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Master Thesis

Accès aux soins cardio-vasculaires à Marie-Galante et perspectives de la Télémédecine : enquête auprès des médecins généralistes et des patients à risque cardio-vasculaire

Abstract : INTRODUCTION: Cardiovascular diseases are the leading cause of death in Guadeloupe and represent a major public health issue. The situation is more worrying in Marie-Galante with excess cardiovascular mortality. The objective of this study was to make an inventory of the cardiological care of cardiovascular patients in Marie-Galante. MATERIAL AND METHOD: An observational cross-sectional survey was conducted among general practitioners and patients with cardiovascular risk. RESULTS: Our sample was composed mainly of women, with a median age of 64 years, 44% of non-graduates, 16% of CMU beneficiaries and 11% of patients without complementary health. 86% of the patients were hypertensive, 41% were diabetic and 13% had 3 cardiovascular risk factors. 44% were over weight. 13% of patients said they never consult doctors in continental Guadeloupe and 8% have already refused to go for treatment. 85% of patients had already consulted a cardiologist, 22% were followed annually and 44% rarely. Follow-up was not optimal since only 35% of patients at high cardiovascular risk were followed annually. 15% of the patients consulted their cardiologist in Marie-Galante. Most of the other patients consulted in Guadeloupe in a private practice and 10% consulted a cardiologist in metropolitan France. The time to obtain a cardiological consultation was greater than 3 months for 44% of the sample. 65% of Marie-Galante’s patients felt difficulties in accessing care and 84% considered this situation as an inequality. Physicians, for their part, felt they were going beyond their competence in the management of cardiovascular diseases and risk factors and would like better communication with cardiologists. CONCLUSION: Dual insularity and limited care provision are the main barriers to access care. The lengthy consultation periods and the physical, financial and organizational constraints related to displacement are all factors that may hinder the use of care for Marie-Galante's patients, or even a renunciation of care. Telemedicine is an important means of improving access to care: cardiological teleconsultation with tele-echocardiography would allow better care closer to the patient's home and help break the isolation of health professionals.
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Master Thesis
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Laura Yacoub-Venutolo. Accès aux soins cardio-vasculaires à Marie-Galante et perspectives de la Télémédecine : enquête auprès des médecins généralistes et des patients à risque cardio-vasculaire. Médecine humaine et pathologie. 2019. ⟨dumas-02983454⟩



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