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Buono N, Sassier B, Thulesius H, Hoffman R, Nabbe P, Petek D, Le Reste JY. Translation of the working alliance inventory short revised into Italian using a Delphi procedure and a forward-backward translation. Front Med (Lausanne) 2024; 10:1236273. [PMID: 38274448 PMCID: PMC10808585 DOI: 10.3389/fmed.2023.1236273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 12/11/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Enhancing treatment adherence, especially for chronic diseases, can be achieved through therapeutic alliance, potentially elevating the quality of care. An instrument to evaluate the therapeutic alliance could be beneficial in routine clinical settings, educational environments, and extensive research efforts at national and European levels. In this study, we translated therapist and patient versions of the Working Alliance Inventory Short Revised (WAI-SR) into Italian. Methodology An email-based Delphi method was employed for the English-to-Italian translation, incorporating a forward-backward process. The initial translation team comprised two Italian family physicians proficient in English, a linguist, and a psychiatrist. The forward translation was then reviewed by 18 Italian family physicians through a Delphi process and was subjected to a backward translation by two Italian English teachers. A cultural correspondence was subsequently identified to adjust translations within a national and international framework. Results All 18 experts fully engaged in the Delphi process, and consensus was achieved by the second Delphi round. A cultural check checked for discrepancies regarding linguistic consistency with other translations and found no difference. Conclusion This Italian translation of the WAI-SR is expected to support Italian family physicians aiming to enhance their clinical practice and therapeutic outcomes. It could also be a valuable tool for Italian medical students to foster therapeutic relationships and improve their communication skills.
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Affiliation(s)
- Nicola Buono
- National Society of Medical Education in General Practice (SNAMID), Caserta, Italy
| | - Béatrice Sassier
- ERA 7479, Departement de Mèdecine Generale, SPURBO Universite de Bretagne Occidentale, Brest, France
| | - Hans Thulesius
- Department of Clinical Sciences in Malmö, Centre for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Robert Hoffman
- Department of Family Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Patrice Nabbe
- ERA 7479, Departement de Mèdecine Generale, SPURBO Universite de Bretagne Occidentale, Brest, France
| | - Davorina Petek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Jean Yves Le Reste
- ERA 7479, Departement de Mèdecine Generale, SPURBO Universite de Bretagne Occidentale, Brest, France
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Leroux PA, Dissaux N, Le Reste JY, Bronsard G, Lavenne-Collot N. Association between Hpa Axis Functioning and Mental Health in Maltreated Children and Adolescents: A Systematic Literature Review. Children (Basel) 2023; 10:1344. [PMID: 37628343 PMCID: PMC10453675 DOI: 10.3390/children10081344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Previous studies have demonstrated that children who experience maltreatment show a more elevated risk of psychopathological disorders than children from the general population. The HPA (hypothalamic-pituitary-adrenal) axis is not mature at birth and undergoes strong social regulation during the first years of life. Consequently, early exposure to stress could modify the usual adaptative response to stress. In stressful situations, perturbations in both cortisol response and cortisol circadian rhythm have been observed. Nevertheless, studies that have evaluated the links between child abuse, dysregulation of the HPA axis, and mental disorders have shown diverse results. Because of the variety of methods employed in the different studies, no formal comparisons have been made. In this systematic review, we have brought together these results. METHODS We conducted a systematic review of studies analyzing the correlation between child abuse, mental disorders, and HPA axis activity in patients aged between 6 and 16 years. PubMed, Scopus, Cochrane, and Google Scholar were searched using relevant keywords and inclusion/exclusion criteria (from 2000 to 2020). RESULTS Fifteen studies from the 351 identified were included. Most patients were children in the child welfare system. Children who had experienced child abuse presented with more severe mental disorders (particularly in the dimensional measure) than children who had not been abused. HPA axis activity was assessed by measuring basal cortisol for some studies and cortisol reactivity for other studies. For children experiencing child abuse, there was a possible association between abuse and a decrease in the reactivity of the HPA axis. In addition, early life stress could be associated with lower matinal cortisol. However, the association between mental disorders and cortisol secretion in maltreated children did not seem obvious. CONCLUSIONS This systematic review demonstrates that mental disorders are more frequent and severe in cases where child abuse has occurred. Moreover, children who experienced child abuse seem to present changes in the reactivity of the HPA axis. Nevertheless, the potential correlation between these changes in the reactivity of the HPA axis and mental disorders in this population needs to be evaluated in further studies.
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Affiliation(s)
- Pierre-Antoine Leroux
- Service de Psychiatrie de l’Enfant et de l’Adolescent, CHRU, 29200 Brest, France
- Faculté de Médecine, Université de Bretagne Occidentale, 29200 Brest, France
| | - Nolwenn Dissaux
- Service de Psychiatrie de l’Enfant et de l’Adolescent, CHRU, 29200 Brest, France
- Faculté de Médecine, Université de Bretagne Occidentale, 29200 Brest, France
| | | | - Guillaume Bronsard
- Service de Psychiatrie de l’Enfant et de l’Adolescent, CHRU, 29200 Brest, France
- Faculté de Médecine, Université de Bretagne Occidentale, 29200 Brest, France
- EA 7479, 29200 Brest, France
- Département de Sciences Humaines et Sociales, EA 3279 (CEReSS, AMU), 29200 Brest, France
| | - Nathalie Lavenne-Collot
- Service de Psychiatrie de l’Enfant et de l’Adolescent, CHRU, 29200 Brest, France
- Faculté de Médecine, Université de Bretagne Occidentale, 29200 Brest, France
- Laboratoire du Traitement de l’Information Médicale, Inserm U1101, 29200 Brest, France
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Rodríguez-Barragán M, Fernández-San-Martín MI, Clavería A, Le Reste JY, Nabbe P, Motrico E, Gómez-Gómez I, Peguero-Rodríguez E. Measuring depression in Primary Health Care in Spain: Psychometric properties and diagnostic accuracy of HSCL-5 and HSCL-10. Front Med (Lausanne) 2023; 9:1014340. [PMID: 36698836 PMCID: PMC9869680 DOI: 10.3389/fmed.2022.1014340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
Background Depression has a high prevalence among European countries. Several instruments have been designed to assess its symptoms in different populations. The Hopkins Symptom Checklist 25 (HSCL-25) scale has been identified as valid, reproducible, effective, and easy to use. There are short versions of this scale that could be useful in Primary Care (PC) settings, but their psychometric properties are unknown. Aim To assess in PC patients the psychometric properties and diagnostic accuracy of the Spanish version of the HSCL-10 and the HSCL-5 consisting of 10 and 5 items, respectively. Methods A multicenter, cross-sectional study was carried out at six PC centers in Spain. The HSCL-25 was administered to outpatients aged 45-75 who also participated in the structured Composite International Diagnostic Interview (CIDI). HSCL-10 and HSCL-5 were assessed and compared to HSCL-25 regarding total score correlation, internal consistency, and criterion validity against the gold-standard CIDI. This is a methodological study from a secondary data analysis and the primary data has been previously published. Results Out of 790 patients, 767 completed the HSCL-25 and 736 the CIDI interview (96.0%). Cronbach's Alpha was 0.84 for HSCL-10 and 0.77 for HSCL-5. The known-group method and confirmatory factor analysis were acceptable for the establishment of construct validity. Sensitivity was 79.7% (CI95%, 67.7-88.0%) for HSCL-10, and 78.0% (CI95%, 65.9-86.6%) for HSCL-5, whereas specificity was 83% (CI95%, 80.0-85.7%) for HSCL-10, and 72.8% (CI95%, 69.3-76.0%) for HSCL-5. Area under the curve against CIDI was 0.88 (CI95%, 0.84-0.92%) for HSCL-10, and 0.85 (CI95%, 0.81-0.89%) for HSCL-5. Optimum cutoff point calculated with Youden Index was 1.90 for the HSCL-10 and 1.80 for the HSCL-5. Conclusion HSCL-10 and HSCL-5 are reliable and valid tools to detect depression symptoms and can be used in PC settings.
