Femenino , Humanos , Masculino , Ucrania/epidemiología
11.
Nutrients ; 12(12)2020 12 08.
Artículo en Inglés | MEDLINE | ID: mdl-33302500

RESUMEN

INTRODUCTION: Recent observations have shown that lengthening the daily eating period may contribute to the onset of chronic diseases. Time-restricted eating (TRE) is a diet that especially limits this daily food window. It could represent a dietary approach that is likely to improve health markers. The aim of this study was to review how time-restricted eating affects human health. METHOD: Five general databases and six nutrition journals were screened to identify all studies published between January 2014 and September 2020 evaluating the effects of TRE on human populations. RESULTS: Among 494 articles collected, 23 were finally included for analysis. The overall adherence rate to TRE was 80%, with a 20% unintentional reduction in caloric intake. TRE induced an average weight loss of 3% and a loss of fat mass. This fat loss was also observed without any caloric restriction. Interestingly, TRE produced beneficial metabolic effects independently of weight loss, suggesting an intrinsic effect based on the realignment of feeding and the circadian clock. CONCLUSIONS: TRE is a simple and well-tolerated diet that generates many beneficial health effects based on chrononutrition principles. More rigorous studies are needed, however, to confirm those effects, to understand their mechanisms and to assess their applicability to human health.


Asunto(s)
Ritmo Circadiano , Ayuno , Alimentos , Salud , Restricción Calórica , Bases de Datos Factuales , Ingestión de Energía , Humanos , Estado Nutricional , Religión
12.
PLoS One ; 15(5): e0232814, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32413044

RESUMEN

BACKGROUND: Cervical cancer screening rates are known to be strongly associated with socioeconomic status. Our objective was to assess whether the rate is also associated with an aggregated deprivation marker, defined by the location of family doctors' offices. METHODS: To access this association, we 1) collected data from the claim database of the French Health Insurance Fund about the registered family doctors and their enlisted female patients eligible for cervical screening; 2) carried out a telephone survey with all registered doctors to establish if they were carrying out Pap-smears in their practices; 3) geotracked all the doctors' offices in the smallest existing blocks of socioeconomic homogenous populations (IRIS census units) that were assigned a census derived marker of deprivation, the European Deprivation Index (EDI), and a binary variable of urbanization; and 4) we used a multivariable linear mixed model with IRIS as a random effect. RESULTS: Of 348 eligible doctors, 343 responded to the telephone survey (98.6%) and were included in the analysis, encompassing 88,152 female enlisted patients aged 25-65 years old. In the multivariable analysis (adjusted by the gender of the family doctor, the practice of Pap-smears by the doctor and the urbanization of the office location), the EDI of the doctor's office was strongly associated with the cervical cancer screening participation rate of eligible patients (p<0.001). CONCLUSION: The EDI linked to the location of the family doctor's office seems to be a robust marker to predict female patients' participation in cervical cancer screening.


Asunto(s)
Detección Precoz del Cáncer , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/epidemiología , Adulto , Anciano , Femenino , Privación de Alimentos/fisiología , Humanos , Seguro de Salud , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Prueba de Papanicolaou , Consultorios Médicos , Médicos de Familia/estadística & datos numéricos , Clase Social , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/terapia , Frotis Vaginal
13.
J Womens Health (Larchmt) ; 29(3): 406-411, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31895647

RESUMEN

Background: Women who occasionally or regularly have sex with other women (WSW) are rarely identified in primary care. Although we know about their specific health needs, health care professionals still find it difficult to ask questions about sexual orientation (SO) and behaviors, and sometimes, patients may find them difficult to answer. The presumption of heterosexuality still remains a widespread attitude in health care. This study took place in a primary care setting, and aimed to identify differences in gynecological health care and clinical practice for women, according to what their presumed SO and behaviors were. Methods: We conducted a cross-sectional observational, descriptive, and comparative study from October 2018 to February 2019. Three hundred thirty-eight general practitioners (GPs) from Rhône-Alpes area (France) received an anonymous questionnaire with clinical case vignettes. The main outcome was the percentage of GPs who perform a different gynecological follow-up for WSW and non-WSW. Results: In total, 165 questionnaires were analyzed. Ninety percent of respondents performed a different gynecological follow-up for WSW, compared with other women. They less often addressed topics such as contraception needs, use of barrier protections, and screening of sexually transmitted infections. Ninety-two percent of respondents were aware that they have WSW among their patients, but 2/3 of them never or rarely asked about SO. Conclusion: Most GPs know that they manage WSW but may misidentify these patients and their real care needs. Therefore, WSW receive a different and poorer follow-up than non-WSW. Clinical guidelines would be useful to improve and standardize quality and experience of health care for WSW.


