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Master Thesis

Médicaments de substitution aux opiacés : quelles perceptions ont les médecins généralistes des objectifs et de la durée de ces traitements ?

Abstract : Opioid dependence is one of the major public health issues. Two substitution drugs, methadone and buprenorphine, were introduced in the 1990s. They have revolutionized the management of opioid-dependent patients. The objective of this study was to assess the general practitioners' perception of the objectives and duration of these treatments. Material and method : qualitative study by semi-directed interviews with reasoned sampling until data saturation. The survey was carried out using a thematic analysis with tools from the anchored theory. Results : eleven interviews were conducted. Six thematic codes have been established. There was a major breakthrough in terms of the management of opioid-dependent patients, complex and individualized care, the socio-professional dimension and the place of the general practitioner. The main objective of opioid substitution treatment was opioid withdrawal. The effectiveness of methadone and HDB was recognized by general practitioners, in terms of opioid withdrawal and socio-professional reintegration. The management of patients was complex because of their vulnerabilities and the lack of consensus on the duration of treatment. Conclusion: MSO have proved their worth in the eyes of general practitioners. For optimal management, medical evolution cannot be separated from that of patients’ socio-professional and family variables. As a result, the management of these patients reflects the skills required of the general practitioner. New consensus on the management of patients on MSO cannot therefore be reached independently of him, since they must strengthen his involvement to ensure the sustainability of ambulatory care in the future.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02405200
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Yvain Lelièvre. Médicaments de substitution aux opiacés : quelles perceptions ont les médecins généralistes des objectifs et de la durée de ces traitements ?. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02405200⟩

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