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Affiliation(s)
- María Rodríguez-Barragán
- Primary Health Centre La Mina, Gerència Territorial d’Atenció Primària de Barcelona, Institut Català de la Salut, Sant Adrià de Besòs, Barcelona, Spain,Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain,Faculty of Medicine, Department of Pediatrics, Obstetrics, Gynecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Isabel Fernández-San-Martín
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain,Gerència Territorial d’Atenció Primària de Barcelona, Institut Català de la Salut, Barcelona, Spain
| | - Ana Clavería
- I-Saúde Group, South Galicia Health Research Institute [IISGS-Servicio Gallego de Salud (SERGAS)], Vigo, Spain,Vigo Health Area, Servicio Gallego de Salud (SERGAS), Vigo, Spain,Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), Vigo, Spain,*Correspondence: Ana Clavería,
| | - Jean Yves Le Reste
- Department of General Practice, ER 7479 SPURBO Soins Primaires, Santé Publique, Registre des Cancers de Bretagne Occidentale, Université de Bretagne Occidentale, Brest, France
| | - Patrice Nabbe
- Department of General Practice, ER 7479 SPURBO Soins Primaires, Santé Publique, Registre des Cancers de Bretagne Occidentale, Université de Bretagne Occidentale, Brest, France
| | - Emma Motrico
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), Vigo, Spain,Department of Psychology, Universidad Loyola, Andalucía, Spain
| | - Irene Gómez-Gómez
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), Vigo, Spain,Department of Psychology, Universidad Loyola, Andalucía, Spain
| | - Eva Peguero-Rodríguez
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain,Primary Health Centre El Castell, Gerència Territorial d’Atenció Primària Metropolitana Sud, Institut Català de la Salut, Castelldefels, Barcelona, Spain,Departamento de Ciencias Clinicas, Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain
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Pautrat M, Tenot M, Le Reste JY, Lebeau JP. French Innovation to Improve the Publication Rate of Primary Care Studies. Fam Med 2022; 54:239. [DOI: 10.22454/fammed.2022.935143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Maxime Pautrat
- Department of General Practice, University of Tours, Tours, France
| | - Melissa Tenot
- Department of General Practice, University of Tours, Tours, France
| | - Jean Yves Le Reste
- Department of General Practice, University of Western Brittany, Brest, France
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Aujoulat P, Le Goff D, Dany A, Robaskiewick M, Nousbaum JB, Derrienic J, Cariou M, Guillou M, Le Reste JY. Improvement of participation rate in colorectal cancer (CRC) screening by training general practitioners in motivational interviewing (AmDepCCR). Trials 2022; 23:144. [PMID: 35164836 PMCID: PMC8842548 DOI: 10.1186/s13063-022-06056-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 01/27/2022] [Indexed: 11/22/2022] Open
Abstract
Background Colorectal cancer (CRC) is the second leading cause of cancer death in France (17,712 annual deaths). However, this cancer is preventable in the majority of cases by the early detection of adenomas. In France, the organized screening for CRC relies on general practitioners (GPs). The tests delivered by the GPs are carried out in 89% of cases. However, GPs do not systematically offer the test, because of time management and communication. Methods AmDepCCR is a cluster randomized trial. Patients are prospectively included by their GPs. The study is designed in 2 phases for the GPs: first, GPs who have never participated in motivational interviewing (MI) training will be recruited then randomly split in 2 groups. Secondly, a 6-day motivational interviewing training will be carried out for the intervention group. Then, patients will be included in both groups during a period of 1 year. The primary outcome will be the number of CRC screenings achieved in each group and its difference. The secondary outcome will be the reluctance to screening and the patient’s self-estimated life expectancy at 0, 6, 12, and 24 months using the Health Belief Model (HBM). Discussion This study will help to know if GPs motivational interviewing is useful to improve organized CRC screening. In addition, it may help to improve communication between patients and GPs. GPs will be able to improve their practice in other fields of application through motivational interviewing (other screenings, addictions…). Trial registration 2019-A01776-51 NCT04492215. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06056-8.
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Le Goff D, Barais M, Perraud G, Derriennic J, Aujoulat P, Guillou-Landreat M, Le Reste JY. Innovative cardiovascular primary prevention population-based strategies: a 2-year hybrid type 1 implementation randomised control trial (RCT) which evaluates behavioural change conducted by community champions compared with brief advice only from the SPICES project (scaling-up packages of interventions for cardiovascular disease prevention in selected sites in Europe and sub-Saharan Africa). BMC Public Health 2021; 21:1422. [PMID: 34281516 PMCID: PMC8287807 DOI: 10.1186/s12889-021-11443-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/01/2021] [Indexed: 11/22/2022] Open
Abstract
Background Cardiovascular diseases (CVD) caused 17.9 million deaths worldwide in 2016, being the world’s leading cause of death. Prevention of CVD in high-income countries is expensive and fails to reach the population at risk. In low-income countries, it is under-developed. The SPICES project implements a community-based program to improve CVD prevention in 3 European countries and 2 Sub-Saharan countries, based on using community champions to effect behavioural changes. In France, the project operates in “Pays Centre Ouest Bretagne” (COB) which is the Central West Brittany area, and a vulnerable, rural setting. The aim of this study is to assess this innovative prevention strategy versus brief advice. Methods A two-step RCT hybrid type 1 implementation study will first of all screen a population using the Non-Laboratory INTERHEART Score (NL-IHRS) and will involve health-care students at public events in the COB area until 1000 participants have been recruited. Second, a RCT will be carried out. The research team will contact each participant with an intermediate NL-IHRS in order to include them. Participants will be over 18 years of age and work or live in the COB area. Participants will be equally randomised in two groups. The intervention group will receive brief advice plus behavioural change guidance carried out by community champions. The control group will receive brief advice only. The main objective for the RCT is to assess a difference of at least 15% in the NL-IHRS between the two groups after 24 months. The primary outcome will be analysed with intention to treat. Secondary outcomes for the RCT will be assessed using validated questionnaires: the WHOQOL-BREF, the DASH Q questionnaire, the IPAQ-short; smoking level will be assessed according to the NL-IHRS scoring system; a modified self-declared alcohol consumption questionnaire has been developed and gauges will be used to assess BMI. The implementation strategy will use mixed methods: qualitative research methods and quantitative epidemiological studies. Discussion A difference in the mean NL-IHRS of 15% will provide an argument in favour of reorganising prevention policies. A substantial change would favour relocating primary prevention from healthcare professionals to lay people and the community. Trial registration Clinical Trials NCT03886064 - the study was recorded on ClinicalTrials.gov, the 22nd of March 2019.
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Affiliation(s)
- Delphine Le Goff
- EA 7479 SPURBO, Department of general practice, University of Western Brittany, Brest, France.
| | - Marie Barais
- EA 7479 SPURBO, Department of general practice, University of Western Brittany, Brest, France
| | - Gabriel Perraud
- EA 7479 SPURBO, Department of general practice, University of Western Brittany, Brest, France
| | - Jeremy Derriennic
- EA 7479 SPURBO, Department of general practice, University of Western Brittany, Brest, France
| | - Paul Aujoulat
- EA 7479 SPURBO, Department of general practice, University of Western Brittany, Brest, France
| | | | - Jean Yves Le Reste
- EA 7479 SPURBO, Department of general practice, University of Western Brittany, Brest, France
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Guillou Landreat M, Baillot M, Le Goff D, Le Reste JY. Acute pain management among patients with opioid maintenance therapy: specificities and difficulties identified in primary care: a qualitative study. BMJ Open 2021; 11:e044433. [PMID: 33468504 PMCID: PMC7817820 DOI: 10.1136/bmjopen-2020-044433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES In the last 30 years, opioid maintenance treatment prescription (OMT) has changed patients' and also changed physicians' practices. General practitioners (GPs) have to deal with patients on OMT who are in acute pain. The objective of this qualitative study was to explore medical care challenges and solutions identified by GPs in the management of acute pain among patients receiving OMT. DESIGN AND SETTING Qualitative study with semistructured interviews were used as a data collection technique with a sampling strategy using a snowball sampling method to obtain a purposive sample of practicing GPs. Analysis was undertaken using a thematic analysis method. PARTICIPANTS Twelve GPs, working in France (Brittany) who prescribe OMT were interviewed. RESULTS The thematic analysis resulted in two main themes relating to specificities and difficulties identified: (1) Medical care and training challenges identified by GPs treating patients on OMT with acute pain, with four subthemes : management of these situations not concerning primary care, lack of training prompts GPs to rely on peer and specialist support, lack of guidelines and conflicting recommendations between clinicians in different settings (2) linked to the patient-GP relationship, with six subthemes: Implementing an individualised centred approach, acute pain management during OMT relies on a relationship based on trust, GPs found difficulties in evaluating and treating pain, difficulties in care adherence, fear of patients destabilisation, fear of misuse and diversion. CONCLUSION The complexity of acute pain and OMT entails significant challenges for clinicians and patients. In primary care, it is hard to achieve a balance between pain relief and opioid use disorder treatment, in a global patient-centred approach. Fear of misuse or diversion was not a important factor, except for patients not known to the practitioners, but GPs were concerned with the risks of patient destabilisation in situations of acute pain.
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Affiliation(s)
- Morgane Guillou Landreat
- EA SPURBO, Universite de Bretagne Occidentale, Brest, France
- addictologie, CHRU de Brest, Brest, France
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Nabbe P, Le Reste JY, Guillou-Landreat M, Assenova R, Kasuba Lazic D, Czachowski S, Stojanović-Špehar S, Hasanagic M, Lingner H, Clavería A, Rodríguez-Barragán M, Sowinska A, Argyriadou S, Lygidakis C, Le Floch B, Montier T, Van Marwijk H, Van Royen P. Nine Forward-Backward Translations of the Hopkins Symptom Checklist-25 With Cultural Checks. Front Psychiatry 2021; 12:688154. [PMID: 34475830 PMCID: PMC8406698 DOI: 10.3389/fpsyt.2021.688154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/07/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The Hopkins Symptom Checklist-25 (HSCL-25) is an effective, reliable, and ergonomic tool that can be used for depression diagnosis and monitoring in daily practice. To allow its broad use by family practice physicians (FPs), it was translated from English into nine European languages (Greek, Polish, Bulgarian, Croatian, Catalan, Galician, Spanish, Italian, and French) and the translation homogeneity was confirmed. This study describes this process. Methods: First, two translators (an academic translator and an FP researcher) were recruited for the forward translation (FT). A panel of English-speaking FPs that included at least 15 experts (researchers, teachers, and practitioners) was organized in each country to finalize the FT using a Delphi procedure. Results: One or two Delphi procedure rounds were sufficient for each translation. Then, a different translator, who did not know the original version of the HSCL-25, performed a backward translation in English. An expert panel of linguists compared the two English versions. Differences were listed and a multicultural consensus group determined whether they were due to linguistic problems or to cultural differences. All versions underwent cultural check. Conclusion: All nine translations were finalized without altering the original meaning.