Asunto(s)
Actitud del Personal de Salud , Ginecología/estadística & datos numéricos , Homosexualidad Femenina/estadística & datos numéricos , Médicos de Atención Primaria/psicología , Bisexualidad/estadística & datos numéricos , Estudios Transversales , Femenino , Francia , Humanos , Masculino , Médicos de Atención Primaria/estadística & datos numéricos , Conducta Sexual , Parejas Sexuales , Enfermedades de Transmisión Sexual/prevención & control , Encuestas y Cuestionarios
14.
BMC Fam Pract ; 21(1): 13, 2020 01 21.
Artículo en Inglés | MEDLINE | ID: mdl-31964335

RESUMEN

BACKGROUND: The study aimed to analyze anemia management in non-pregnant, and non-menopausal women aged from 18 to 50 years old, in a French primary care setting. METHODS: An observational descriptive prospective study was conducted between November 2018 and February 2019. Inclusion criteria were as followed: anemia diagnosed in women aged from 18 to 50, not pregnant and not menopausal. Quantitative and qualitative data were anonymized and collected through an electronic survey. Investigating general practitioners completed the questionnaire for each newly diagnosed woman. Mean values and medians were calculated for the quantitative data. Answers to the open questions were encoded manually and proportions of the different modalities have been calculated. RESULTS: Altogether, 43 women with anemia were ascertained. Moderate microcytic anemia, due to an iron deficiency in a context of menorrhagia, was the most observed anemia profile. The mean value of hemoglobin was 10.5 ± 1 g/dl. Among these women: 32 (74%) presented an iron deficiency, 17 (53%) had inappropriate intakes, and 9 (28%) reported menorrhagia. For 17 (40%) women, unnecessary or inappropriate exams were prescribed. The investigations did not allow to establish a differential diagnosis for 12 women (28%). Even for similar clinical situations, anemia management was variable. Among the women who presented iron deficiency, 15 (47%) were informed about an iron-rich diet and received a daily iron supplementation of ferrous sulfate between 80 mg and 160 mg. CONCLUSIONS: Our study highlights that, in the absence of specific national guidelines for anemia management in non-pregnant, non-menopausal women in primary care settings, French GPs undergo various clinical management strategies leading to a heterogeneous, sometimes inappropriate follow-up. Women with iron deficiency were prescribed higher daily iron supplementation than recommended, according to new evidence, suggesting a maximal daily dose of 50 mg of elementary iron in a context of Hepcidin up-regulation in the case of an iron overload. Additional longitudinal studies with a bigger sample size and randomized controlled trials are needed to confirm our results and to elaborate national guidelines.


Asunto(s)
Anemia Ferropénica/terapia , Compuestos Ferrosos/uso terapéutico , Hematínicos/uso terapéutico , Hierro de la Dieta/uso terapéutico , Pautas de la Práctica en Medicina , Adolescente , Adulto , Anemia/diagnóstico , Anemia/metabolismo , Anemia/terapia , Anemia Ferropénica/diagnóstico , Anemia Ferropénica/etiología , Anemia Ferropénica/metabolismo , Dietoterapia , Manejo de la Enfermedad , Índices de Eritrocitos , Femenino , Ferritinas/sangre , Deficiencia de Ácido Fólico/complicaciones , Francia , Adhesión a Directriz , Hemoglobinas/metabolismo , Humanos , Menorragia/complicaciones , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Premenopausia , Atención Primaria de Salud , Estudios Prospectivos , Deficiencia de Vitamina B 12/complicaciones , Adulto Joven
15.
Sante Publique ; 32(4): 347-358, 2020.
Artículo en Francés | MEDLINE | ID: mdl-33512101

RESUMEN

INTRODUCTION: Social science concepts (intimate distance, personal space) suggest that the gynecological examination environment (GEE) might influence women’s feelings during the exam.Purpose of research: We explore this hypothesis by assessing women’s preferences for the GEE. RESULTS: An opinion poll was conducted, without randomization to explore women’s point of view. In 2017, questionnaires were referred to women by 14 general practitioners in the Lille region. Among 173 answers, 73% granted importance to the medical setting, especially to a comfortable ambiance and an isolated place during an exam (to respect women’s privacy). Women expected at least: a separation of consultation/examination (77%), disposal of sanitary towels (80%), a place to leave clothes and underwear (74%), a changing area (56%). Fifty-five percent judged it unnecessary to cover the lower body. Concerning the examination table: comfort was satisfactory (93%), “calm and peaceful colors” were appreciated, but clamps should be improved. CONCLUSIONS: The GEE is characterized by a balance of natural comfort and a sequentially delimited spatial configuration. The study revealed cultural and subjective dimensions of privacy. Physicians need to apply psychosocial competences to perform a person-centered gynecological exam.


