Comparaison de l’évolution de patients usagers et dépendants aux opiacés substitués par un traitement par Buprénorphine haut dosage initié et suivi en médecine générale ou en centre spécialisé

Abstract : Background and purpose: our main objective was to compare the evolution of BHD-substituted drug patients initiated and followed either in general medicine or in addiction center. Methods: a comparative epidemiological study of the exposed/unexposed type was carried out on a historical cohort. The exposure factor studied was the method of monitoring: initiation of treatment by BHD and followed either by a general practitioner of the network Béarn and Soule, or by a doctor of the addiction center Béarn Addiction of Pau with comparison of the profile of patients and then to become After five years of follow-up. Results: 14 patients were included in the Addiction center group and 15 patients were included in the general medicine group. At the time of the TSO initiation, patient profiles were similar in the 2 groups, except for intra-venous consumption and somatic disorders that were more common in general medicine. After 5 years of treatment, the relapse rate (47% mg, 7% Addiction Center, p = 0.04) and the misuse rate (33% mg, 14% Addiction Center, p = 0.01) were higher in general medicine than in the specialized centre. There was more general state improvement in patients followed in general medicine (40% MG, 14% Addiction Center, p = 0.01). The fate of patients after 5 years of treatment was similar for the evolution of housing, environment, employment and co-consumption regardless of the mode of follow-up. Conclusion: although our results show a superiority of addiction center management on relapse and misuse rates, the management of general medicine is effective in improving the overall condition of patients.
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Master Thesis
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Anne Grintchenko Bigourdan. Comparaison de l’évolution de patients usagers et dépendants aux opiacés substitués par un traitement par Buprénorphine haut dosage initié et suivi en médecine générale ou en centre spécialisé. Médecine humaine et pathologie. 2018. ⟨dumas-02061783⟩

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