RPIB « Benzos » : impact de la proposition de formation en ligne des médecins généralistes sur leurs prescriptions et leurs perceptions de la prise en charge du trouble de l’usage des benzodiazépines

Abstract : The different studies dealing with the problem of benzodiazepines (BZD) misuse highlight the difficulty of applying guidelines in terms of BZD prescriptions in general practice. Physicians’ conditions of practice, the health system organization, as well as patients and doctors’ representations can explain it. The objective of our study is to evaluate the impact of an online tutorial proposal on the prescription of benzodiazepines by general practitioners. Two groups have been compared in this observational study: a 100-physician group from Gironde who have been introduced to the online tutorial by a delegate and a second group of 1435 physicians who have not. They were matched on the age, sex and installation medium. The evolution of the prescriptions of BZD (anxiolytics and hypnotics), in total number of boxes given by the CPAM, was observed between a period before the visit (November 2016-April 2017) and a period after (November 2017-April 2018). The CPAM provided the data. GP’s changes in opinions and practices after the online tutorial training offer were analyzed, as well as if they were satisfied by the tutorial. Our results show that prescribers in the "intervention" group prescribed fewer boxes (339) than the comparison group (406, i.e. +19.8 %) before the tutorial was made available. There was an increase in the average number of boxes prescribed by the prescribers of the "intervention" group after this one (382 b/p versus 339 b/p i.e. +12.7 %), remaining lower than in the non-introduced group, while we can notice a stability of prescriptions in the comparison group (407 b/p versus 406 b/p i.e. +0.2 %). The results show a positive but modest, non-significant impact of the SBIRT training on the perceptions of GPs. Difficulties related to the patient seem to remain the main problem encountered by general practitioners, whether in terms of patient demand or refusal to reduce existing consumption. Reminding hygienic-dietary rules proves to be the most important contribution of the tutorial as alternatives to prescriptions. SBIRT offers a simplified mechanism for routine screening, with short-term intervention. It provides information on the existence of validated alternatives for use disorders that can be implemented in primary care, and resources to obtain specialized care if needed.
Keywords : SBIRT Benzodiazepines
Document type :
Master Thesis
Complete list of metadatas

Cited literature [116 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-02101471
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Tuesday, April 16, 2019 - 5:17:37 PM
Last modification on : Saturday, June 29, 2019 - 1:25:08 AM

File

Med_generale_2019_Bosseboeuf.p...
Files produced by the author(s)

Identifiers

  • HAL Id : dumas-02101471, version 1

Collections

Citation

Guillaume Bosseboeuf. RPIB « Benzos » : impact de la proposition de formation en ligne des médecins généralistes sur leurs prescriptions et leurs perceptions de la prise en charge du trouble de l’usage des benzodiazépines. Médecine humaine et pathologie. 2019. ⟨dumas-02101471⟩

Share

Metrics

Record views

7

Files downloads

8