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Affiliation(s)
- Patrice Nabbe
- Department of General Practice, EA 7479 Soins primaires, Santé publique, Registre des cancers de Bretagne Occidentale, Université de Bretagne Occidentale, Brest, France
| | - Jean Yves Le Reste
- Department of General Practice, EA 7479 Soins primaires, Santé publique, Registre des cancers de Bretagne Occidentale, Université de Bretagne Occidentale, Brest, France
| | - Morgane Guillou-Landreat
- Department of Addictology, EA 7479 Soins primaires, Santé publique, Registre des cancers de Bretagne Occidentale, Université de Bretagne Occidentale, Brest, France
| | - Radost Assenova
- Department of Urology and General Medicine, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Djurdjica Kasuba Lazic
- Department of Family Medicine "Andrija Stampar, " School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Slawomir Czachowski
- Department of Clinical Psychology and Neuropsychology, Nicolaus Copernicus University, Torun, Poland
| | - Stanislava Stojanović-Špehar
- Department of Family Medicine "Andrija Stampar, " School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Melida Hasanagic
- Health Care Studies, University "Djemal Bijedic, " Mostar, Bosnia and Herzegovina
| | - Heidrun Lingner
- Centre for Public Health and Healthcare, Hannover Medical School, Hanover, Germany
| | - Ana Clavería
- Xerencia Xestión Integrada de Vigo, Servizo Galego de Saúde, Instituto de Investigación Sanitaria Galicia-Sur, Red de Investigación en Actividades Preventivas y de Promoción de la Salud, Vigo, Spain
| | - María Rodríguez-Barragán
- Centro de Atención Primaria La Mina, Gerencia Territorial de Atención Primaria de Barcelona, Instituto Catalán de la Salud, Sant Adrià de Besòs, Barcelona, Spain.,Fundación Instituto Universitario de Investigación en Atención Primaria de Salud Jordi Gol i Gurina (IDIAP Jordi Gol), Barcelona, Spain.,Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Agnieszka Sowinska
- Department of Experimental Linguistics, Nicolaus Copernicus University, Torun, Poland.,Escuela de Inglés, Universidad Catolica del Norte, Antofagasta, Chile
| | - Stella Argyriadou
- The Greek Association of General Practitioners (ELEGEIA), Thessaloniki, Greece
| | - Charileos Lygidakis
- Department of Behavioral and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Bernard Le Floch
- Department of General Practice, EA 7479 Soins primaires, Santé publique, Registre des cancers de Bretagne Occidentale, Université de Bretagne Occidentale, Brest, France
| | - Tristan Montier
- INSERM, Etablissement Français du Sang, UMR 1078, Génétique, Génomique Fonctionnelle et biotechnologies, Univ Brest, Brest, France.,Service de Génétique Médicale et Biologie de la Reproduction, CHRU de Brest, Brest, France
| | - Harm Van Marwijk
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Brighton, United Kingdom
| | - Paul Van Royen
- INSERM, Etablissement Français du Sang, UMR 1078, Génétique, Génomique Fonctionnelle et biotechnologies, Univ Brest, Brest, France.,Department of Family Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Guillou Landreat M, Beauvais C, Grall Bronnec M, Le Goff D, Le Reste JY, Lever D, Dany A, Gallopel Morvan K. Alcohol use disorders, beverage preferences and the influence of alcohol marketing: a preliminary study. Subst Abuse Treat Prev Policy 2020; 15:90. [PMID: 33256798 PMCID: PMC7706018 DOI: 10.1186/s13011-020-00329-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 11/15/2020] [Indexed: 11/10/2022]
Abstract
Background Alcohol Use Disorders (AUD) are among the most prevalent mental disorders in the world. They are the leading risk factor for premature mortality and disability among 15 to 49-year-olds. Links between alcohol marketing and patterns of alcohol consumption are well defined in adolescents but there is few data on the impact of alcohol marketing on a population of drinkers with an AUD and seeking treatment. This study was designed in collaboration among researchers specialising in addictive disorders, in social marketing and primary care. Methods This was a monocentric, cross-sectional, descriptive study. The main objective of this study was to define the type of marketing identified by drinkers with an AUD who were seeking treatment and their beverage preferences. Drinkers aged 18+ with an AUD and seeking treatment were included. A descriptive analysis and a logistic regression were carried out . Results N = 91 patients were included, 73.6% were male, the average age was 46.2 years. 72% said they were not influenced by alcohol marketing, but 76% recalled an alcohol advertisement in the last 6 months. The most frequently reported beverage preferences were wine (39.6%), standard beers (29.6%), spirits (27.5%) and strong beers (16.5%). Conclusions Patients with AUD, defined as vulnerable, reported exposure to alcohol marketing but did not seem to identify it consciously. Marketing influences differed according to beverage preferences. These results need to be confirmed by a larger study. Supplementary Information The online version contains supplementary material available at 10.1186/s13011-020-00329-8.
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Affiliation(s)
- Morgane Guillou Landreat
- EA SPURBO 7479, Université de Bretagne Occidentale, Addictologie de liaison , Pole 3 , 1 étage, Hôpital de la Cavale Blanche , Bld Tanguy Prigent, 29200, Brest, France. .,UMR 1246 SPHERE, University of Nantes / Tours, Tours, France. .,HUGOPSY NETWORK, Rennes, France.
| | | | - Marie Grall Bronnec
- UMR 1246 SPHERE, University of Nantes / Tours, Tours, France.,HUGOPSY NETWORK, Rennes, France.,CHU Nantes, Addictology and Psychiatry Department, Nantes, France
| | - Delphine Le Goff
- EA SPURBO 7479, Université de Bretagne Occidentale, Addictologie de liaison , Pole 3 , 1 étage, Hôpital de la Cavale Blanche , Bld Tanguy Prigent, 29200, Brest, France
| | - Jean Yves Le Reste
- EA SPURBO 7479, Université de Bretagne Occidentale, Addictologie de liaison , Pole 3 , 1 étage, Hôpital de la Cavale Blanche , Bld Tanguy Prigent, 29200, Brest, France
| | - Delphine Lever
- MD, CHRU BREST, Addictology Unit CHRU BREST, Brest, France
| | - Antoine Dany
- EA SPURBO 7479, Université de Bretagne Occidentale, Addictologie de liaison , Pole 3 , 1 étage, Hôpital de la Cavale Blanche , Bld Tanguy Prigent, 29200, Brest, France
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10
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Petrazzuoli F, Vinker S, Palmqvist S, Midlöv P, Lepeleire JD, Pirani A, Frese T, Buono N, Ahrensberg J, Asenova R, Boreu QF, Peker GC, Collins C, Hanževački M, Hoffmann K, Iftode C, Koskela TH, Kurpas D, Reste JYL, Lichtwarck B, Petek D, Schrans D, Soler JK, Streit S, Tatsioni A, Torzsa P, Unalan PC, van Marwijk H, Thulesius H. Unburdening dementia - a basic social process grounded theory based on a primary care physician survey from 25 countries. Scand J Prim Health Care 2020; 38:253-264. [PMID: 32720874 PMCID: PMC7470166 DOI: 10.1080/02813432.2020.1794166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE To explore dementia management from a primary care physician perspective. DESIGN One-page seven-item multiple choice questionnaire; free text space for every item; final narrative question of a dementia case story. Inductive explorative grounded theory analysis. Derived results in cluster analyses. Appropriateness of dementia drugs assessed by tertiary care specialist. SETTING Twenty-five European General Practice Research Network member countries. SUBJECTS Four hundred and forty-five key informant primary care physician respondents of which 106 presented 155 case stories. MAIN OUTCOME MEASURES Processes and typologies of dementia management. Proportion of case stories with drug treatment and treatment according to guidelines. RESULTS Unburdening dementia - a basic social process - explained physicians' dementia management according to a grounded theory analysis using both qualitative and quantitative data. Unburdening starts with Recognizing the dementia burden by Burden Identification and Burden Assessment followed by Burden Relief. Drugs to relieve the dementia burden were reported for 130 of 155 patients; acetylcholinesterase inhibitors or memantine treatment in 89 of 155 patients - 60% appropriate according to guidelines and 40% outside of guidelines. More Central and Northern primary care physicians were allowed to prescribe, and more were engaged in dementia management than Eastern and Mediterranean physicians according to cluster analyses. Physicians typically identified and assessed the dementia burden and then tried to relieve it, commonly by drug prescriptions, but also by community health and home help services, mentioned in more than half of the case stories. CONCLUSIONS Primary care physician dementia management was explained by an Unburdening process with the goal to relieve the dementia burden, mainly by drugs often prescribed outside of guideline indications. Implications: Unique data about dementia management by European primary care physicians to inform appropriate stakeholders. Key points Dementia as a syndrome of cognitive and functional decline and behavioural and psychological symptoms causes a tremendous burden on patients, their families, and society. •We found that a basic social process of Unburdening dementia explained dementia management according to case stories and survey comments from primary care physicians in 25 countries. •First, Burden Recognition by Identification and Assessment and then Burden Relief - often by drugs. •Prescribing physicians repeatedly broadened guideline indications for dementia drugs. The more physicians were allowed to prescribe dementia drugs, the more they were responsible for the dementia work-up. Our study provides unique data about dementia management in European primary care for the benefit of national and international stakeholders.
