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Author: Stephane Oustric (42)


Dec
2017

General Practitioners (GPs) are the leading antidepressants prescribers in Europe and in France. Difficulties in implementing existing recommendations in daily practice have been described.
The objective of this study was to elaborate two algorithms to guide GPs in the patient management for a first major depressive disorder (MDD) or generalized anxiety disorder (GAD) episode in primary care.

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Dec
2017

The script concordance test (SCT) is a validated method of examining students' clinical reasoning. Medical students' professional skills are assessed during their postgraduate years as they study for a specialist qualification in general practice. However, no specific provision is made for assessing their clinical reasoning during their postgraduate study.

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Aug
2017

To explore representations of the first pelvic examination (PE) among adolescents who had not yet had this examination and to identify their criteria for a positive experience of it.
Qualitative study using semistructured interviews.
Midi-Pyrénées and Auvergne in France.

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Aug
2017

Can Fam Physician 2017 Aug;63(8):e371-e375
Anne Freyens, Mélanie Dejeanne, Elise Fabre, Marie-Eve Rouge-Bugat, Stéphane Oustric

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Jul
2017

In France, most cases of opioid use disorder are treated with buprenorphine by general practitioners in private practice. Using reimbursement data of a representative sample of the French population, Echantillon Généraliste des Bénéficiaires, we investigated mortality during periods when patients were in and out of treatment in a cohort of 713 new users of buprenorphine having a mean (SD) follow-up of 4.5 (1.

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Feb
2017

The progression of frailty is marked by an increased risk of adverse health outcomes in the elderly including falls, physical and/or cognitive disability, hospitalizations, and mortality. In primary care, the general practitioner's (GP's) clinical impression about their elderly patients' frailty state seems to be a key point in identifying frail individuals in their clinical practice. The aim of this article is to examine if GPs' clinical impressions regarding frailty concurs with objective measures of the gold standard frailty phenotype as described by Fried in community-dwelling older persons.

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Jun
2017

The main limitation of adverse drug reactions (ADRs) reporting, particularly by general practitioners (GP), to the regional pharmacovigilance centers is under-reporting. The Midi-Pyrénées Regional Pharmacovigilance Center (South western, France) sets up regular visits by a clinical research assistant (CRA) to GP in order to increase the number of ADR reports. The aim of this pilot study was to assess the effect of regular visits of a CRA in GPs offices on the rate of ADR reporting.

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Dec
2016

This is an addictovigilance report of a pregabalin use disorder case in a young female patient who secondarily presented a tobacco use disorder after smoking initiation combined with pregabalin intake. Pregabalin was first prescribed for anxiety. Concomitant use of pregabalin with tobacco led to a synergic effect of both substances.

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Jan
2017

Aging can be affected by frailty and chronic diseases causing physical, cognitive, sensory, and functional decline evolving gradually to disability. The assessment of older patients is carried out in some geriatric day hospitals (GDHFs). However, it seems difficult to assess all patients in these GDHFs.

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Oct
2016

Cancer care in people over 75 years of age is particularly complex and requires collaboration between oncologists, geriatricians, GPs and other professional and family carers. To improve the care pathways for elderly people living with cancer, the French health authorities have created a network of oncologists and geriatricians; however, GPs experience difficulties in establishing their place in this network.
This study aimed to analyse the impressions of French GPs involved in the care of elderly patients with cancer, including their feelings regarding their relationships with their oncologist and geriatrician colleagues.

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Sep
2016

Many countries are seeking to improve health care delivery by reviewing the roles of health professionals, including nurses. Developing new and more advanced roles for nurses could improve access to care in the face of a limited or diminishing supply of doctors and growing health care demand. The development of new nursing roles varies greatly from country to country.

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Oct
2016

Antipapillomavirus vaccination is used to prevent genital infection by papilloma virus, responsible for a high morbidity. In France, the High Council for Public Health published on September 28th 2012 a new guideline decreasing the age of vaccination from 16 to between 11 to 14 allowing a joint vaccination with mandatory tetravalent or trivalent (against diphtheria, tetanus, pertussis and poliomyelitis Tdap-IPV or Td/IPV booster) vaccination. Our study aimed to assess if this guideline changed the rate of joint vaccinations.

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Dec
1969

The primary care physician (PCP) is central to cancer patients' management. Announcement of the diagnosis is a critical time for patients, even if they wish to be fully informed. The French National Cancer Plan, developed 10 years ago, includes a diagnosis disclosure procedure (DDP) to be used by oncologists, which makes specific provision for a time of communication with PCPs.

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Dec
1969

The objective of this study was to describe the level of knowledge about paracetamol (acetaminophen), ibuprofen, and aspirin of subjects who purchased nonprescription medications containing one of these drugs. We conducted this cross-sectional descriptive study in 42 community pharmacies located in southwestern France between July and November 2013. A six-item self-administered questionnaire was used.

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Apr
2015

An osteoblastoma is an uncommon benign but painful tumor, typically found on the axial skeleton or on long bones in the case of young patients. Some cases of humeral osteoblastomas have been described in literature but not in men older than 30. We report the case of a painless bone tumor on the humerus of a 52-year-old patient.

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Dec
2015

General practitioners (GPs) are more and more involved in the treatment of cancer patients but feel not informed enough about anticancer treatments and associated side effects. Better communication with treatment centers is needed. We hypothesized that information sheets could improve communication.

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Jan
2015

To study the characteristics of off-label prescribing and adverse drug reaction (ADR) occurrence in a sample of pediatric outpatients treated by general practitioners.
A survey on pediatric drug prescribing was implemented in 46 general practices in southwestern France. All consecutive patients aged 0 to 16 years were included.