Asunto(s)
Ginecología , Privacidad , Derivación y Consulta , Femenino , Humanos , Consultorios Médicos , Encuestas y Cuestionarios
16.
Drug Alcohol Depend ; 188: 10-15, 2018 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-29727755

RESUMEN

BACKGROUND: In France, buprenorphine is at once the most widely prescribed and the most commonly misused opioid maintenance treatment (OMT). Unlike other medicines, it is seldom prescribed as a generic drug. Several studies have underlined the influence of the patient's representations when choosing brand-name rather than generic forms. We aim to prove a link between these pejorative representations and misuse, a higher degree of addiction and a preference for brand-name products. METHODS: An observational study carried out at 11 sites in France using self-assessment questionnaires filled out in dispensing pharmacies by patients having come to them for buprenorphine delivery. RESULTS: Analysis was based on 806 usable questionnaires. There indeed exists a significant correlation between pejorative representations of OMT by means of buprenorphine, and a higher degree of addiction and misuse (p < .0001 for each). Preference for the brand-name product is correlated with the representation of OMT as a "trap" (p = .020). CONCLUSION: Our results underscore the existence of a link between patients' negative representations of their OMT and their drug-taking behavior. Prescribing physicians should consequently take these representations into account to more precisely identify the relevant behaviors and help their patients to evolve positively.


Asunto(s)
Analgésicos Opioides/administración & dosificación , Conducta Adictiva/epidemiología , Conducta Adictiva/psicología , Buprenorfina/administración & dosificación , Trastornos Relacionados con Opioides/epidemiología , Trastornos Relacionados con Opioides/psicología , Adulto , Conducta Adictiva/tratamiento farmacológico , Estudios Transversales , Femenino , Francia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Tratamiento de Sustitución de Opiáceos/métodos , Tratamiento de Sustitución de Opiáceos/psicología , Trastornos Relacionados con Opioides/tratamiento farmacológico , Encuestas y Cuestionarios
17.
J Womens Health (Larchmt) ; 27(7): 933-938, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29583084

RESUMEN

PURPOSE: Cervical cancer screening reduces the incidence and specific mortality rate of cervical neoplasms. In most cases screening by means of Pap smears is performed in France by gynecologists. The primary objective of this study was to confirm whether the participation rate is increased when general practitioners (GPs) carry out the smears themselves. The secondary objective was to evaluate other independent characteristics of GPs predicting participation rates in women. METHODS: The population of 347 GPs, including their relevant characteristics and their 90,094 female patients eligible for screening over 2 years (2013-2014), was derived from the SIAM claim database of the Flanders Healthcare Insurance Fund (CPAM). A telephone survey among all GPs was carried out to know whether they were performing smears in their surgeries. RESULTS: A total of 343 GPs were included for analysis (98.8% participation rate). The mean cervical cancer screening participation rate over 2 years among all the women in the recommended age group (25-65 years) was 43.3% (±6.9). Bivariate analysis showed that participation rate was higher when the GP performed smears (adjusted difference of mean: 2.06 [95% CI: 0.67-3.45], p = 0.037) and whether the GP was female (2.08 [0.42-3.74], p = 0.0144). After multivariate analysis the only significant characteristic of the GP was the performance of smears (1.71 [0.27-3.16], p = 0.0204). CONCLUSIONS: Cervical smears performed by GPs led to increased screening participation rates within the recommended age group of women. However, the size of this increase is insufficient to reach the expected participation rates.