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Affiliation(s)
- Ferdinando Petrazzuoli
- Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
- CONTACT Ferdinando Petrazzuoli Center for Primary Health Care Research, Clinical Research Center, Lund University, Box 50332, Malmö202 13, Sweden
| | - Shlomo Vinker
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University, Sweden
| | - Patrik Midlöv
- Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Jan De Lepeleire
- Department of Public Health and Primary Care, General Practice, University of Leuven, Leuven, Belgium
| | - Alessandro Pirani
- Family and Nursing Home Practice – Memory Clinic, Alzheimer’s Association “Francesco Mazzucca” Onlus, Ferrara, Italy
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Nicola Buono
- SNAMID (National Society of Medical Education in General Practice), Caserta, Italy
| | - Jette Ahrensberg
- Research Center for Emergency Medicine, Aarhus University, Aarhus, Denmark
| | - Radost Asenova
- Department of Urology and General Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Quintí Foguet Boreu
- Institut Universitari d’Investigació en Atenció Primària- IDIAP Jordi Gol, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Gülsen Ceyhun Peker
- Department of Family Medicine, Ankara University School of Medicine, Ankara, Turkey
| | | | | | - Kathryn Hoffmann
- Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | | | | | - Donata Kurpas
- Family Medicine Department, Wroclaw Medical University, Wroclaw, Poland
| | - Jean Yves Le Reste
- EA 7479 SPURBO. Department of General Practice, Université de Bretagne Occidentale, Brest, France
| | - Bjørn Lichtwarck
- The Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Davorina Petek
- Department of Family medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Diego Schrans
- Department of Family Medicine and Primary, Health Care Ghent University, Ghent, Belgium
| | | | - Sven Streit
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Athina Tatsioni
- Department of Internal Medicine, General Medicine, Faculty of Medicine, University of Ioannina School of Health Sciences, Ioannina, Greece
| | - Péter Torzsa
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Pemra C. Unalan
- Department of Family Medicine, Marmara University Medical Faculty, Istanbul, Turkey
| | | | - Hans Thulesius
- Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
- Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
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11
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Guillou-Landreat M, Dany A, Le Reste JY, Le Goff D, Benyamina A, Grall-Bronnec M, Gallopel-Morvan K. Impact of alcohol marketing on drinkers with Alcohol use disorders seeking treatment: a mixed-method study protocol. BMC Public Health 2020; 20:467. [PMID: 32264848 PMCID: PMC7140499 DOI: 10.1186/s12889-020-08543-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/18/2020] [Indexed: 12/21/2022] Open
Abstract
Background The marketing of alcohol influences patterns of alcohol consumption. Existing studies have focused, for the most part, on adolescents and the links between exposure to marketing and alcohol initiation. In France, the Evin law, a French exception, was set up in 1991 with the aim of regulating this exposure to marketing, but since 2009 it has been severely compromised. Alcohol consumption causes severe damage, which may be seenfrom 1 standard unit per day and mostly among adults who are regular users of alcohol. In this at-risk population, studies analysing the impact of marketing are sparse. The specific objectives include (i) the evaluation of the perception of alcohol marketing by patients with an AUD (ii) gaining understanding of the links between alcohol marketing and patients with AUD behaviours (iii) the development of alcohol demarketing strategy in patients receiving AUD coaching. Methods Our main objective isto evaluate the impact of marketing on a population with an AUD. The methodology was in 4 steps: step 1 is a pre-test (N = 100) selecting type of alcohol consumed and type of marketing stimuli identified by patients aged 18 + with an AUD. Step 2 is a qualitative study (N = 20), with in-depth interview, to understand links between alcohol marketing and patients with AUD behaviours. Step 3 is a quantitative study(N = 600) to confirm these links and the impact of alcohol marketing on patients with AUD behaviours. Step 4 is an interventional step, including and testing the impact of demarketing intervention on patients with AUD while using the results of the three first steps (N = 120). Discussion This study will contribute to a better definition of the impact of alcohol marketing on patients with AUD and will enable identification of the determinants of this impact. These data will inform the development of interventions that take into account demarketingstrategies on patients under AUD management. Trial registration The Trial registrationregistration number is NCT03876132, and it was registered on the 15th march 2019.
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Affiliation(s)
- Morgane Guillou-Landreat
- Addictive disorders Unit, CHU Brest, Brest, France. .,EA 7479 SPURBO, University of Brest, Brest, France. .,HUGOPSY network, Brest, France.
| | - Antoine Dany
- EA 7479 SPURBO, University of Brest, Brest, France
| | | | | | | | - Marie Grall-Bronnec
- HUGOPSY network, Brest, France.,Addictive Medicine and Psychiatry Department, CHU Nantes, Nantes, France.,INSERM UMR 1246, SPHERE, Methods in Patient-Centered Outcomes and Health Research, Nantes and Tours University, Nantes, France
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12
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Nahar P, van Marwijk H, Gibson L, Musinguzi G, Anthierens S, Ford E, Bremner SA, Bowyer M, Le Reste JY, Sodi T, Bastiaens H. A protocol paper: community engagement interventions for cardiovascular disease prevention in socially disadvantaged populations in the UK: an implementation research study. Glob Health Res Policy 2020; 5:12. [PMID: 32190745 PMCID: PMC7068925 DOI: 10.1186/s41256-020-0131-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 01/05/2020] [Indexed: 12/27/2022] Open
Abstract
Background Cardiovascular disorders (CVD) are the single greatest cause of mortality worldwide. In the UK, the National Health Service (NHS) has launched an initiative of health checks over and above current care to tackle CVD. However, the uptake of Health Checks is poor in disadvantaged communities. This protocol paper sets out a UK-based study (Sussex and Nottingham) aiming to co-produce a community delivered CVD risk assessment and coaching intervention to support community members to reduce their risk of CVD. The overall aim of the project is to implement a tailored-to-context community engagement (CE) intervention on awareness of CVD risks in vulnerable populations in high, middle and low-income countries. The specific objectives of the study are to enhance stakeholder’ engagement; to implement lifestyle interventions for cardiovascular primary prevention, in disadvantaged populations and motivate uptake of NHS health checks. Methods This study uses both qualitative and quantitative methods in three phases of evaluation, including pre-, per- and post-implementation. To ensure contextual appropriateness the ‘Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa: An implementation research’ (SPICES) project will organize a multi-component community-engagement intervention. For the qualitative component, the pre-implementation phase will involve a contextual assessment and stakeholder mapping, exploring potentials for CVD risk profiling strategies and led by trained Community Health Volunteers (CHV) to identify accessibility and acceptability. The per-implementation phase will involve healthy lifestyle counselling provided by CHVs and evaluation of the outcome to identify fidelity and scalability. The post-implementation phase will involve developing sustainable community-based strategies for CVD risk reduction. All three components will include a process evaluation. A stepped wedge cluster randomised trial of the roll out will focus on implementation outcomes including uptake and engagement and changes in risk profiles. The quantitative component includes pre and post-intervention surveys. The theory of the socio-ecological framework will be applied to analyse the community engagement approach. Discussion Based on the results ultimately a sustainable community engagement-based strategy for the primary prevention of CVD risk will be developed to enhance the performance of NHS health care in the UK. The Trial Registration number is ISRCTN68334579.
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Affiliation(s)
- Papreen Nahar
- 1Department of Global Health and Infection, Brighton and Sussex Medical School, The University of Sussex, Brighton, UK
| | - Harm van Marwijk
- 2Department of Primary Care and Public Health, Brighton and Sussex Medical School, The University of Sussex, Brighton, UK
| | - Linda Gibson
- 3School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Geofrey Musinguzi
- 4Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.,5Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
| | - Sibyl Anthierens
- 5Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
| | - Elizabeth Ford
- 2Department of Primary Care and Public Health, Brighton and Sussex Medical School, The University of Sussex, Brighton, UK
| | - Stephen A Bremner
- 2Department of Primary Care and Public Health, Brighton and Sussex Medical School, The University of Sussex, Brighton, UK
| | - Mark Bowyer
- 3School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Jean Yves Le Reste
- 6EA 7479 SPURBO, Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France
| | - Tholene Sodi
- 7Department of Psychology, University of Limpopo, Mankweng, South Africa
| | - Hilde Bastiaens
- 5Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
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13
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Odorico M, Le Goff D, Aerts N, Bastiaens H, Le Reste JY. How To Support Smoking Cessation In Primary Care And The Community: A Systematic Review Of Interventions For The Prevention Of Cardiovascular Diseases. Vasc Health Risk Manag 2019; 15:485-502. [PMID: 31802882 PMCID: PMC6827500 DOI: 10.2147/vhrm.s221744] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 09/14/2019] [Indexed: 01/18/2023] Open
Abstract
Introduction Smoking is a major risk factor for cardiovascular diseases (CVDs) and for many types of cancers. Despite recent policies, 1.1 billion people are active smokers and tobacco is the leading cause of mortality and illness throughout the world. The aim of this work was to identify smoking cessation interventions which could be implemented in primary care and/or at a community level. Methods A systematic review of CVDs prevention guidelines was realized using the ADAPTE Process. These were identified on G-I-N and TRIP databases. Additionally, a purposive search for national guidelines was successfully undertaken. Guidelines focusing on non-pharmacological lifestyle interventions, published or updated after 2011, were included. Exclusion criteria were specific populations, management of acute disease and exclusive focus on pharmacological or surgical interventions. After appraisal with the AGREE II tool, high-quality guidelines were included for analysis. High-grade recommendations and the supporting bibliographic references were extracted. References had to be checked in detail where sufficient information was not available in the guidelines. Results Nine hundred and ten guidelines were identified, 47 evaluated with AGREE II and 26 included. Guidelines recommended that patients quit smoking and that health care professionals provided advice to smokers but failed to propose precise implementation strategies for such recommendations. Only two guidelines provided specific recommendations. In the guideline bibliographic references, brief advice (BA) and multiple session strategies were identified as effective interventions. These interventions used Prochaska theory, motivational interviewing or cognitive-behavioral therapies. Self-help documentation alone was less effective than face-to-face counseling. Community-based or workplace public interventions alone did not seem effective. Discussion Behavioral change strategies were effective in helping patients to give up smoking. BA alone was less effective than multiple session strategies although it required fewer resources. Evidence for community-based interventions effectiveness was weak, mainly due to the lack of robust studies.
