Abstract
BackgroundIn Switzerland, general practitioners (GPs) manage most of the patients receiving methadone maintenance treatment (MMT).MethodsUsing a cross-sectional postal survey of GPs who treat MMT patients and GPs who do not, we studied the difficulties encountered in the out-patient management of drug-addicted patients. We sent a questionnaire to every GP with MMT patients (556) in the French-speaking part of Switzerland (1,757,000 inhabitants). We sent another shorter questionnaire to primary care physicians without MMT patients living in the Swiss Canton of Vaud.ResultsThe response rate was 63.3%. The highest methadone dose given by GPs to MMT patients averaged 120.4 mg/day. When asked about help they would like to be given, GPs with MMT patients primarily mentioned the importance of receiving adequate fees for the care they provide. Secondly, they mentioned the importance of better training, better knowledge of psychiatric pathologies, and discussion groups on practical cases. GPs without MMT patients refuse to treat these patients mostly for emotional and relational reasons.ConclusionGPs encounter financial, relational and emotional difficulties with MMT patients. They desire better fees for services and better training.
Highlights
In Switzerland, general practitioners (GPs) manage most of the patients receiving methadone maintenance treatment (MMT)
We received replies from 231 (63%) of the targeted 365 primary care physicians without MMT patients (PWT: practitioners without MMT patients)
Of the PWTs, 88.7% did not treat MMT patients because they refused to accept them into their practice
Summary
In Switzerland, general practitioners (GPs) manage most of the patients receiving methadone maintenance treatment (MMT). Providing care in an officebased practice is feasible [1,2] and produces outcomes comparable to those from specialist treatment [1,3,4,5,6,7]. It reduces the stigma associated with the diagnosis and treatment of substance abuse and increases the amount of attention paid to medical and psychiatric conditions [3,4].
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