Дисертації з теми "Médecins généralistes – Prescription médicale"
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Pause, Jean-Bernard. "Analyse des prescriptions médicales de médecins généralistes de Charente à partir de cas simulés." Bordeaux 2, 1994. http://www.theses.fr/1994BOR2M166.
Vandebussche, Anne. "Prescription des examens morphologiques coliques : propositions de recommandations faites par un groupe d'experts et de médecins généralistes." Bordeaux 2, 1996. http://www.theses.fr/1996BOR2M054.
Nicolas, Jean-Louis. "Examen d'un processus d'analyse typologique : application à l'étude de la perception de la publicité médicale et des prescriptions des médecins généralistes." Clermont-Ferrand 1, 1990. http://www.theses.fr/1990CLF10001.
Laurence, Dominique. "Les variables explicatives du comportement de recherche d'information du prescripteur médical : une étude exploratoire." Dijon, 1995. http://www.theses.fr/1995DIJOE003.
This study of prescriber-oriented communication patterns in medecine within a statutory context enforcing specific constrains underlines the difficulty experienced by general practitionners in targeting appropriate population groups. It directs our attentio to the question of whether taking in account the individual caracteristiques of prescribers could approuve our knowledge of their information-seeking procedures. The conception and validation of a model derived from these patterns reflecting variables linked to professional codes of pratice and to individual cognitive factors lead to the definition of operationally effective targenting of this population and the personnalization of promotional material
Mauffré, Christian-Eric. "Influence de la qualité de la relation visiteur médical–médecin généraliste sur l’intention de prescrire un nouveau médicament." Thesis, Grenoble, 2013. http://www.theses.fr/2013GRENG012.
The quality of the relationship between the pharmaceutical sales representative and the physician, influence the prescribing physician loyalty to the pharmaceutical sales representative, the relationship quality also influences the physician to prescribe a new product. The decision to refer exclusively to the contents of the relationship with the concept of the relationship, is a novel approach in the field of prescription, it is validated by the results of the investigation. If the general practitioner, to prescribe, does not need items other than his personal experience of this drug, the influence of loyalty to the health visitor will have little importance. Conversely, for a new drug the doctor will base its intention to prescribe on the quality of the established relationship, but also on his loyalty to the pharmaceutical representative, Isolating the variable sensitivity to innovation, of the general practitioner, we can demonstrate its influence on his intention to prescribe a new drug. But innovation is a major challenge for the pharmaceutical industry and also for the physician; it involves both knowledge and prescription of drugs. The information appears complex due to the multiplicity of sources and the doctor will base its decision to prescribe a new drug on personal characteristic, its own vision of the novelty, his own sensitivity to innovation. Our results show that in 2013 in France it is difficult to develop strategies to launch drug while ignoring the relational orientation of physicians. Our results highlight the influence of the quality of the relationship on the intention to prescribe. Our approach will not only allow a better understanding of the mechanisms of creation and development of the quality of the relationship between the pharmaceutical sales representative and the general practitioner, but also to measure this concept through its components (trust, satisfaction and commitment in the relationship). Similarly, sensitivity to innovation is an individual characteristic of the general practitioner, as marketers in targeting strategies physicians should consider before launch. Similarly, sensitivity to innovation is an individual characteristic of the general practitioner, as such; it must be taken in account when marketers are targeting strategies to them
Gaston, Philippe. "Vers un droit du médecin généraliste libéral à l'information relative au médicament." Electronic Thesis or Diss., Paris 8, 2014. http://www.theses.fr/2014PA080014.
The proper use of medicinal products is in the general interest and a public health issue. The quality of the information received by the prescribing general practitioners is a determining factor in the good use of medicinal products. The health crises related to medicinal products have revealed their misuse due to prescribers’ lack of information. Doctor’s prescriptions are the patient’s only means of access to the medicinal product. A prerequisite for the sale of medicine eligible for refunding, general practitioners are receiving a great deal of attention from pharmaceutical firms. The marketing strategy is global and the visit of pharma reps is its armed wing. Companies invest disproportionately compared with public authorities.Which means that most of the information received by prescribers comes from the pharmaceutical industry. The information provided is biased and doesn’t stand the test in the face of public interest. Faced with the power of the pharmaceutical industry one should not ask how it could be improved but how to change it. This research paper will demonstrate that it is in the general interest that when it comes to the information given on the proper use of medicinal products, a paradigm shift is not only needed but also possible. The author seeks to encourage the legislator to provide the prescriber with the statutory right to receive independent public information on medicinal products. It proposes to make this right effective by setting up a new public service under the auspices of a new actor, the Pharmaceutical Informer, which would be conducted and managed by an autonomous Agency providing independent information on medecinal products
Chabrol-Rivière, Sylvie. "La visite du délégué médical en cabinet de médecine générale a-t-elle une valeur formatrice ? : enquête auprès de 20 praticiens." Montpellier 1, 1992. http://www.theses.fr/1992MON11158.
