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Master Thesis

Activité physique pour la santé : état des lieux de la prescription par les médecins généralistes du Pays Basque depuis la loi de modernisation du système de santé

Abstract : Introduction: physical activity is a drug-free therapy that has proved to be effective with numerous chronic pathologies in secondary prevention. Since March 1st 2017, the legislative decree following the Fourneyron amendment allows the referring physician to prescribe a physical activity that is adapted to the patient’s pathology, physical capacities and medical risk. Aims: examining the state of the prescriptions of Adapted Physical Activity by the general practitioners of the Basque Country, by assessing the impact of the government measures implemented recently, as well as of the local initiatives to develop the health aspects of sports in the Basque region. Method: conducting a quantitative, descriptive, cross-sectional survey from a questionnaire distributed and hand-delivered to 311 general practitioners who are present in the ten Basque agglomeration communities between February 7th and March 13th 2019. The replies to the questionnaire were sent back by post. Salaried physicians and practitioners whom primary care is not the main activity were excluded from the survey. Results: 167 general practitioners sent the questionnaire back, which represents a response rate of 53.7%. Among them, 80.8% were aware of the 2016 law, but it did not change or changed only a little bit the prescribing behaviors of 79.6% of them. Besides, 83.8% of the respondents believe that a structure that coordinates prescribers and players of the health-sport sector helps them prescribe; 55.1% are aware of the existing structure in the Basque Country: Côte Basque Sport Santé. The prescription of physical activity is linked in a statistically significant way to the awareness of the existence of CBSS. This structure significantly promotes prescription. The prescription modes which are the most frequently used are simple oral advice (91%), referral to a structure that provides APA (54.5%), or performance of motivational interviewing (28.1%). Restraints for prescription are the lack of training (55.1%) and the difficulties referring the patients to a suitable structure (43.7%). The incentives to prescription are providing better information regarding the places offering APA (86.2%), educating about prescribing (68.9%), coverage of the costs of APA (67.1%). Conclusion: general practitioners in the Basque Country prescribe health-promoting physical activity using the local PA coordinating bodies. Expansion of these structures in the rural areas can be considered. The health system modernization law is known, but it has not modified the prescription habits since the implementation of the decree. Better training and promotion of the structures providing APA need to be improved.
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Master Thesis
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Pierre Lecarpentier. Activité physique pour la santé : état des lieux de la prescription par les médecins généralistes du Pays Basque depuis la loi de modernisation du système de santé. Médecine humaine et pathologie. 2019. ⟨dumas-02513321⟩

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