Repositionnement du médecin généraliste au centre de la prise en charge des patients sous chimiothérapie orale grâce aux plateformes territoriales d'appui : élaboration d'un nouveau fonctionnement avec Santé Landes pour les patients atteints d’un myélome multiple traité par Lénalidomide-Dexaméthasone

Abstract : The rise of oral chemotherapy (OC) implies an ambulatory shift that requires to redefine the role of the general practitioner (GP). The territorial support platform (TSP) provides a coordination of the town-hospital network and strengthens a local health care focused on the GP. The objective is to create a new system that restores the GPs’ central role in management of patients receiving OC, through the use of the TSP « Santé Landes » and its messaging system « Globule ». Among other things, the project allows GPs to validate the beginning of the chemotherapy cycle. We will assess the effect of this system on the GPs’ role and on the improvement of the coordination of the town-hospital network. A descriptive cross-sectional study was performed between 6 September and 6 November 2018 with 10 patients on antimyeloma therapy by Lenalidomide/Dexamethason who are follow at Mont-de-Marsan hospital, and with their respective GP. To answer our questionnaire, GPs sent an email, patients were called. Two GPs who didn’t use Globule, refused to be part of the project. Out of 8 GPs who agreed to participate, 7 responded to the questionnaire. All GPs feel reintegrated into the management of patients under OC and find that coordination, transmission of information and access to the specialist are improved. Eight patient’s questionnaire were completed. 87.5% (n=7) believed that communication and collaboration between their GP and the hematologist had been improved and that getting the medical approval to begin the cycle was simplified. Finally, 24 medical agreements were given : 7 cycles were validated during a planned hematological consultation (29.2%), and 17 via Globule (70.8%) including 7 validation by GPs (41.2%) and 10 by the hematologist (58.8%). The project seems to have reinstated the GPs’ role into the management of the patients under OC. Both GPs and patients think that the coordination of the town-hospital network was improved.
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Master Thesis
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Marion Rougier. Repositionnement du médecin généraliste au centre de la prise en charge des patients sous chimiothérapie orale grâce aux plateformes territoriales d'appui : élaboration d'un nouveau fonctionnement avec Santé Landes pour les patients atteints d’un myélome multiple traité par Lénalidomide-Dexaméthasone. Médecine humaine et pathologie. 2018. ⟨dumas-01964255⟩

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