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Affiliation(s)
- Michele Odorico
- Department of General Practice, EA 7479 SPURBO, Université de Bretagne Occidentale (UBO - University of West Brittany), Brest, France
| | - Delphine Le Goff
- Department of General Practice, EA 7479 SPURBO, Université de Bretagne Occidentale (UBO - University of West Brittany), Brest, France
| | - Naomi Aerts
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
| | - Hilde Bastiaens
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
| | - Jean Yves Le Reste
- Department of General Practice, EA 7479 SPURBO, Université de Bretagne Occidentale (UBO - University of West Brittany), Brest, France
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14
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Nabbe P, Le Reste JY, Guillou-Landreat M, Gatineau F, Le Floch B, Montier T, Van Marwijk H, Van Royen P. The French version of the HSCL-25 has now been validated for use in primary care. PLoS One 2019; 14:e0214804. [PMID: 30946774 PMCID: PMC6448853 DOI: 10.1371/journal.pone.0214804] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 03/20/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The Hopkins Symptom Checklist in 25 items (HSCL-25) helps to assess anxiety and depression in Primary Care. Anxiety and depression show considerable overlap in primary care. This self-administrated questionnaire is valid, reliable and ergonomic in the original US version. We have translated it into French. The aim of this study was to estimate the test characteristics of the HSCL-25, in its French version (F-HSCL-25), by comparing it to the Present State Examination-9 French version (F-PSE-9) and by determining its internal validity and dimensions. METHOD Outpatients from three French General Practice settings (rural, semi-rural and urban) were recruited: approximately 20,000 outpatients among 17 GPs. Two groups were formed: F-HSCL-25 ≥1.75 and F-HSCL-25 <1.75. A validated cut-off score of > 1.75 was considered to indicate a clinically relevant level of symptoms of depression and anxiety. In order to obtain two balanced groups, a different method of randomization was chosen for each group. The F-PSE-9 was randomly administered to 1 in 2 patients in the F-HSCL-25 ≥1.75 group, and to 1 in 16 in the (much larger) F-HSCL-25 <1.75 group. The diagnostic performance was assessed and the test results obtained from both groups were compared with their F-PSE-9 results. RESULTS Of the 1126 patients who completed the F-HCL-25, 886 joined the F-HSCL-25 <1.75 group and 240 the F-HSCL-25 ≥1.75 group. The overall prevalence of depression, using the F-HSCL-25, was 21% in these medical practices. The diagnostic performance of the F-HSCL-25 versus the F-PSE-9, the external criteria were as follows: Positive Predictive Value (PPV) 69.8%, Negative Predictive Value (NPV) 87%; Sensitivity 59.1%, and Specificity 91.4%. The Principal Component Analysis showed that F-HSCL-25 is a one-dimensional tool (anxiety and depression dimensions combined) with a Cronbach Alpha of 0.93. CONCLUSION The F-HSCL-25 is an appropriate diagnostic tool for anxiety and depression in primary care in France due to its high specificity and high NPV. The HSCL-25 scale has a high eigenvalue. This pilot study will be extended throughout Europe; however, preliminary evidence suggests that the HSCL-25 is a reliable and suitable diagnostic tool for primary care.
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Affiliation(s)
- Patrice Nabbe
- EA 7479 SPURBO, Department of general practice, Université de Bretagne Occidentale, Brest, France
| | - Jean Yves Le Reste
- EA 7479 SPURBO, Department of general practice, Université de Bretagne Occidentale, Brest, France
| | | | - Florence Gatineau
- EA 7479 SPURBO, Department of general practice, Université de Bretagne Occidentale, Brest, France
| | - Bernard Le Floch
- EA 7479 SPURBO, Department of general practice, Université de Bretagne Occidentale, Brest, France
| | - Tristan Montier
- Unité INSERM 1078, SFR 148 ScInBioS, Université de Bretagne Occidentale, Brest, France
| | - Harm Van Marwijk
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester I Williamson Building, Oxford Road, Manchester, United Kingdom
| | - Paul Van Royen
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, Universiteit Antwerpen, Antwerpen, Belgium
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15
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Michel L, Conq E, Combs E, Cholet J, Bodenez P, Le Reste JY, Landreat MG. Alcohol use by people in their seventies is not an exception: a preliminary prospective study. Br J Community Nurs 2019; 24:128-133. [PMID: 30817203 DOI: 10.12968/bjcn.2019.24.3.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The ageing population is rapidly increasing worldwide, and the alcohol-related disease burden in most Western countries is on the rise. However, very few studies assess alcohol use in older people. Here, a self-reported questionnaire was administered to all individuals aged 70 years or more who visited a social centre for older people in western France. The average age of the 98 subjects included in the survey was 79 years (range, 70-97 years; SD=6), and 57.1% (n=56) reported weekly alcohol consumption. An average consumption of over two standard units each day during weekends was reported by 53% subjects (n=52), and the same on each weekday was reported by 34% (n=33). Thus, a significant proportion of subjects aged 70 years or over consumed more alcohol than is recommended in current guidelines. The participants also reported that they rarely discussed alcohol consumption with their general practitioners. Alcohol use should be assessed regularly. District nurses and members of the primary care team should recommend strategies to help older people reduce their alcohol consumption.
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Affiliation(s)
- Lenaig Michel
- Specialised Nurse, Addictive Disorders Unit, University Hospital of Brest, Brest, France
| | - Estelle Conq
- EA Soins primaires, Santé publique, Registre des cancers de Bretagne Occidentale (SPURBO), Family Practice Department, Université Bretagne Occidentale, Brest, France
| | | | - Jennyfer Cholet
- Addictive Disorders Unit, University Hospital of Nantes, Nantes, France
| | - Pierre Bodenez
- EA SPURBO, Université Bretagne Occidentale, Brest, France
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16
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Guillou Landreat M, Cholet J, Grall Bronnec M, Lalande S, Le Reste JY. Determinants of Gambling Disorders in Elderly People-A Systematic Review. Front Psychiatry 2019; 10:837. [PMID: 31824348 PMCID: PMC6886010 DOI: 10.3389/fpsyt.2019.00837] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 10/22/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Despite the growth in the number of studies on gambling disorders (GDs) and the potentially severe harm it may cause, problem gambling in older adults is rarely apparent in literature. Driven by the need to overcome this limitation, a broad systematic review is essential to cover the studies that have already assessed the determinants of GD in the elderly. Objectives: The aim of this systematic review is to understand the determinants related to GDs in elderly people. Methods: A total of 51 studies met the inclusion criteria, and data were synthesized. Results: Three major types of determinants were identified in this review: individual, socio-financial and environmental. Conclusions: This review explored the determinants influencing GDs in older people. The findings are relevant to academics, policymakers, patients, and practitioners interested in the identification and prevention of GD in older people.
