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Master Thesis

Utilisation des corticoïdes par voie générale en unités de soins palliatifs : enquête réalisée auprès des médecins, en France en 2014

Abstract : Introduction: Corticoids are widely prescribed in cancer research, but also in therapeutic palliative medicine. However, the level of evidence of their efficiency remains weak for some indications. There are no precise recommendations regarding their use in advanced palliative situations. The goal of the study is to describe the current systemic use of corticosteroids, by French medical doctors, in palliative care units. Method: A declarative and descriptive study was conducted, from July to September 2014, on the basis of a questionnaire, sent twice, by e-mail, to the medical doctors of the 122 French metropolitan palliative care units. The objective was to observe their use of corticoids: indications, contraindications, prescription modalities, therapeutic effects, adverse effects, and means of monitoring of the corticosteroid therapy. Results: 63 doctors from 49 palliative care units out of 122 answered. 63.5% of doctors prescribe a corticoid for at least 1 patient out of 2 and 95.2% do not use a protocol. The three main indications (MA or recommended) justifying a prescription of corticoid are: cerebral edema of tumoral nature, bowel obstruction and abdomino-pelvic compression. Most of the doctors retain neither arterial hypertension nor diabetes as a contraindication. Methylprednisolone and prednisolone are the two molecules most usually used, mainly orally. Steroid-induced diabetes, insomnia and arterial hypertension are the three adverse effects most often reported. Conclusion: The modalities of use of corticoids by French medical doctors from palliative care units are often similar and aligned with the existing recommendations, even if there are of low level of evidence. Differences of practice exist. Recommendations with a higher level of evidence would allow optimizing the prescription of corticoids in palliative care units.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01188730
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Submitted on : Monday, August 31, 2015 - 2:24:32 PM
Last modification on : Wednesday, August 23, 2017 - 4:33:56 PM
Long-term archiving on: : Tuesday, December 1, 2015 - 10:30:27 AM

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Adeline Lejeune. Utilisation des corticoïdes par voie générale en unités de soins palliatifs : enquête réalisée auprès des médecins, en France en 2014. Médecine humaine et pathologie. 2015. ⟨dumas-01188730⟩

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