Collaboration entre médecins et pharmaciens pour le suivi des patients sous buprénorphine haut dosage: Pratiques des médecins prescripteurs

Abstract

This paper examines the collaboration between general practitioners (GPs) and pharmacists in the outpatient management of patients on high-dosage buprenorphine (HDB) treatment.A telephone survey of a sample of HDB prescribers in southeastern France questioned them about their knowledge, practices, and opinions about HDB treatment in October 2002; data from the national health insurance fund and the national statistics institute completed the study. Logistic regression was used to investigate factors associated with collaboration with pharmacists. GPs' practices were compared to assess their correlation, if any, with this collaboration.345 GPs participated in the study. Only 54% reported collaborating with dispensing pharmacists in managing patients on HDB, despite official guidelines encouraging it. Collaboration was independently related to training in addiction treatment, a favorable opinion of maintenance treatment by GPs, long experience in HDB prescription, and participation in a specialized medical network.Implementation of recommendations on physician-pharmacist collaboration requires additional training in addiction medicine for GPs and the encouragement of their participation in medical networks. On the other hand, increasing the constraints on GPs may negatively affect patients' access to care.