Asunto(s)
Detección Precoz del Cáncer/estadística & datos numéricos , Médicos Generales/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Prueba de Papanicolaou/estadística & datos numéricos , Neoplasias del Cuello Uterino/diagnóstico , Frotis Vaginal/estadística & datos numéricos , Adulto , Anciano , Estudios Transversales , Femenino , Francia , Humanos , Persona de Mediana Edad , Atención Primaria de Salud , Neoplasias del Cuello Uterino/prevención & control
18.
BMC Res Notes ; 10(1): 723, 2017 Dec 08.
Artículo en Inglés | MEDLINE | ID: mdl-29221494

RESUMEN

OBJECTIVE: Reliable data about general practitioners performing pap-tests are insufficient. A claim code for the achievement of pap-smears exists in France, but its use by general practitioners is not known. The main purpose of this study was to highlight independent factors associated with the achievement of pap-smears by the general practitioner (GP). We carried out a descriptive and analytic epidemiologic study in 347 GPs and their 244,889 patients, registered at the Health Care Insurance Fund of Flanders. The European Deprivation Index (EDI) in the area of GP's surgeries was specified. All GPs were questioned by telephone about their performance of pap-tests. The claim database of the insurance fund was analyzed to describe characteristics of GPs. RESULTS: The answer rate among questioned GPs was 98.8%. Pap-smears were performed in their surgeries by 182 GPs (53.1%). Among males, 45.7% performed pap-smears versus 78.4% of the female (adjusted odds-ratio = 4.5, p < 0.001). The mean rate of screened women in the target population was 44% when GPs were performing smears versus 42% when they were not (adjusted odds-ratio = 1.04, p = 0.03). Only 19.5% of GPs used the claim code. The number of patients, and the EDI were not associated with pap-smears. Trial registration ClinicalTrials.gov NCT02749110 (April 22, 2016).


Asunto(s)
Detección Precoz del Cáncer/estadística & datos numéricos , Médicos Generales/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Prueba de Papanicolaou/estadística & datos numéricos , Neoplasias del Cuello Uterino/diagnóstico , Frotis Vaginal/estadística & datos numéricos , Adulto , Femenino , Francia , Humanos , Persona de Mediana Edad
19.
Sante Publique ; 28(1): 77-82, 2016.
Artículo en Francés | MEDLINE | ID: mdl-27391887

RESUMEN

INTRODUCTION: The search and exchange of digital data via Networks or Internet, especially the web, have become more widely available over recent years. Patients can now find information about their problems. OBJECTIVES: Determine the impact of this information in terms of seeking care. METHODS: Questionnaires were given to adults consulting their doctor. RESULTS: Health Information on the Internet was searched by 69% of patients which prompted 57% of them to consult. Some of them asked for medical imaging, blood tests or another medical advice. Self-medication was reported by 12% of patients, 15% requested a drug from the pharmacist or doctor, and 11% stopped using or requested a change of the drug. DISCUSSION: Access to digital data by patients impacts their access to care at various stages. Knowledge leads to changes in behaviour that resulted in modification of access to care … The use of the Internet and the digital data are by patients is a source of learning about the disease itself and also about its management in their interactions with caregivers. CONCLUSION: These skills could be used by caregivers to empower the patient's autonomy.


Asunto(s)
Acceso a la Información , Información de Salud al Consumidor , Conocimientos, Actitudes y Práctica en Salud , Internet , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Francia , Humanos , Conducta en la Búsqueda de Información , Masculino , Persona de Mediana Edad , Relaciones Médico-Paciente , Encuestas y Cuestionarios , Adulto Joven
20.
Therapie ; 71(3): 329-33, 2016 Jun.
Artículo en Francés | MEDLINE | ID: mdl-27235657

RESUMEN

We posted the Nord-Pas-de-Calais regional pharmacovigilance center website and distributed a survey to its potential users between August 2014 and October 2014 (135 general practitioners, 45 pharmacists, 14 patients). Satisfaction was 7.3±1.6 out of 10 points for the visual aspect, 7.8±1.5 out of 10 points for navigation and 7.6±1.4 out of 10 points for content. The website was declared useful by 98% respondents, particularly for the reporting of adverse drugs reactions (89%).


Asunto(s)
Sistemas de Registro de Reacción Adversa a Medicamentos/normas , Comportamiento del Consumidor/estadística & datos numéricos , Información de Salud al Consumidor/normas , Médicos Generales/estadística & datos numéricos , Internet/normas , Satisfacción del Paciente/estadística & datos numéricos , Farmacéuticos/estadística & datos numéricos , Farmacovigilancia , Adulto , Información de Salud al Consumidor/estadística & datos numéricos , Femenino , Francia , Humanos , Masculino
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA