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Master Thesis

Prescription du zolpidem sur une ordonnance sécurisée : regards des médecins généralistes d’Aquitaine sur leurs pratiques de prescription depuis la nouvelle réglementation

Abstract : Introduction: insomnia affects 15 to 20% of French population. France ranks second among European countries, in terms of consumption of hypnotic benzodiazepines. General practitioners are the first prescribers of benzodiazepine hypnotics in insomnia. A new regulation regarding Zolpidem in France, launched in April 2017, consists of a prescription only on security paper. Our study aims at studying general practitioners’ views on their prescribing practices since this regulation. Method: for this qualitative study by semi-directed interviews, 14 general practitioners in Aquitaine were interviewed in order to obtain data saturation. Results: according to the physicians interviewed, this regulation allowed them to better inform their patients about side effects of zolpidem. On the other hand, it may have resulted in a shift to another molecule: zopiclone. Zolpidem may be less chosen for the first prescription. The withdrawal of chronic and elderly users remains difficult for doctors. Discussion: the new regulation did not facilitate the “deprescription” of zolpidem. Offlabel prescriptions and prescriptions without consultation persists. It enlightens the need to train physicians on non-drug therapies. Conclusion: according to the doctors, zolpidem's prescription on security paper may have resulted in decreasing its use in first prescription. On the other hand, taking care of chronic users remains difficult and needs a multidisciplinary care.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02441450
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Élodie Bortolin. Prescription du zolpidem sur une ordonnance sécurisée : regards des médecins généralistes d’Aquitaine sur leurs pratiques de prescription depuis la nouvelle réglementation. Médecine humaine et pathologie. 2019. ⟨dumas-02441450⟩

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