Understanding the prescription of antidepressants: a Qualitative study among French GPs

<p>Abstract</p> <p>Background</p> <p>One-tenth of France's population is prescribed at least one antidepressant, primarily by General Practitioners. The reasons for this high prescription rate remain unclear. One-third of these prescriptions may not comply with clinical practice guidelines, and 20% are potentially unrelated to any psychiatric condition. Our aim was to explore how GPs declare they use antidepressants in daily practice and understand their reasons for prescribing them.</p> <p>Method</p> <p>Six focus groups including a total of 56 rural and urban GPs, with four interviews were performed. The topic guide focused on reasons for prescribing antidepressants in various primary care situations. Phenomenological analysis was performed by four researchers.</p> <p>Results</p> <p>Antidepressants were seen as useful and not harmful. Personal assessment based on experience and feeling determined the GPs' decisions rather than the use of scales. Twenty-four "non-psychiatric" conditions possibly leading to prescription of antidepressants in primary care were found.</p> <p>Conclusions</p> <p>The GPs reported prescribing antidepressants for a wide range of conditions other than depression. The GPs' decision making process is difficult and complex. They seemed to prefer to focus on their difficulties in diagnosing depression rather than on useless overtreatment. Instead of using the guidelines criteria to detect potential cases of useful prescription, physicians tend to use their own tools based on gut feelings, knowledge of the patient and contextual issues.</p

Parental use of the Internet to seek health information and primary care utilisation for their child: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Using the Internet to seek health information is becoming more common. Its consequences on health care utilisation are hardly known in the general population, in particular among children whose parents seek health information on the Internet. Our objective was to investigate the relationship between parental use of the Internet to seek health information and primary care utilisation for their child.</p> <p>Methods</p> <p>This cross-sectional survey has been carried out in a population of parents of pre-school children in France. The main outcome measure was the self-reported number of primary care consultations for the child, according to parental use of the Internet to seek health information, adjusted for the characteristics of the parents and their child respectively, and parental use of other health information sources.</p> <p>Results</p> <p>A total of 1 068 out of 2 197 questionnaires were returned (response rate of 49%). No association was found between parental use of the Internet to seek health information and the number of consultations within the last 12 months for their child. Variables related to the number of primary care consultations were characteristics of the child (age, medical conditions, homeopathic treatment), parental characteristics (occupation, income, stress level) and consultation of other health information sources (advice from pharmacist, relatives).</p> <p>Conclusion</p> <p>We did not find any relationship between parental use of the Internet to seek health information and primary care utilisation for children. The Internet seems to be used as a supplement to health services rather than as a replacement.</p

Enquete sur le statut vitaminique de trois groupes d'adultes francais. Temoins, obeses, buveurs excessifs

CNRS AR 10534 / INIST-CNRS - Institut de l'Information Scientifique et TechniqueSIGLEFRFranc

Relationships of job and some individual characteristics to occupational injuries in employed people: a community-based study

International audienceThis study assessed the associations of job and some individual factors with occupational injuries among employed people from a general population in north-eastern France; 2,562 workers were randomly selected from the working population. A mailed auto-questionnaire was filled in by each subject. Statistical analysis was performed with loglinear models. The annual incidence rate of at least one occupational injury was 4.45%. Significant contributing factors for occupational injuries were job category (60.8%), sex (16.2%), regular psychotropic drug use (8.5%), age groups (7.5%), and presence of a disease (7.0%). The men had higher risk than the women (adjusted odds-ratio 1.99, 95% CI 1.43-2.78). Compared to executives, intellectual professionals and teachers, labourers had the highest risk (6.40, 3.55-11.52). They were followed by farmers, craftsmen and tradesmen (6.18, 2.86-13.08), technicians (3.14, 1.41-6.70), employees (2.94, 1.59-5.48) and other subjects (3.87, 1.90-7.88). The young (< or = 29 yr) showed an increased risk. Similar odds-ratios were observed for regular psychotropic drug use (1.54, 1.16-2.05) and the presence of a disease (1.50, 1.11-2.02). Univariate analysis showed that smoking habit, overweight and excess alcohol use were also associated with injuries. The loglinear model results showed that there were associations between some of these independent factors. It was concluded that job, sex, young age, smoking habit, excess alcohol use, overweight, psychotropic drug use, and disease influenced the occupational injuries. Preventive measures concerning work conditions, risk assessment and job knowledge should be conducted in overall active population, especially in men, young workers, smokers, alcohol users, overweight workers and in individuals with a disease or psychosomatic disorders