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Master Thesis

L'effet blouse blanche en médecine générale : étude nationale à partir d’une vignette clinique

Abstract : Introduction: the white coat effect (WCE) is defined as the presence of high blood pressure (BP) in the medical setting and normal outpatient BP, its prevalence is estimated at 10-15% of the general population. Objectives: to study WCE with French general practitioners (GPs) and apprehend its management in general medicine. Methods: a questionnaire sent by e-mail between October 2017 and March 2018, to 4057 GPs by the county councils of the order of doctors. The theme was the management of arterial hypertension (HTA) in general practice. Part 1 referred to a typical clinical case of hypertension and related issues. The 2nd more specifically dealt with the WCE and the last sociodemographic data. Results: among the 335 GPs included, 52% responded to hypertension and 48% to WCH in the first part of the clinical vignette. In the 2nd after ambulatory measurement of the BP and conclusion to a WCE, GPs did not start treatment. They treated this patient in the same way regardless of her overall cardiovascular risk, and mostly saw her between 3 and 6 months. A majority of GPs were women (52.5%), the average age was 41 years, exercising equally in rural or urban areas (58.2% vs. 41.8%), in a mono-disciplinary group (38,5%). 59.4% had academic activities, 51.6% thought that there were no recommendations regarding the management of WCE. Conclusion: the use of this clinical vignette has shown that the recommendations for the management of WCE are still too little known and applied. There is a need to improve continuing medical education and educate patients.
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Master Thesis
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Submitted on : Thursday, October 17, 2019 - 5:29:13 PM
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Geoffrey Rendu. L'effet blouse blanche en médecine générale : étude nationale à partir d’une vignette clinique. Médecine humaine et pathologie. 2019. ⟨dumas-02319208⟩

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