Pub Date : 2023-01-01DOI: 10.1016/j.lpmope.2023.100043
Sophie Le Bail , Jocelyn Mouden , Margaux Gaillard , Julie Dupouy
Background
The duration of untreated psychosis is negatively associated with long-term outcomes. General practitioners play a key role in the pathway to care but they have difficulties managing an acute psychiatric crisis such as first-episode psychosis. Therefore, the objective of this meta-review was to provide clinical practical guides on the management of first-episode psychosis, aimed to general practitioners.
Methods
We searched Pubmed, Cochrane and Web of Science for systematic reviews of literature, meta-analyses and guidelines of oral antipsychotics or benzodiazepines treatment for the management of acute psychiatric crisis, published from 2005 to 2021. The reports have been selected and reviewed independently by two researchers.
Results
31 articles were included, with 25 on first-episode psychosis. Second-generation antipsychotics are the mainstay of treatment. The choice of the antipsychotic drugs should be guided mainly by side-effects, to maximize tolerability and acceptability. It must be introduced at a low starting dose with gradual titration until the minimal effective dosage is reached.
Conclusion
We merged our meta-review findings into a comprehensive algorithm for the management of first-episode psychosis in primary care, from assessment to first-line therapies and follow-up.
背景未经治疗的精神病持续时间与长期结果呈负相关。全科医生在获得护理的过程中发挥着关键作用，但他们很难应对急性精神危机，如首发精神病。因此，这篇元综述的目的是为全科医生提供治疗首发精神病的临床实践指南。方法我们在Pubmed、Cochrane和Web of Science上搜索了2005年至2021年发表的关于口服抗精神病药物或苯二氮卓类药物治疗急性精神危机的文献、荟萃分析和指南的系统综述。这些报告是由两名研究人员独立挑选和审查的。结果共收录文章31篇，其中首发精神病25篇。第二代抗精神病药物是治疗的主要药物。抗精神病药物的选择应主要以副作用为指导，以最大限度地提高耐受性和可接受性。它必须以低起始剂量引入，并逐渐滴定，直到达到最小有效剂量。结论我们将我们的元综述结果合并到一个综合算法中，用于在初级保健中管理首发精神病，从评估到一线治疗和随访。
{"title":"Clinical practical guide for the management of an acute psychiatric crisis in primary care: A meta-review of systematic literature","authors":"Sophie Le Bail , Jocelyn Mouden , Margaux Gaillard , Julie Dupouy","doi":"10.1016/j.lpmope.2023.100043","DOIUrl":"https://doi.org/10.1016/j.lpmope.2023.100043","url":null,"abstract":"<div><h3>Background</h3><p>The duration of untreated psychosis is negatively associated with long-term outcomes. General practitioners play a key role in the pathway to care but they have difficulties managing an acute psychiatric crisis such as first-episode psychosis. Therefore, the objective of this meta-review was to provide clinical practical guides on the management of first-episode psychosis, aimed to general practitioners.</p></div><div><h3>Methods</h3><p>We searched Pubmed, Cochrane and Web of Science for systematic reviews of literature, meta-analyses and guidelines of oral antipsychotics or benzodiazepines treatment for the management of acute psychiatric crisis, published from 2005 to 2021. The reports have been selected and reviewed independently by two researchers.</p></div><div><h3>Results</h3><p>31 articles were included, with 25 on first-episode psychosis. Second-generation antipsychotics are the mainstay of treatment. The choice of the antipsychotic drugs should be guided mainly by side-effects, to maximize tolerability and acceptability. It must be introduced at a low starting dose with gradual titration until the minimal effective dosage is reached.</p></div><div><h3>Conclusion</h3><p>We merged our meta-review findings into a comprehensive algorithm for the management of first-episode psychosis in primary care, from assessment to first-line therapies and follow-up.</p></div>","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"4 ","pages":"Article 100043"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1016/j.lpmope.2023.100039
Stacy Geffroy , Théo Reynaud , Jérémy Khouani , Simon Lavabre , Sandrine Loubière , Maeva Jego
Background
Vulnerable people have complex health needs but face multiple barriers to accessing healthcare. In 2018, Médecins du Monde (MDM), a French non-governmental association which care for underserved people, initiated an ambulatory primary care network in Marseille, France: the “PASS De Ville” (PDV). It supports vulnerable populations in obtaining immediate access to common primary care in the city before their health insurance rights are established. We aimed to assess the experience and care expectations of the patients who used the PDV.
