Le rôle du médecin généraliste dans la prise en charge diagnostique et thérapeutique des maladies inflammatoires chroniques de l'intestin

Abstract : Introduction: Evolving by flares, Chronic Inflammatory Bowel Diseases (IBD), including Rectocolitis Hemorrhagic (RCH) and Crohn's Disease (CD). They affect more than 200,000 people in France. The main objective of this study is to better understand the role of the general practitioner in the management of these complex pathologies: attitude and feeling towards the diagnostic and therapeutic management of patients, communication with gastroenterologist specialists and the hospital. The study also focused on understanding the difficulties encountered daily by general practitioners (GP). Method: Survey of opinions and practices in general medicine based on a standardized questionnaire, sent by email to general practitioners practicing in the department of Bouches-du-Rhône, carried out between October 16 and December 29, 2017. Results: 61 general practitioners were included (22% response rate), with an average age of 50 years. A predominance of male physicians (56%), both freelance (90%) and group practice (70%) participated in the study. While all of these doctors emphasized the central role they play in the different stages of care, they did not necessarily feel comfortable with the diagnostic and / or therapeutic management. On the other hand, doctors with complementary training in the area of IBD have generally found themselves more comfortable. Conclusion: Complex pathologies, IBD require the use of specific exams and therapeutics evolving regularly. GPs do not seem to be familiar with this exercise, declaring themselves uncomfortable in the overall care of these patients. Still playing a crucial role in terms of primary care, the general practitioner must be able to rely on a multidisciplinary network in order to remain the coordinator of the care pathway.
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Stéphanie Becamel. Le rôle du médecin généraliste dans la prise en charge diagnostique et thérapeutique des maladies inflammatoires chroniques de l'intestin. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02045572⟩

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