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Master Thesis

Collaboration médecins généralistes et psychiatres : cas particulier du syndrome métabolique sous antipsychotiques atypiques

Abstract : The prescription of atypical antipsychotics (AAP) is becoming a more and more common habit, given the extension of the indication and the tolerance of the molecules. The arisen of side effects under atypical antipsychotics, and specifically the appearance of a metabolic syndrome is widely admitted today, leading the AFSSAPS to publish recommendations for the follow up of patients treated by AAP. Our objective was to do an inventory on the team work between general practitioners (GP) and psychiatrists in this specific situation, as well as an evaluation of the supervision of the patients treated by AAP; the knowledge of the recommendation by the doctors of these two specialties and to elaborate propositions to improve the collaboration. In order to accomplish this task, we have done a questionnaire intended to general practitioners and psychiatrists who practice in ambulatory in Grenoble (Data collected via the Yellow Pages). We have received 76 answers among the 244 contacted doctors (28 from the psychiatrist and 46 from the general practitioners) based on which we have done statistical analyses. Besides, we have contacted the CRAM of Lyon, who have provided us with the requested information in term of numbers of prescriptions for 4 AAP for the first half-year / semester of 2011. The most relevant results of our study confirm that, most of the time, the collaboration isn't fully satisfactory between GPs and psychiatrists, which leads to a under-achievement medical supervision of the patients (even though it is well known by doctors that the metabolic side effect are very common). There is an important difference between the statements done by the GP in the questionnaire, who declare issuing fewer prescriptions than shown in the CRAM results. The solutions proposed are often simple and realistic, such as communication over the phone between GPs and psychiatrists, introducing ourselves at the time of settlement, multidisciplinary meetings... all of these mentioned solutions are methods that already exist but which are currently not used to their full potential. There is a significant difference between GPs (41%) and psychiatrists (93%) about the knowledge of the recommendations of AFSSAPS. In this two specialties, a real need of working together appears, as well as an acknowledge of the contribution of each one, who just request to set up. The called reasons were: the lack of time, the difference of opinion.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00666961
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Submitted on : Monday, February 6, 2012 - 3:40:25 PM
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  • HAL Id : dumas-00666961, version 1

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Mathilde Simand, Claire Windey. Collaboration médecins généralistes et psychiatres : cas particulier du syndrome métabolique sous antipsychotiques atypiques. Médecine humaine et pathologie. 2012. ⟨dumas-00666961⟩

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