Methods
We conducted a qualitative study based on a grounded theory approach. Patients who met at least one of the general practitioners involved in the PDV were included. We conducted semi-structured interviews amongst 16 service users, between February and May 2021. Two researchers performed an inductive analysis using NVivo.
Results
The patients had both medical and non-medical needs. Alongside health, access to health insurance was a subject often considered a key priority. Although patients seemed to have little understanding of how the PDV works, they nevertheless managed to benefit from it and access medical care more easily. PDV users reported feeling more socially integrated through consideration by healthcare givers. Most of them still identified the general practitioner encountered during the PDV as their referent doctor once their health insurance rights were established.
Conclusion
The PDV seems to support better integration into the French primary care system for patients who encounter barriers seeking medical care. Other studies are needed to identify PDV's efficiency on care pathways and patients’ overall health.
背景弱势人群有复杂的健康需求，但在获得医疗保健方面面临多重障碍。2018年，法国非政府组织世界医学会（MDM）在法国马赛启动了一个流动初级保健网络：“PASS De Ville”（PDV）。它支持弱势群体在建立健康保险权利之前立即获得城市的普通初级保健。我们旨在评估使用PDV的患者的经验和护理期望。方法我们基于有根据的理论方法进行了定性研究。至少见过一名参与PDV的全科医生的患者也包括在内。2021年2月至5月，我们对16名服务用户进行了半结构化访谈。两名研究人员使用NVivo进行了归纳分析。结果患者既有医疗需求，也有非医疗需求。除了健康，获得医疗保险也是一个经常被视为关键优先事项的问题。尽管患者似乎对PDV的工作原理知之甚少，但他们还是设法从中受益，更容易获得医疗服务。PDV用户报告说，通过医疗保健提供者的考虑，他们感觉自己更融入了社会。一旦他们的健康保险权利确立，他们中的大多数人仍然将PDV期间遇到的全科医生确定为他们的参考医生。结论PDV似乎支持那些遇到就医障碍的患者更好地融入法国初级保健系统。还需要进行其他研究来确定PDV在护理途径和患者整体健康方面的效率。
{"title":"An innovative model for improving access to care: Patients’ experience of a primary care network caring for underserved communities in France","authors":"Stacy Geffroy , Théo Reynaud , Jérémy Khouani , Simon Lavabre , Sandrine Loubière , Maeva Jego","doi":"10.1016/j.lpmope.2023.100039","DOIUrl":"https://doi.org/10.1016/j.lpmope.2023.100039","url":null,"abstract":"<div><h3>Background</h3><p>Vulnerable people have complex health needs but face multiple barriers to accessing healthcare. In 2018, Médecins du Monde (MDM), a French non-governmental association which care for underserved people, initiated an ambulatory primary care network in Marseille, France: the <em>“PASS De Ville”</em> (PDV). It supports vulnerable populations in obtaining immediate access to common primary care in the city before their health insurance rights are established. We aimed to assess the experience and care expectations of the patients who used the PDV.</p></div><div><h3>Methods</h3><p>We conducted a qualitative study based on a grounded theory approach. Patients who met at least one of the general practitioners involved in the PDV were included. We conducted semi-structured interviews amongst 16 service users, between February and May 2021. Two researchers performed an inductive analysis using NVivo.</p></div><div><h3>Results</h3><p>The patients had both medical and non-medical needs. Alongside health, access to health insurance was a subject often considered a key priority. Although patients seemed to have little understanding of how the PDV works, they nevertheless managed to benefit from it and access medical care more easily. PDV users reported feeling more socially integrated through consideration by healthcare givers. Most of them still identified the general practitioner encountered during the PDV as their referent doctor once their health insurance rights were established.</p></div><div><h3>Conclusion</h3><p>The PDV seems to support better integration into the French primary care system for patients who encounter barriers seeking medical care. Other studies are needed to identify PDV's efficiency on care pathways and patients’ overall health.</p></div>","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"4 ","pages":"Article 100039"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1016/j.lpmope.2023.100040
Gabrielle Lisembard, Sabine Bayen, Pierre Fontaine, Francois Glowacki, François Quersin, Alissa Sebbah, Marc Bayen
Background
The number of diabetic patients is constantly increasing in France. The severity of long-term diabetes is linked to the complications it causes, including renal failure. GFR decline is a good means of measuring a loss of renal function. General practitioners (GPs) are in the front line concerning the global accompaniment of these patients. This includes prevention, follow-up, therapeutical adaptation.
