État des lieux et propositions d’amélioration de la prise en charge des patients insuffisants cardiaques : étude qualitative auprès des médecins généralistes du bassin grenoblois

Abstract : Introduction: Heart failure is a serious disease with an increasing incidence. Despite the health care offer and the therapeutic tools, day to day patient care remains imperfect. Objective: This work was intended to make an inventory on the management of patients with heart failure by general practitioners in Grenoble area and collect their proposals in order to improve the latter. Method : Qualitative survey ran by semi conducted interviews by focus groups and individual interviews between july 2018 and march 2019 in Grenoble city basin. Results: Twenty one general practitioners were interviewed. There was a diversity of feelings among general practitioners regarding the management of patients with heart failure according to their place of exercise. There have been pitfalls in the communicating with cardiologists, disparities in relations with the ESIC38, difficulties in the management of patient care, unequal training and, lastly, adherence to treatment depending on the patient. The improvements proposed by the general practitioners included improving the liberal/hospital networks communication, the reconciliation of the RESIC38 network via the creation of peripheral antennas, strenghtening interactions between the various actors of proximity to improve the patient care, as well as the development of digital tools. Finally they underlined the importance of continuing therapeutic education efforts for patients by proposing the use of specialized paramedics ressources. Conclusion: The feeling of general practitioners confirms that patient care is not perfect despite the available means. Improving the management of the heart failure patients in general practice requires the optimization of existing ressources and the emergence of new practices.
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Master Thesis
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Marion Sicardy, Noémie Strzalkowski. État des lieux et propositions d’amélioration de la prise en charge des patients insuffisants cardiaques : étude qualitative auprès des médecins généralistes du bassin grenoblois. Médecine humaine et pathologie. 2019. ⟨dumas-02143700⟩

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