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Attitudes des médecins généralistes face aux prescriptions chroniques de benzodiazépines : étude qualitative par entretiens semi-dirigés auprès de 13 médecins généralistes

Year: 2015
Type: dissertation
Abstract: Introduction : Benzodiazepines are widely prescribed in France and often prescribed long-term inappropriately, especially in the elderly, despite their many side effects. We aimed to explore the attitudes of general practitioners on chronic benzodiazepine prescriptions they renew in their daily practice in the context of anxiety and insomnia. Method : Qualitative study by semi-structured interviews between November 2014 and March 2015 with 13 GPs working in the Haute Savoie and Isère and settled for at least one year. Results: In our study, doctors seemed aware of the adverse effects of benzodiazepines.They said they wanted to prevent long term use, regularly review the prescriptions and try to educate the patient to adverse events. Many obstacles related to physician practice conditions (lack of time) and the patient (dependance, attachment to treatment) limited the possibilities for changing the treatment. These difficulties were greater in the elderly: doctors sometimes resigned and abandoned withdrawal attempts. When treatment was well tolerated, the risk of causing a withdrawal syndrome was sometimes perceived as superior to the benefit of stopping benzodiazepines. When treatment should be renewed, the doctor preferred to help the patient to face his difficulties by showing empathy and thus maintain a good relationship with the patient. Conclusion: It seems necessary to improve the training of physicians to psychotropic drugs prescribing, promote access to cognitive behavioral therapy and involvement of general practitioners in the development and evaluation of withdrawal protocols.
Source: HAL
Language: French
Field: Medicine
Open Access status: green
OpenAlex ID: W1642711900
Cites: 22
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Related to: 10