Titre : | Barriers and facilitators to the involvement of general practitioners in the prescription of buprenorphine (2024) |
Auteurs : | L. T. GIMENEZ ; D. L. BONIS ; M. MOREL ; A. PALMARO ; L. DASSIEU ; J. DUPOUY |
Type de document : | Article : Périodique |
Dans : | Journal of Substance Use and Addiction Treatment (Vol.156, January 2024) |
Article en page(s) : | art. 209182 |
Langues: | Anglais |
Discipline : | TRA (Traitement et prise en charge / Treatment and care) |
Mots-clés : |
Thésaurus géographique FRANCEThésaurus mots-clés TRAITEMENT DE MAINTENANCE ; BUPRENORPHINE ; MEDECIN GENERALISTE ; PRESCRIPTION MEDICALE ; SOINS DE PREMIER RECOURS ; ETUDE QUALITATIVE ; PRATIQUE PROFESSIONNELLE ; REPRESENTATION SOCIALE |
Résumé : |
Introduction: France has one of the highest opioid agonist treatment (OAT) coverage rates in the world. French general practitioners (GPs) are providing the majority of prescriptions. However, a fall in the number of GPs initiating buprenorphine has been observed over the last decade.
Methods: The objective of this study was to explore the obstacles and facilitators to the involvement of GPs in the prescription of buprenorphine. A qualitative study comprising 14 individual interviews and a focus group bringing together 5 GPs was conducted among GPs based in France between June 2021 and March 2022. We performed data analysis using a grounded theory methodology. Results: The interviews showed a great diversity in the level of involvement of GPs, depending on their experience, their representations of patients with OUD, their mode of exercise, and their personal preferences. The negative representations of the patients associated with the feeling of physical and ethical endangerment, the feeling of powerlessness, the fear of a disruption of the practice and the feeling of incompetence appeared at the forefront of the difficulties stated. Conversely, the strengthening of initial training and the facilitation of access to self-training tools and multidisciplinarity, the consideration of opioid use disorder (OUD) as a chronic illness with the application of a patient-centered motivational approach, as well as the defining and respecting one's own limits when prescribing buprenorphine seem to be the keys to a balanced and fulfilling practice. Conclusion: Raising awareness of the frequency of OUD appeared to be an additional lever to enhance the interest of the GPs concerned. Additional studies focusing on the evolution of professional practices would be necessary to extend these findings. |
Domaine : | Autres substances / Other substances |
Affiliation : |
Département Universitaire de Médecine Générale, Université de Toulouse, Faculté de Médecine, Toulouse, France MSPU La Providence, Toulouse, France CERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Canada MSPU de Pins Justaret, Pins Justaret, France |
Lien : | https://doi.org/10.1016/j.josat.2023.209182 |
Accueil