Gaston, Philippe. "Vers un droit du médecin généraliste libéral à l'information relative au médicament." Thesis, Paris 8, 2014. http://www.theses.fr/2014PA080014.
The proper use of medicinal products is in the general interest and a public health issue. The quality of the information received by the prescribing general practitioners is a determining factor in the good use of medicinal products. The health crises related to medicinal products have revealed their misuse due to prescribers’ lack of information. Doctor’s prescriptions are the patient’s only means of access to the medicinal product. A prerequisite for the sale of medicine eligible for refunding, general practitioners are receiving a great deal of attention from pharmaceutical firms. The marketing strategy is global and the visit of pharma reps is its armed wing. Companies invest disproportionately compared with public authorities.Which means that most of the information received by prescribers comes from the pharmaceutical industry. The information provided is biased and doesn’t stand the test in the face of public interest. Faced with the power of the pharmaceutical industry one should not ask how it could be improved but how to change it. This research paper will demonstrate that it is in the general interest that when it comes to the information given on the proper use of medicinal products, a paradigm shift is not only needed but also possible. The author seeks to encourage the legislator to provide the prescriber with the statutory right to receive independent public information on medicinal products. It proposes to make this right effective by setting up a new public service under the auspices of a new actor, the Pharmaceutical Informer, which would be conducted and managed by an autonomous Agency providing independent information on medecinal products
Bègue, Cyril. "Prise en charge des problématiques de santé au travail par le médecin généraliste." Electronic Thesis or Diss., Angers, 2023. http://www.theses.fr/2023ANGE0045.
General practitioners are frequently confronted with patients presenting occupational health problems. The aim of this thesis was to explore this type of care by documenting practices, to help improving practices by designing an educational resource, and to help producing contextualised data by proposing a research protocol. The study confirmed that GPs frequently prescribe sick leave. The prescription rate varied according to gender, age, socioprofessional category and length of consultation. The frequency of use of two return to work tools (pre-return-to-work medical consultation and therapeutic part-time work) and the frequency of contact with the occupational physician were satisfactory, although not optimal. A book chapter was written to document the role of the general practitioner in dealing with these problems, while also providing a training resource. Finally, a protocol was proposed for a complex intervention designed to improve the management of psychological suffering at work, based on 4 axes : training of GPs, rapid referral to the occupational physician, prescription and extension of sick leave and close follow-up
Rebecq, Geneviève. "La prescription médicale." Toulon, 1997. http://www.theses.fr/1997TOUL0024.
Owing to the scientific progresses of these last few years, the medical prescription altered and it deserves to be analysed both individually and collectively. Individually, with regard to the particular relation doctor, patient : in that case, this prescription lies within the scope of free therapy. To the doctor's prerogative comes up the patient's legitime expectations. The prescriptor brings to a welle considered choice, in accordance with the informations of science and the well of his patient. Letting prudence be his guide, owing to the elaboration of the prescription, the doctor must never forget that his patient is a human being with its own wishes that have to be respected. Prescription is carried through the patient's content. Collectively, because health has a cost and the singular colloquium concerns from now an other persons that provide repayment for the expenses due to patients. Concerned with the financial effects linked to prescription, these persons have the right to control the medical activity. Kept under a watch that becomes higher and higher, prescription must also be analysed according to the social interest. That's the reason why prescription is subjected, not only to the control of social securities but also to that of the employer and of the privat insurance company. These controls reveal behaviours that are prejudicial to the social interest, they show inconsiderate spendings for the collectivity and they can come to a vast number of penalities prononced against the doctor on the cause oh his social responsability. Against that, the authorities are firmly determinated to penalize according two completely different means. Actually, the reform, carried out by the edict of 1996 has not only maintained the existence of an individuel social responsability of the doctor, but also conducted to a collective social responsability, conducting to the principle of a reversion concerning all the doctors linked to the state health service
Clement, Quentin. "La formation médicale continue des médecins généralistes au travers de l'analyse de la presse médicale." Montpellier 1, 1996. http://www.theses.fr/1996MON11130.
