Partenariat ville-hôpital pour la prise en charge de l'arrêt du tabac : retour d'expérience de 30 médecins généralistes de l'agglomération bordelaise

Abstract : Introduction: general practitioners express some brakes to help stop smoking and do not feel trained enough in this domain. The new health policies have focused many of their prevention measures around the smoking issue. The idea of a city-hospital partnership has emerged as a new way to support patients in their approach, while offering a formative line for the general practitioners, knowing that no such device exists in France. Objectives and method: it was a question of collecting the feedback of general practitioners involved in the partnership, in terms of perceptions (motivation, satisfaction, perceived utility), attitudes (wish to renew this support, feeling of capacity), and practices ( adherence to the course, use of the proposed tools, evolution of practices). We conducted a cross-sectional survey by individual directive interviews, supplemented by a qualitative approach, conducted from January to March 2018 among 30 general practitioners in the Bordeaux agglomeration. Results: general practitioners have been motivated and satisfied by this partnership and wish for the majority to renew it. They felt helped and supported, benefitting from better formation. They were all the more so since their patients managed to maintain abstinence, which was evaluated at 1, 3 and 6 months. The longer the course of care was followed, the more the abstinence was maintained over time. Their practice in helping to stop smoking has been strengthened. Discussion: in the limit of our small sample of study, it appears that this innovative device gives convincing results and could be transposable to a wider population. This is the notion of transferability of interventions, at a time when policies advocate innovation in the health system and the decompartmentalization of the city and hospital. Since smoking is a public health priority, the doctors interviewed raise the question of valuing the tobacco consultation. Conclusion: this partnership appears as a new way of care to offer patients to optimize their chances of reaching the cessation of smoking and its maintenance. It also allows refocusing the general practitioner in the course by fully attributing to him his role as a major player in primary care. The deployment of this method is envisaged in the coming months.
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Master Thesis
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Margaux Fournols. Partenariat ville-hôpital pour la prise en charge de l'arrêt du tabac : retour d'expérience de 30 médecins généralistes de l'agglomération bordelaise. Médecine humaine et pathologie. 2018. ⟨dumas-01970428⟩

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