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Affiliation(s)
- Morgane Guillou Landreat
- EA 7479 SPURBO, Department of Addiction Disorders, Université de Bretagne Occidentale, Brest, France
| | - Jennyfer Cholet
- Addictive Disorders Unit, University Hospital of Nantes, Nantes, France
| | - Marie Grall Bronnec
- Addictive Disorders Unit, University Hospital of Nantes, Nantes, France.,EA 4275, Faculté de Médecine de Nantes, Nantes, France
| | - Sophie Lalande
- EA 7479, Department of Family Practice, Université de Bretagne Occidentale, Brest, France
| | - Jean Yves Le Reste
- ERCR SPURBO, Department of Family Practice, Université de Bretagne Occidentale, Brest, France
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17
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Le Reste JY, Nabbe P, Billot Grasset A, Le Floch B, Grall P, Derriennic J, odorico M, Lalande S, le Goff D, Barais M, Chiron B, Lingner H, Guillou M, Barraine P. Multimorbid outpatients: A high frequency of FP appointments and/or family difficulties, should alert FPs to the possibility of death or acute hospitalization occurring within six months; A primary care feasibility study. PLoS One 2017; 12:e0186931. [PMID: 29095849 PMCID: PMC5667834 DOI: 10.1371/journal.pone.0186931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 10/10/2017] [Indexed: 11/24/2022] Open
Abstract
Background The European General Practitioners Research Network (EGPRN) designed and validated a comprehensive definition of multimorbidity using a systematic literature review and qualitative research throughout Europe. This definition was tested as a model to assess death or acute hospitalization in multimorbid outpatients. Objective To assess which criteria in the EGPRN concept of multimorbidity could detect outpatients at risk of death or acute hospitalization in a primary care cohort at a 6-month follow-up and to assess whether a large scale cohort with FPs would be feasible. Method Family Physicians included a random sample of multimorbid patients who attended appointments in their offices from July to December 2014. Inclusion criteria were those of the EGPRN definition of Multimorbidity. Exclusion criteria were patients under legal protection and those unable to complete the 2-year follow-up. Statistical analysis was undertaken with uni- and multivariate analysis at a 6-month follow-up using a combination of approaches including both automatic classification and expert decision making. A Multiple Correspondence Analysis (MCA) completed the process with a projection of illustrative variables. A logistic regression was finally performed in order to identify and quantify risk factors for decompensation. Results 19 FPs participated in the study. 96 patients were analyzed. 3 different clusters were identified. MCA showed the central function of psychosocial factors and peaceful versus conflictual relationships with relatives in all clusters. While taking into account the limit of a small cohort, age, frequency of family physician visits and extent of family difficulties were the factors which predicted death or acute hospitalization. Conclusion A large scale cohort seems feasible in primary care. A sense of alarm should be triggered to prevent death or acute hospitalization in multimorbid older outpatients who have frequent family physician visits and who experience family difficulties.
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Affiliation(s)
- Jean Yves Le Reste
- EA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France
- * E-mail: (JYLR); (PN)
| | - Patrice Nabbe
- EA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France
- * E-mail: (JYLR); (PN)
| | - Alice Billot Grasset
- EA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France
| | - Bernard Le Floch
- EA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France
| | - Pauline Grall
- EA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France
| | - Jeremy Derriennic
- EA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France
| | - Michele odorico
- EA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France
| | - Sophie Lalande
- EA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France
| | - Delphine le Goff
- EA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France
| | - Marie Barais
- EA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France
| | - Benoit Chiron
- EA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France
| | | | - Morgane Guillou
- EA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France
| | - Pierre Barraine
- EA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France
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Kalda R, Silina V, Bayen-Krohn S, Deruytter N, Streit S, Verschoor M, Rodondi Bonfim Daiana N, Burman RA, Canan T, Collins C, Gerasimovska Biljana K, Gintere S, Bravo Gómez R, Hoffmann K, Biyiklioglu T, Kolesnyk P, Mechili EA, Harris M, Schonmann Y, Bleich O, Matalon A, Yeshua H, Vinker S, Prus J, Comaneshter DS, Cohen AD, Lahad A, Terjajeva L, Silina V, Skurule I, Le Reste JY, Le Mer R, Derriennic J, odorico M, le Goff D, Lalande S, Nabbe P, Le Floch B, Billot Grasset A, Baptiste Nousbaum J, Collins C, O’Shea M, Wrigley M, Ryan J, Osborne B, Thakore J, Hanlon DO, Finegan P, Skuja E, Kristina Zackrisson E, Skuja I, Biyiklioglu T, Kolesnyk P, Mechili EA, Harris M, Bösner S, Abushi J, Donner-Banzhoff N, Stolper E, Van Royen P, van de Wiel M, van Bokhoven L, Jan Dinant G, Schmalstieg K, Himmel W, Hummers E, Pautrat M, Laporte C, Pierre Lebeau J, Ivanova J, Silina V, Muñoz MA, Vaillant-Roussel H, Lingner H, Demurtas J, Neves AL, Torsza P, Asenova R, Klemenc-Ketis Z, Glynn L, Kulbay H, Verdú JM, Tabenkin H, Nothnagle M, Borkan J, Schlöszler K, Splittgerber R, Kühlwind A, Donner-Banzhoff N, Saxvik A, Franz A, Hagqvist I, Rödjer S, Bondjers G, Saxvik A, Petek Šter M, Selič P, Hauswaldt J, Heinemann S, Verhoeven A, Leuridan E, Peremans L, Remmen R, Mada L, Tilea R. European General Practice Research Network (EGPRN) Abstracts from the EGPRN conference in Riga, Latvia, 11?14 May 2017. Theme: 'Reducing the risk of chronic diseases in general practice/family medicine'. Eur J Gen Pract 2017; 23:227-240. [PMID: 29022405 PMCID: PMC5965853 DOI: 10.1080/13814788.2017.1357694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ruth Kalda
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Vija Silina
- Department of Family Medicine, Riga Stradins University, Riga, Latvia
| | | | | | - Sven Streit
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Schweiz
| | | | | | - Robert A. Burman
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Schweiz
| | - Tuz Canan
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Schweiz
| | - Claire Collins
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Schweiz
| | | | - Sandra Gintere
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Schweiz
| | - Raquel Bravo Gómez
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Schweiz
| | - Kath Hoffmann
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Schweiz
| | | | | | | | | | - Yochai Schonmann
- Clalit Health Services and Department of Family Medicine, Rabin Medical Center, Tel Aviv, Israel
| | - O. Bleich
- Clalit Health Services and Department of Family Medicine, Rabin Medical Center, Tel Aviv, Israel
| | - Andre Matalon
- Clalit Health Services and Department of Family Medicine, Rabin Medical Center, Tel Aviv, Israel
| | - Hanny Yeshua
- Clalit Health Services and Department of Family Medicine, Rabin Medical Center, Tel Aviv, Israel
| | - Shlomo Vinker
- Family Medicine, Tel Aviv University, Ashdod, Israel
| | - Judit Prus
- Family Medicine, Tel Aviv University, Ashdod, Israel
| | | | | | - Amnon Lahad
- Family Medicine, Tel Aviv University, Ashdod, Israel
| | | | - Vija Silina
- Family Medicine, Riga Stradins University, Salaspils, Latvia
| | - Iveta Skurule
- Family Medicine, Riga Stradins University, Salaspils, Latvia
| | | | - Ronan Le Mer
- General Practice, Université de Bretagne Occidentale, Brest, France
| | | | - Michele odorico
- General Practice, Université de Bretagne Occidentale, Brest, France
| | - Delphine le Goff
- General Practice, Université de Bretagne Occidentale, Brest, France
| | - Sophie Lalande
- General Practice, Université de Bretagne Occidentale, Brest, France
| | - Patrice Nabbe
- General Practice, Université de Bretagne Occidentale, Brest, France
| | - Bernard Le Floch
- General Practice, Université de Bretagne Occidentale, Brest, France
| | | | | | | | | | | | | | | | | | | | | | - Elina Skuja
- Family Medicine, Riga Stradins University, Riga, Latvija
| | | | - Ilze Skuja
- Family Medicine, Riga Stradins University, Riga, Latvija
| | | | | | | | | | | | | | | | - Erik Stolper
- General Practice, CAPHRI, Maastricht, The Netherlands
| | | | | | | | | | - Katharina Schmalstieg
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Wolfgang Himmel
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Eva Hummers
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Maxime Pautrat
- Département universitaire de médecine générale, Faculté de médecine, Tours, France
| | - Catherine Laporte
- Département universitaire de médecine générale, Faculté de médecine, Tours, France
| | - Jean Pierre Lebeau
- Département universitaire de médecine générale, Faculté de médecine, Tours, France
| | | | - Vija Silina
- Continuing education faculty, Riga Stradins University, Riga, Latvia
| | - Miguel-Angel Muñoz
- Unitat de Suport a la Recerca, Primary Healthcare University Research Institute IDIAP-Jordi Gol, Barcelona, Spain
| | - Helene Vaillant-Roussel
- Unitat de Suport a la Recerca, Primary Healthcare University Research Institute IDIAP-Jordi Gol, Barcelona, Spain
| | - Heidrun Lingner
- Unitat de Suport a la Recerca, Primary Healthcare University Research Institute IDIAP-Jordi Gol, Barcelona, Spain
| | - Jacopo Demurtas
- Unitat de Suport a la Recerca, Primary Healthcare University Research Institute IDIAP-Jordi Gol, Barcelona, Spain
| | - Ana-Luisa Neves
- Unitat de Suport a la Recerca, Primary Healthcare University Research Institute IDIAP-Jordi Gol, Barcelona, Spain
| | - Peter Torsza
- Unitat de Suport a la Recerca, Primary Healthcare University Research Institute IDIAP-Jordi Gol, Barcelona, Spain
| | - Radost Asenova
- Unitat de Suport a la Recerca, Primary Healthcare University Research Institute IDIAP-Jordi Gol, Barcelona, Spain
| | - Zalika Klemenc-Ketis
- Unitat de Suport a la Recerca, Primary Healthcare University Research Institute IDIAP-Jordi Gol, Barcelona, Spain
| | - Liam Glynn
- Unitat de Suport a la Recerca, Primary Healthcare University Research Institute IDIAP-Jordi Gol, Barcelona, Spain
| | - Hayriye Kulbay
- Unitat de Suport a la Recerca, Primary Healthcare University Research Institute IDIAP-Jordi Gol, Barcelona, Spain