Purpose
To identify GFR decline diabetic patients and the impact of implemented measures in general practice to reduce this loss.
Materials and methods
We present the protocol of a prospective, multicentred, randomized, controlled, two-arm interventional study amongst a study population in the North-West region of France. The 360 types 2 diabetic patients will be recruited by 36 GPs. The inclusion criteria target women or men over 50 with type 2 diabetes, and GFR less than 90 ml/min and greater than 45 ml/min (stage 2 and 3a renal failure). 18 GPs will be randomized in an intervention group (training on GFR decline screening and specific patient-centred measures). The study is promoted by the University Hospital of Lille. The main objective of the study is to demonstrate that patient-adapted preventive management reduces GFR decline in type 2 diabetic patients.
Expected results
To improve the patients’ quality of life through the early screening any study on GFR decline should involve GPs since they do have a preventive role in general practice and avoid renal failure.
Conclusion
Up to now, in France, any study on GFR decline should involve GPs since they do have a preventive role
{"title":"Prevention of NEphron loss in type 2 DIABetic patients followed in general practice. Protocol of the French PENEDIAB study","authors":"Gabrielle Lisembard, Sabine Bayen, Pierre Fontaine, Francois Glowacki, François Quersin, Alissa Sebbah, Marc Bayen","doi":"10.1016/j.lpmope.2023.100040","DOIUrl":"https://doi.org/10.1016/j.lpmope.2023.100040","url":null,"abstract":"<div><h3>Background</h3><p>The number of diabetic patients is constantly increasing in France. The severity of long-term diabetes is linked to the complications it causes, including renal failure. GFR decline is a good means of measuring a loss of renal function. General practitioners (GPs) are in the front line concerning the global accompaniment of these patients. This includes prevention, follow-up, therapeutical adaptation.</p></div><div><h3>Purpose</h3><p>To identify GFR decline diabetic patients and the impact of implemented measures in general practice to reduce this loss.</p></div><div><h3>Materials and methods</h3><p>We present the protocol of a prospective, multicentred, randomized, controlled, two-arm interventional study amongst a study population in the North-West region of France. The 360 types 2 diabetic patients will be recruited by 36 GPs. The inclusion criteria target women or men over 50 with type 2 diabetes, and GFR less than 90 ml/min and greater than 45 ml/min (stage 2 and 3a renal failure). 18 GPs will be randomized in an intervention group (training on GFR decline screening and specific patient-centred measures). The study is promoted by the University Hospital of Lille. The main objective of the study is to demonstrate that patient-adapted preventive management reduces GFR decline in type 2 diabetic patients.</p></div><div><h3>Expected results</h3><p>To improve the patients’ quality of life through the early screening any study on GFR decline should involve GPs since they do have a preventive role in general practice and avoid renal failure.</p></div><div><h3>Conclusion</h3><p>Up to now, in France, any study on GFR decline should involve GPs since they do have a preventive role</p></div>","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"4 ","pages":"Article 100040"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1016/j.lpmope.2022.100033
Eva Hanras, Sasha Mathieu, Basilie Chevrier, E. Boujut, G. Dorard
