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Master Thesis

Évolution des consultations des médecins généralistes et modification des contraceptions de leurs patientes suite à la polémique sur les pilules de 3e et 4e générations

Abstract : This study aimed at assessing the consequences of the debate surrounding 3rd and 4th generation oestro-progestogenic pills on first time prescription of a contraceptive by general practitioners, as well as analysing the change they made in contraception method for patients using 3rd and 4th generations. It is an observational study involving 147 general practitioners from Paris, Bordeaux and Angoulême, having themselves included 214 patients under 3rd or 4th oestro-progestogenic contraceptive between August and December 2013. Regarding general practitioners, 10.53% (CI 95%: 5.31 - 15.74) modified their gynaecological practice. Preferential prescription of a 2nd generation pill showed a significant increase (66.42% to 95.49%, p<0,0001) while the preferential prescription rate for 3rd and 4th generation contraceptives decreased (44.03% to 6.02%, p<0.0001). 35.05% (CI 95%: 25.56 - 44.55) of general practitioners stopped prescribing 3rd and 4th generations hormonal contraceptives as a 1st choice (p<0.0001). 65.41% (CI 95%: 57.33 - 73.5) of general practitioners had waived initiating any form of contraception. The rate of practitioners realizing specific first-time prescription consultations for contraceptives went up 3.47%. 17.19% (CI 95%: 10.65 - 23.72) of general practitioners changed the content of their first-time prescription consultation. As for the change in contraception method for 3rd or 4th generation patients, general practitioners advised a different method in 73.91% (CI 95%: 67.93 – 79.89) of cases. Their renewed the on-going prescription in 39.25% of cases (CI 95%: 32.71 – 45.79). After the consultation, 45.79% (CI 95%: 39.12 - 52.47) of patients were prescribed 2nd generation pills. The IUD replaced 3rd or 4th generation contraception in 2.34% of cases. The debate enabled some of the practitioners to acquire new skills; on the contrary, others renounced gynecological practice altogether. Half of the patients using 3rd or 4th generation oestro-progestogenic contraception changed their contraceptive, mostly for 2nd generation pills, but also some substitution in favour of the IUD was observed.
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Master Thesis
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  • HAL Id : dumas-01217345, version 1

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Claire Combasteix. Évolution des consultations des médecins généralistes et modification des contraceptions de leurs patientes suite à la polémique sur les pilules de 3e et 4e générations. Médecine humaine et pathologie. 2014. ⟨dumas-01217345⟩

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