| | - José-Maria Verdú
- Unitat de Suport a la Recerca, Primary Healthcare University Research Institute IDIAP-Jordi Gol, Barcelona, Spain
| | - Hava Tabenkin
- Family Medicine, Ben Gurion University, Ein Harod M, Israel
| | | | - Jeffrey Borkan
- Family Medicine, Ben Gurion University, Ein Harod M, Israel
| | | | | | - Anne Kühlwind
- Family Medicine, Philipps-University Marburg, Marburg, Germany
| | | | - Ausra Saxvik
- Family Physician Center Närhälsan Öckerö, PLUS program, Hönö, Sweden
| | - Anna Franz
- Family Physician Center Närhälsan Öckerö, PLUS program, Hönö, Sweden
| | - Inger Hagqvist
- Family Physician Center Närhälsan Öckerö, PLUS program, Hönö, Sweden
| | - Stig Rödjer
- Family Physician Center Närhälsan Öckerö, PLUS program, Hönö, Sweden
| | - Göran Bondjers
- Family Physician Center Närhälsan Öckerö, PLUS program, Hönö, Sweden
| | - Ausra Saxvik
- Family Physician Center Närhälsan Öckerö, PLUS program, Hönö, Sweden
| | - Marija Petek Šter
- Department for Family medicine, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Polona Selič
- Department for Family medicine, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Johannes Hauswaldt
- University Medicine Göttingen, Institute of General Practice and Family Medicine, Göttingen, Germany
| | - Stephanie Heinemann
- University Medicine Göttingen, Institute of General Practice and Family Medicine, Göttingen, Germany
| | - Ann Verhoeven
- Centre for general practice-department Eliza, University of Antwerp, Antwerpen, Belgium
| | - Elke Leuridan
- Centre for general practice-department Eliza, University of Antwerp, Antwerpen, Belgium
| | - Lieve Peremans
- Centre for general practice-department Eliza, University of Antwerp, Antwerpen, Belgium
| | - Roy Remmen
- Centre for general practice-department Eliza, University of Antwerp, Antwerpen, Belgium
| | - Leonard Mada
- Department of Research, Syonic SRL, Timisoara, Romania
| | - Roxana Tilea
- Department of Research, Syonic SRL, Timisoara, Romania
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Le Reste JY, Nabbe P, Lazic D, Assenova R, Lingner H, Czachowski S, Argyriadou S, Sowinska A, Lygidakis C, Doerr C, Claveria A, Le Floch B, Derriennic J, Van Marwijk H, Van Royen P. How do general practitioners recognize the definition of multimorbidity? A European qualitative study. Eur J Gen Pract 2016; 22:159-68. [PMID: 27232846 DOI: 10.3109/13814788.2015.1136619] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Multimorbidity is a challenging concept for general practice. An EGPRN working group has published a comprehensive definition of the concept of multimorbidity. As multimorbidity could be a way to explore complexity in general practice, it was of importance to explore whether European general practitioners (GPs) recognize this concept and whether they would change it. OBJECTIVES To investigate whether European GPs recognize the EGPRN concept of multimorbidity and whether they would change it. METHODS Focus group meetings and semi-structured interviews as data collection techniques with a purposive sample of practicing GPs from every country. Data collection continued until saturation was reached in every country. The analysis was undertaken using a grounded theory based method. In each national team, four independent researchers, working blind and pooling data, carried out the analysis. To ensure the internationalization of the data, an international team of 10 researchers pooled the axial and selective coding of all national teams to check the concept and highlight emerging themes. RESULTS The maximal variation and saturation of the sample were reached in all countries with 211 selected GPs. The EGPRN definition was recognized in all countries. Two additional ideas emerged, the use of Wonca's core competencies of general practice, and the dynamics of the doctor-patient relationship for detecting and managing multimorbidity and patient's complexity. CONCLUSION European GPs recognized and enhanced the EGPRN concept of multimorbidity. These results open new perspectives regarding the management of complexity using the concept of multimorbidity in general practice. [Box: see text].
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Affiliation(s)
- Jean Yves Le Reste
- a ERCR SPURBO , Département de Médecine Générale, Université de Bretagne Occidentale , Brest , France
| | - Patrice Nabbe
- a ERCR SPURBO , Département de Médecine Générale, Université de Bretagne Occidentale , Brest , France
| | - Djurdjica Lazic
- b Department of Family Medicine, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb , Zagreb , Croatia
| | | | | | | | - Stella Argyriadou
- f The Greek Association of General Practitioners (ELEGEIA) , Thessaloniki , Greece
| | - Agnieszka Sowinska
- g Department of English, Nicolaus Copernicus University , Torun , Poland
| | | | - Christa Doerr
- i Department of General Practice, University Medical Center Göttingen , Georg-August-Universität , Göttingen , Germany
| | - Ana Claveria
- j Galician National Health Service , Vigo , Spain
| | - Bernard Le Floch
- a ERCR SPURBO , Département de Médecine Générale, Université de Bretagne Occidentale , Brest , France
| | - Jeremy Derriennic
- a ERCR SPURBO , Département de Médecine Générale, Université de Bretagne Occidentale , Brest , France
| | - Harm Van Marwijk
- k Department of General Practice and the EMGO Institute for Health and Care Research , VU University Medical Center , Amsterdam , Netherlands
| | - Paul Van Royen
- l Primary and Interdisciplinary Care, University of Antwerp , Antwerp , Belgium
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Assenova RS, Le Reste JY, Foreva GH, Mileva DS, Czachowski S, Sowinska A, Nabbe P, Argyriadou S, Lazic D, Hasaganic M, Lingner H, Lygidakis H, Muñoz MA, Claveria A, Doerr C, Van Marwijk H, Van Royen P, Lietard C. Cross-Cultural Validation of the Definition of Multimorbidity in the Bulgarian Language. Folia Med (Plovdiv) 2016; 57:127-32. [PMID: 26933783 DOI: 10.1515/folmed-2015-0031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 06/01/2015] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Multimorbidity is a health issue with growing importance. During the last few decades the populations of most countries in the world have been ageing rapidly. Bulgaria is affected by the issue because of the high prevalence of ageing population in the country with multiple chronic conditions. The AIM of the present study was to validate the translated definition of multimorbidity from English into the Bulgarian language. MATERIALS AND METHODS The present study is part of an international project involving 8 national groups. We performed a forward and backward translation of the original English definition of multimorbidity using a Delphi consensus procedure. RESULTS The physicians involved accepted the definition with a high percentage of agreement in the first round. The backward translation was accepted by the scientific committee using the Nominal group technique. DISCUSSION Some of the GPs provided comments on the linguistic expressions which arose in order to improve understanding in Bulgarian. The remarks were not relevant to the content. The conclusion of the discussion, using a meta-ethnographic approach, was that the differences were acceptable and no further changes were required. CONCLUSIONS A native version of the published English multimorbidity definition has been finalized. This definition is a prerequisite for better management of multimorbidity by clinicians, researchers and policy makers.
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Affiliation(s)
| | - Jean Yves Le Reste
- Department of General Practice, Université de Bretagne occidentale, Brest, France
| | - Gergana H Foreva
- Section of General Practice, Medical University - Plovdiv, Bulgaria
| | - Daniela S Mileva
- Section of General Practice, Medical University - Plovdiv, Bulgaria
| | | | | | - Patrice Nabbe
- Department of General Practice, Université de Bretagne occidentale, Brest, France
| | - Stella Argyriadou
- The Greek Association of General Practitioners (ELEGEIA), Thessaloniki, Greece
| | - Djurdjica Lazic
- Department of Family Medicine, School of medicine, Univesity of Zagreb, Croatia
| | | | | | - Harris Lygidakis
- President of Vasco da Gama Movement, General Practitioner, Bologna Area, Italy
| | | | - Ana Claveria
- Xerencia de atención primaria de Vigo, Vigo, Spain
| | - Chista Doerr
- Institut für Allgemeinmedizin UMG Göttingen, Göttingen, Germany
| | - Harm Van Marwijk
- Department of General Practice, VU University Medical Center, Amsterdam, The Nederland
| | - Paul Van Royen
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, Universiteit Antwerpen, Belgium
| | - Claire Lietard
- Department of General Practice, Université de Bretagne occidentale, Brest, France
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Guillou Landreat M, Rozaire C, Guillet JY, Victorri Vigneau C, Le Reste JY, Grall Bronnec M. French Experience with Buprenorphine : Do Physicians Follow the Guidelines? PLoS One 2015; 10:e0137708. [PMID: 26479400 PMCID: PMC4610705 DOI: 10.1371/journal.pone.0137708] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 08/21/2015] [Indexed: 01/06/2023] Open
Abstract
Opiate dependence affects about 15,479,000 people worldwide. The effectiveness of opiate substitution treatments (OST) has been widely demonstrated. Buprenorphine plays a particular role in opiate dependence care provision in France. It is widely prescribed by physicians and national opiate substitution treatment guidelines have been available since 2004. In order to study the prescribing of buprenorphine, we used a questionnaire sent by email, to a large sample of physicians. These physicians were either in practice, or belonged to an addiction treatment network or a hospital. The main objective of this work was to measure the extent to which the theoretical, clinical attitude of physicians towards prescribing buprenorphine (BHD) complied with the statutory guidelines. We showed that the physicians we interviewed rarely took into account the guidelines regarding buprenorphine prescription. The actual prescribing of Buprenorphine differed from the guidelines. Only 42% of independent Family Physicians (FPs), working outside the national health care system, had prescribed buprenorphine as a first-time prescription and 40% of FPs do not follow up patients on buprenorphine. In terms of compliance with the guidelines, 55% of FPs gave theoretical answers that only partially complied with the guidelines. The variations in compliance with the guidelines was noted according to different variables and took into particular account whether the physician were affiliated to a network or in training.
