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Master Thesis

Les médecins généralistes d’Île-de-France savent-ils utiliser les dispositifs inhalés qu’ils prescrivent ?

Abstract : Introduction: asthma is a frequent disease, whose treatment has been modified since the 90’s with the expansion of inhaled medication. Those treatment have permitted a reduction in mortality. However, they require a particular technique that is not easy to acquire using only the leaflet provided. As the GINA recommends, the caregiver should educate on the technique at the beginning of treatment and regularly. However, this practice is not yet common. Health professionals’ knowledge on inhaled devices is frequently insufficient. No study has centered their attention on general practitioner’s knowledge even though he has a major role in the patient’s education. The goal of this thesis is to understand if general practitioners of Île-de-France know how to use the inhalers they prescribe. Materials & method: it is a transversal quantitative, descriptive and analytic study centered on general practitioners, practicing in Île-de-France. Individual interviews in presence with each general practitioner were conducted. The interview was divided in two parts: a questionnaire about the doctor’s characteristics, and an evaluation of inhalation devices’ use. To define which inhalation devices were to be evaluated, we offered two clinical cases: a child under six years old and an adult. This way, the general practitioner would propose the treatments he usually prescribes. The evaluation was done with the aid of a checklist that emphasized critical errors as defined by the ADMIT. Overall success, defined as success in taking every inhalation devices used, was the main interest variable.
Results: thirty-seven general practitioners were recruited between July 2018 and July 2019.The general practitioner’s education on inhalation devices was primary due to pharmaceutical representatives. Nineteen general practitioners (51,4%) were able to take each inhaler they prescribed without a single critical error. This overall success was more frequent in general practitioners that had used inhalation devices for personal or familial reasons (OR 7,1 [1.4; 43.8], p=0,008), and GPs prescribing to adults only one type of inhalation device (OR 4,6 ; [0.95 ; 26.95] ; p=0,045). A failure in taking at least one of the inhalation devices tested was strongly associated to the prescription of a metered dose inhaler (OR 21, [2.4;1056.4], p=0,001). Conclusion: half of the GPs interviewed in our study were not able to master the inhalation devices that they usually prescribe. This failure was more common in general practitioners that had never used inhalation devices for personal reasons, and in general practitioners prescribing more than one type of inhalation device for an adult. Nowadays general practitioner’s education on inhalation devices is insufficient. This lack of knowledge is the main obstacle to patient’s education. To better education and observance, it would be interesting to strengthen GP’s institutional education, and to train other healthcare professionals in inhaler’s education.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03462310
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Submitted on : Wednesday, December 1, 2021 - 5:11:52 PM
Last modification on : Thursday, January 6, 2022 - 3:08:41 AM
Long-term archiving on: : Wednesday, March 2, 2022 - 8:01:21 PM

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Arthur Pierre Teixeira. Les médecins généralistes d’Île-de-France savent-ils utiliser les dispositifs inhalés qu’ils prescrivent ?. Médecine humaine et pathologie. 2019. ⟨dumas-03462310⟩

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