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Dec
1969

The "nonrefundable" term use leads to the princep's drug dispensing. The aim of our study was to compare the views of its use between general practitioners and community pharmacists.
We conducted a descriptive study with similar questionnaires about "nonfundable" term use.

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Aug
2014

Teaching of medication prescribing is a specific challenge in general practice curriculum. The aim of this study was to identify and rank the competencies required for prescribing medication for general practice residents in France.
Qualitative consensus study using the nominal group technique.

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Mar
2014

In the field of addiction, assessment of psychoactive substance use is a key element. Nevertheless, self-reports and clinical examination underestimate the use of psychoactive substances. The implementation of urine drug screening tests (UDS) should improve this assessment.

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Feb
2014

Recently, baclofen has been widely promoted for treatment of alcohol dependence in France. Our aim was firstly to describe the incidence of patients newly treated with baclofen for alcohol dependence in France from 2007 to 2011, and secondly to describe baclofen prescription patterns and prescribers. A retrospective cohort study of patients newly treated with baclofen was conducted using the "Echantillon Généraliste des Bénéficiaires" database (EGB).

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Feb
2014

To describe opiate substitution treatment (OST) cycles in a five year followed-up cohort of patients initiating OST during 5 years in ambulatory practice.
Data were extracted from Health Insurance System Database from January 1(st) 2005 to December 31(st) 2010 for "Haute Garonne" (South Western France area, 1 million inhabitants). Patients starting OST were included.

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Dec
2012

Fundus photographs using non-mydriatic digital cameras for diabetic retinopathy screening have been studied in France during the past 10 years. Nevertheless, the different screening modalities have not been compared. The main goal of this study was to compare patient recruitment with two different screening modalities, and secondarily to compare diagnostic effectiveness and cost.

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Dec
2012

We aimed to assess the effectiveness of drug tests for treatment retention in outpatients starting opioid substitution therapy. A retrospective cohort was created from the data of the French health insurance system database for the Midi-Pyrenees region. Patients starting opioid substitution treatment (OST) were included and followed for 18 to 30 months.

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Oct
2012

Five to ten percent of cancers are of occupational origin but only 0.5% of cancers are compensable occupational diseases recognized in 2001. The project "Curriculum Laboris" was launched in Midi-Pyrenees with the objective to establish an organization to improve the identification, reporting and recognition of occupational cancers.

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Nov
2012

Non-steroidal anti-inflammatory drugs (NSAIDs) are known to antagonize the effects of antihypertensive drugs, and these associations can lead to an increase in arterial blood pressure. However, the impact of NSAIDs on hypertension treatment management in large-scale populations remains poorly evaluated. We examined whether the introduction of NSAID into the treatment regimen would induce an intensification of hypertension treatment (defined as the introduction of a new antihypertensive drug).

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Dec
1969

In France, opiate-addicted patients are mainly managed by general practitioners (GPs). Because on-site abuse drugs urinary screening tests (ODUTs) are now on the market, we investigated French GPs' knowledge and practices concerning drug tests with a focus on ODUTs. We conducted a descriptive cross-sectional study in ambulatory practice.

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Oct
2011

Possession of drugs at home in the family pharmacy and self-medication are at risk.
Appraisal based upon an analysis of 247 questionnaires completed by patients and 116 questionnaires completed by general practitioners in the French department of Haute Garonne (Southwestern, France).
Two hundred and forty-four patients were involved in the study.

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Oct
2011

Following the announcement of the future withdrawal in Europe of drugs containing dextropropoxyphene-paracetamol (DXP-P), we performed a postal survey in a randomly selected sample of 350 general practitioners (GP) from the Midi-Pyrénées area (2.6 million inhabitants) in order to investigate which drug (s) they are willing to prescribe in anticipation of the announced withdrawal. Most of GP prescribed DXP-P in acute and chronic pain.

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Dec
2010

In French patients over 65 years, drug intake is characterized by polytherapy, causing iatrogenic events. The general practitioner is the main actor in the follow-up and reassessment of drug prescriptions.
To assess the proportion of ASMR V (Amélioration du service medical rendu - additional therapeutic benefit versus current standards) drugs [drugs producing no medical improvement] prescribed to patients over 65 years in the management of a chronic disease.

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Jun
2010

Self-medication is a common practice in France. What is parent's behaviour towards their children? Trying to draw an inventory of this practice, we carried out a survey of self-medication of children under 12 years of age by their parents. The main objective was to assess the frequency of self-medication and the secondary purposes were to describe habits, dangerous behaviours and common mistakes.

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Jun
2010

The management of high blood pressure after 80 years is an issue in general practice. In 2008, the HYVET study supported the benefit and security of antithypertensive therapy in that population. In a preliminary study, we compared the characteristics of hypertensive patients over 80 years seen in daily practice to those included in the HYVET study: is the HYVET message transferable to daily practice?
A transversal study was conducted in 2008.

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Oct
2009

to evaluate the knowledge and the practice of the general practitioners of the French region of Midi Pyrénées evaluation fixing of the total disablement of work (ITT).
inquire of practice by anonymous self-administered questionnaire near 500 drawn general practitioners of the area Midi the Pyrenees to the fate. This questionnaire comprised four parts (profile of the doctor, self-assessment of the occupation as regards drafting of certificate of aggravated assault and fixing of the ITT, questions of theoretical knowledge concerning the ITT, evaluation of knowledge in analysis of clinical situations).

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Oct
2009

Among the irrational factors involved in medical prescribing, few studies have investigated the problem of the 'pressure to prescribe'. The aim of the present work was to quantify this 'pressure to prescribe' and to investigate some potential predisposing factors. Each instance of a patient's behaviour suggesting 'pressure to prescribe' was registered for 599 outpatient general-practice clinics.

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