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Affiliation(s)
- Morgane Guillou Landreat
- Department of addictive disorders, ERCR SPURBO,, Université de Bretagne occidentale, Brest, France
| | | | | | - Caroline Victorri Vigneau
- Pharmacology department, Universitary Hospital Nantes, Nantes, France
- EA 4275, Faculté de médecine Nantes, Nantes, France
| | - Jean Yves Le Reste
- Department of general practice, ERCR SPURBO, Universitéde Bretagne occidentale, Brest, France
| | - Marie Grall Bronnec
- Pharmacology department, Universitary Hospital Nantes, Nantes, France
- Addiction psychiatry, Universitary Hospital Nantes, Nantes, France
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Le Reste JY, Nabbe P, Rivet C, Lygidakis C, Doerr C, Czachowski S, Lingner H, Argyriadou S, Lazic D, Assenova R, Hasaganic M, Munoz MA, Thulesius H, Le Floch B, Derriennic J, Sowinska A, Van Marwijk H, Lietard C, Van Royen P. The European general practice research network presents the translations of its comprehensive definition of multimorbidity in family medicine in ten European languages. PLoS One 2015; 10:e0115796. [PMID: 25607642 PMCID: PMC4301631 DOI: 10.1371/journal.pone.0115796] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 11/26/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Multimorbidity, according to the World Health Organization, exists when there are two or more chronic conditions in one patient. This definition seems inaccurate for the holistic approach to Family Medicine (FM) and long-term care. To avoid this pitfall the European General Practitioners Research Network (EGPRN) designed a comprehensive definition of multimorbidity using a systematic literature review. OBJECTIVE To translate that English definition into European languages and to validate the semantic, conceptual and cultural homogeneity of the translations for further research. METHOD Forward translation of the EGPRN's definition of multimorbidity followed by a Delphi consensus procedure assessment, a backward translation and a cultural check with all teams to ensure the homogeneity of the translations in their national context. Consensus was defined as 70% of the scores being higher than 6. Delphi rounds were repeated in each country until a consensus was reached. RESULTS 229 European medical expert FPs participated in the study. Ten consensual translations of the EGPRN comprehensive definition of multimorbidity were achieved. CONCLUSION A comprehensive definition of multimorbidity is now available in English and ten European languages for further collaborative research in FM and long-term care.
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Affiliation(s)
- Jean Yves Le Reste
- Department of General Practice, Université de Bretagne occidentale, Brest, France
| | - Patrice Nabbe
- Department of General Practice, Université de Bretagne occidentale, Brest, France
| | - Charles Rivet
- Department of General Practice, Université de Bretagne occidentale, Brest, France
| | | | - Christa Doerr
- Allgemein Medizin Hochschule Göttingen, Göttingen, Germany
| | | | | | - Stella Argyriadou
- The Greek Association of General Practitioners (ELEGEIA), Thessaloniki, Greece
| | - Djurdjica Lazic
- University of Zagreb, School of Medicine, Andrija Stampar School of Public Health, Department of Family Medicine, Zagreb, Croatia
| | - Radost Assenova
- Department of General Practice, University of Plovdiv, Plovdiv, Bulgaria
| | - Melida Hasaganic
- Department of General Practice, University of Sarajevo, Sarajevo, Bosnia
| | | | - Hans Thulesius
- Department of Clinical Sciences, Lund University, Malmo, Sweden
| | - Bernard Le Floch
- Department of General Practice, Université de Bretagne occidentale, Brest, France
| | - Jeremy Derriennic
- Department of General Practice, Université de Bretagne occidentale, Brest, France
| | - Agnieska Sowinska
- Department of English, Nicolaus Copernicus University, Torun, Poland
| | - Harm Van Marwijk
- Department of General Practice, VU University Medical Center, Amsterdam, The Nederland
| | - Claire Lietard
- Department of Public Health, Université de Bretagne occidentale, Brest, France
| | - Paul Van Royen
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, Universiteit Antwerpen, Antwerpen, Belgium
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Le Reste JY, Chiron B, Le Floch B, Nabbe P, Barrais M, Mansourati J, Cadier S, Barraine P, Lietard C. There are considerable drawbacks to oral anticoagulant for monitoring patients at home which should lead family physicians to discuss alternative or enhanced solutions: a cross-sectional study. BMC Cardiovasc Disord 2013; 13:71. [PMID: 24024556 PMCID: PMC3846900 DOI: 10.1186/1471-2261-13-71] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 09/04/2013] [Indexed: 11/30/2022] Open
Abstract
Background INR (International Normalized Ratio) is the biological reference test for the monitoring of vitamin K antagonist (VKA) therapy. Overdosage of VKAs causes about 17,000 hospitalizations and 5,000 deaths each year in France. To avoid these complications, monitoring and blood sampling conditions must be rigorous. In France, more than half of INRs are carried out at home. The aim was to determine blood-sampling conditions at home, transit time and the quality of the laboratory reagents used. Method Questionnaire-based, descriptive epidemiological cross-sectional prevalence study involving home care nurses, family physicians (FPs) and clinical laboratories. Setting: Brittany, France, 2008. Study of the pre-analytical phase of INRs sampled at home and its influence on INR results. Results The study included 291 FPs, 249 home care nurses, and 49 laboratories. 32.5% of reported INRs were outside the therapeutic range. Samples were drawn into unsuitable tubes in 5.5% of cases and delivered in a chilled condition in 9% of cases. In urban areas 50% of the tubes took more than 2 hours to reach the laboratory compared with 71% from rural areas. The average International Sensitivity Index (ISI) of the thromboplastin was 1.62. The INRs provided by the laboratories were not analyzable in 64.7% of cases where blood samples had been taken at home. Conclusion Blood sample quality, transit time and the reagents used are currently inadequate. The majority of INRs taken at home are not reliable. FPs should consider these drawbacks in comparison with alternative solutions to increase patient safety.
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Affiliation(s)
- Jean Yves Le Reste
- Département de médecine générale - UFR Brest, Rue Camille Desmoulins, 29200 Brest, France.
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Le Reste JY, Nabbe P, Manceau B, Lygidakis C, Doerr C, Lingner H, Czachowski S, Munoz M, Argyriadou S, Claveria A, Le Floch B, Barais M, Bower P, Van Marwijk H, Van Royen P, Lietard C. The European General Practice Research Network presents a comprehensive definition of multimorbidity in family medicine and long term care, following a systematic review of relevant literature. J Am Med Dir Assoc 2013; 14:319-25. [PMID: 23411065 DOI: 10.1016/j.jamda.2013.01.001] [Citation(s) in RCA: 138] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 12/27/2012] [Accepted: 01/03/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND Multimorbidity is a new concept encompassing all the medical conditions of an individual patient. The concept links into the European definition of family medicine and its core competencies. However, the definition of multimorbidity and its subsequent operationalization are still unclear. The European General Practice Research Network wanted to produce a comprehensive definition of multimorbidity. METHOD Systematic review of literature involving eight European General Practice Research Network national teams. The databases searched were PubMed, Embase, and Cochrane (1990-2010). Only articles containing descriptions of multimorbidity criteria were selected for inclusion. The multinational team undertook a methodic data extraction, according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. RESULTS The team identified 416 documents, selected 68 abstracts, included 54 articles, and found 132 definitions with 1631 different criteria. These criteria were aggregated into 11 themes that led to the following definition: Multimorbidity is defined as any combination of chronic disease with at least one other disease (acute or chronic) or biopsychosocial factor (associated or not) or somatic risk factor. Any biopsychosocial factor, any risk factor, the social network, the burden of diseases, the health care consumption, and the patient's coping strategies may function as modifiers (of the effects of multimorbidity). Multimorbidity may modify the health outcomes and lead to an increased disability or a decreased quality of life or frailty. CONCLUSION This study has produced a comprehensive definition of multimorbidity. The resulting improvements in the management of multimorbidity, and its usefulness in long term care and in family medicine, will have to be assessed in future studies.
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Affiliation(s)
- Jean Yves Le Reste
- Department of General Practice, Université de Bretagne Occidentale, Brest, France.
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Le Reste JY, Nabbe P, Lygidakis C, Doerr C, Lingner H, Czachowski S, Munoz M, Argyriadou S, Claveria A, Calvez A, Barais M, Lietard C, Van Royen P, van Marwijk H. A Research Group from the European General Practice Research Network (EGPRN) Explores the Concept of Multimorbidity for Further Research into Long Term Care. J Am Med Dir Assoc 2013; 14:132-3. [DOI: 10.1016/j.jamda.2012.07.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 07/30/2012] [Indexed: 10/27/2022]
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