{"title":"Vegans, strict vegetarians, partial vegetarians, omnivores: Do they differ in food choice motives, coping, and quality of life?","authors":"Eva Hanras, Sasha Mathieu, Basilie Chevrier, E. Boujut, G. Dorard","doi":"10.1016/j.lpmope.2022.100033","DOIUrl":"https://doi.org/10.1016/j.lpmope.2022.100033","url":null,"abstract":"","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"659 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76843693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1016/j.lpmope.2022.100032
B. Chicoulaa, E. Escourrou, Florence Durrieu, V. Milon, Louise Savary, Maxime Gelibert, A. Stillmunkés, S. Oustric, M. Rougé-Bugat
{"title":"Challenges in management of frailty by primary healthcare teams: from identification to follow-up","authors":"B. Chicoulaa, E. Escourrou, Florence Durrieu, V. Milon, Louise Savary, Maxime Gelibert, A. Stillmunkés, S. Oustric, M. Rougé-Bugat","doi":"10.1016/j.lpmope.2022.100032","DOIUrl":"https://doi.org/10.1016/j.lpmope.2022.100032","url":null,"abstract":"","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78692735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1016/j.lpmope.2022.100034
Aslı Kazgan Kılıçaslan, S. Yıldız, B. S. Emir, Faruk Kılıç
{"title":"Alexithymia, Reading the Mind in the Eyes and Empathy in Patients with Antisocial Personality Disorder","authors":"Aslı Kazgan Kılıçaslan, S. Yıldız, B. S. Emir, Faruk Kılıç","doi":"10.1016/j.lpmope.2022.100034","DOIUrl":"https://doi.org/10.1016/j.lpmope.2022.100034","url":null,"abstract":"","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83103196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.1016/j.lpmope.2022.100030
P. Patrizio, C. Clesse, L. Bernard, M. Batt, G. Kanny
{"title":"The remaining role and feasibility of detoxification in opioid addiction after 30 years of medication for opioid use disorder: A systematic review","authors":"P. Patrizio, C. Clesse, L. Bernard, M. Batt, G. Kanny","doi":"10.1016/j.lpmope.2022.100030","DOIUrl":"https://doi.org/10.1016/j.lpmope.2022.100030","url":null,"abstract":"","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75948198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.1016/j.lpmope.2022.100029
L. Cuminetti, C. d'Andréa, N. Bouscaren
{"title":"Alcohol and diving: a cross-sectional study of attitudes towards alcohol consumption among 4,322 French divers","authors":"L. Cuminetti, C. d'Andréa, N. Bouscaren","doi":"10.1016/j.lpmope.2022.100029","DOIUrl":"https://doi.org/10.1016/j.lpmope.2022.100029","url":null,"abstract":"","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"139 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76114571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1016/j.lpmope.2022.100027
T. S. Nguyen, G. Kanny, C. Clesse, L. Bernard, Charly Beyaert, M. Batt, P. Patrizio
{"title":"Views, facilitators, barriers and strategies associated with detoxification in patients with opioid use disorder: A qualitative study on primary care general practitioners.","authors":"T. S. Nguyen, G. Kanny, C. Clesse, L. Bernard, Charly Beyaert, M. Batt, P. Patrizio","doi":"10.1016/j.lpmope.2022.100027","DOIUrl":"https://doi.org/10.1016/j.lpmope.2022.100027","url":null,"abstract":"","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"117 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79403518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1016/j.lpmope.2022.100025
{"title":"Erratum to: “Reprint of: Development of vaccines and vaccinal strategies against COVID-19: The information contributing to shared decision-making” by Bruet S et al. (La Presse Medicale Open 2022; 3: 100024 -https://doi.org/10.1016/j.lpmope.2022.100024)","authors":"","doi":"10.1016/j.lpmope.2022.100025","DOIUrl":"https://doi.org/10.1016/j.lpmope.2022.100025","url":null,"abstract":"","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"3 1","pages":"100025 - 100025"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88780674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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