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Master Thesis

La déprescription : les patients sont-ils prêts ? Analyse du vécu et du ressenti des patients à qui le médecin généraliste propose une déprescription

Abstract : Context: Several studies have shown that doctors consider their patients to be a hindrance to deprescribing. We gathered the patients perspective, never before addressed in this issue of public health, to identify solutions to facilitate its implementation. Method and Results: A qualitative study, consisting of semi-directive interviews of 28 polymedicated patients who were grouped according to their reaction to deprescribing. The majority of patients agreed to deprescribing, seeking autonomy and responsibility. Older patients, dependent, isolated and anxious, refused deprescribing, considering it too risky and without benefit. The barriers to the acceptance and implementation of deprescribing were fear of: drugs and pathologies, poorly understood by the patients; losing a possible therapeutic benefit; withdrawal syndrome and the recurrence of symptoms; the required effort and the lack of support; breach of trust with their physician. The solutions proposed by both patients and doctors to deprescribe drugs were similar. To become involved, the patient needs to be educated and made aware of his responsibilities. He must be helped to free himself of his medication and non-pharmacological alternatives must be proposed. The general practitioner, better trained, must dare to remove drugs. A “customized deprescribing plan” for all polymedicated patients needs to be created, coordinating all healthcare providers and relatives. Conclusion: Deprescribing is a difficult process even when it is agreed to by the patient. The solutions proposed aim at overcoming the barriers identified, but they necessitate the implementation of concrete public health measures.
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Master Thesis
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  • HAL Id : dumas-01474734, version 1

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Marine Guilluy Crest. La déprescription : les patients sont-ils prêts ? Analyse du vécu et du ressenti des patients à qui le médecin généraliste propose une déprescription. Médecine humaine et pathologie. 2012. ⟨dumas-01474734⟩

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