François Carbonnel

Management of Current Psychiatric Disorders A French Family Physician Experience. A Qualitative Study

Objective: Describe and analyse the experience of family physicians in managing current psychiatric disorders to obtain a better understanding of the underlying reasons of under-detection and inadequate prescribing identified in studies. Methods: A qualitative study using in-depth interviews. Sample of 15 practicing family physicians, recruited by telephone from a precedent cohort (Sesame1) with a maximum variation: sex, age, single or group practice, urban or rural. Qualitative method is inspired by the completed grounded theory of a verbatim semiopragmatic analysis from 2 experts in this approach. Results: Family physicians found that current psychiatric disorders were related to psychological symptoms in reaction to life events. Their role was to make patients aware of a psychiatric symptom rather than establish a diagnosis. Their management responsibility was considered in contrasting ways: it was claimed or endured. They defined their position as facilitating compliance to psychiatrist consultations, while assuring a complementary psychotherapeutic approach. Prescribing medication was not a priority for them. Conclusions: The identified under-detection is essentially due to inherent frontline conditions and complexity of clinical forms. The family physician role, facilitating compliance to psychiatrist consultations while assuring a support psychotherapy is the main result of this study. More studies should be conducted to define more accurately the clinical reality, management and course of current psychiatric disorders in primary care.

Motrial, le premier méta-moteur de recherche des études cliniques sur les interventions non médicamenteuses (INM)

The number of clinical trial publications assessing non-pharmacological intervention (NPI) has been increasing exponentially since 2000. It encourages researchers to carry out the systematic reviews and meta-analyzes expected by health professionals, patients, and decision-makers to learn about their real effectiveness and their relevant indication. However, the diversification of medical and scientific communication media, opportunistic publishing strategies, missing data in publications and non-exhaustiveness of biomedical databases make bibliographic research complex and at risk of bias. To address this shortcoming, the academic Plateforme CEPS offers a search engine, called Motrial, that collects, sorts and organizes publications of NPI clinical trials.

La Plateforme CEPS : Une structure universitaire de réflexion sur l’évaluation des interventions non médicamenteuses (INM)

Les Interventions Non Medicamenteuses (INM) sont devenues des solutions incontournables pour ameliorer la qualite de vie et la sante. Elles presentent dans certains cas un impact positif sur la duree de vie et des benefices sociaux et economiques. Leur usage augmente sans cesse. Une plateforme universitaire collaborative basee a Montpellier, la Plateforme CEPS, reflechit aux manieres de les evaluer. Cet article presente plus en detail ses activites.

Vécu et adaptation des médecins généralistes face à la crise sanitaire sur les pilules de 3 e et 4 e génération

En 2012 suite a la plainte d’une patiente les medias relataient au grand public le sur-risque thromboembolique des pilules dites de troisieme et quatrieme generation, alors largement prescrites. Cette crise a eu un impact considerable sur les habitudes contraceptives des Francaises. Par ailleurs les medecins generalistes etaient en premiere ligne pour repondre aux interrogations legitimes de leurs patientes. Nous avons realise une etude qualitative aupres de 11 medecins generalistes installes dans l’Herault pour tenter de decrire leur vecu de cet evenement et la maniere dont ils l’ont gere et evaluer son impact sur les pratiques et les differents acteurs.

Pour un modèle consensuel de validation clinique et de surveillance des interventions non médicamenteuses (INM)

Introduction: More and more non-pharmacological interventions (NPIs) are prescribed by doctors for patients with chronic disease, as additional or alternative paths to conventional treatments. Some are recommended by other professionals. The offer of NPIs extends every day especially in the areas of nutrition, e-health and psychological adjustment to the disease. The aim of this work was to verify if there was a consensus model or dominant clinical validation and surveillance of these solutions as is the case for the drug and medical devices. Material and method: We conducted a literature review on the validation and surveillance models of NPIs. DOI : 10.4267/2042/61405 Th ér ap ie s co m p lé m en ta ir es p er so n n al is ée s