Laurens, Vincent. "Le sein en pratique médicale courante : bilan actuel." Montpellier 1, 1988. http://www.theses.fr/1988MON11323.
Viallon, Alain. "La demande en formation médicale continue des médecins généralistes issus de la faculté de Saint-Etienne." Saint-Etienne, 1993. http://www.theses.fr/1993STET6210.
Remignon-Dalverny, Claude. "La formation médicale continue des médecins généralistes : place de l'industrie pharmaceutique, enquête-entretiens et comptes rendus." Bordeaux 2, 1992. http://www.theses.fr/1992BOR2M050.
Guo, Jing. "Serious Games pour la e-Santé : application à la formation des médecins généralistes." Phd thesis, Toulouse 3, 2016. http://oatao.univ-toulouse.fr/17813/1/the%CC%80se_GUO.pdf.
Luquet, Thierry. "La trousse médicale d'urgence du médecin généraliste de campagne." Bordeaux 2, 1991. http://www.theses.fr/1991BOR2M215.
Leal-Choy, Florence. "Des médecins généralistes et leur association locale de formation médicale continue : marge pour un processus d'autoformation et consèquences ; analyse d'une association professionnelle de formation continue dans une ville moyenne : 1995-1996." Bordeaux 2, 1999. http://www.theses.fr/1999BOR21020.
Albareil, Christian. "Réalisation d'un document pédagogique de vidéo interactive (vidéodisque) pour la formation médicale continue. Thème :"L'examen gynécologique par le médecin généraliste." Bordeaux 2, 1990. http://www.theses.fr/1990BOR25147.
Ducla, Michel de. "Réalisation d'un vidéodisque interactif de formation médicale continue : "Les gestes d'urgence par le médecin généraliste"." Bordeaux 2, 1993. http://www.theses.fr/1993BOR2M026.
Heuillet, Philippe. "Evaluation médicale et medecine générale (Buts/Objectifs): enquête d'opinion auprés de vingt praticiens." Bordeaux 2, 1995. http://www.theses.fr/1995BOR2M085.
Dagada, Corinne. "Perception de la prise en charge des patients atteints de cancer par les médecins généralistes : résultats d'une enquête auprès de 422 médecins en Aquitaine." Bordeaux 2, 2000. http://www.theses.fr/2000BOR23070.
Papin, Marie-Nathalie. "Structure d'urgence du CHU de Pointe-à-Pitre : analyse du recours par les omnipraticiens de ville et comparaison à une population témoin." Antilles-Guyane, 2010. http://www.theses.fr/2010AGUY0370.
INTRODUCTION: the activity of the emergency departments (ED) is in constant increase. We analyzed the recourse to the ED by the general practitioners and tried to know if they establish a predictive factor of hospitalization and specialized coverage. METHOD : descriptive forward-Iooking Study not randomized realized over 3 weeks in the ED of the teaching hospital of Pointe-à-Pitre (FWI). Ali the patients with a letter of admission were included. The concemed doctors were contacted by phone. The main analyzed variables concerned the characteristics of the consultation, the reason of the recourse to the ED, and satisfaction of the doctor on the coverage. This population was then compared with a witness population. The main criteria of comparison were the request of additional examination, specialized notice, the rate of hospitalization and the CCMU classification (Clinical Classification of the ED's patients). RESULTS ; 154 inclusive patients. Sex-ratio 1,17. Somalie pathologies concem more than 80 % of the recourse. Main motives to resort t the ED are the request of additional examination (57%), specialized notice (45%) and\or of hospitalization (36%). Their proportion in ED i more important among refered patients (respectively 82 % vs 49 %, 36 % vs 17 % and 38 % vs 9 %), who are mainly classified CCMU 2 (74 %) and CCMU 1 (13 %). CONCLUSION: the resort to the ED by general practitioners seems often motivated by the lack of accessibility to available resources in Iiberal. The emergency degree does not appear as the main factor. The fact of being sent seems to represent a predictive factor of more specific care
Jourdain, Patrick. "Prescription médicamenteuse en médecine générale pendant la grossesse : à propos d'une enquête menée auprès de 107 omnipraticiens." Bordeaux 2, 1999. http://www.theses.fr/1999BOR2M136.
Paradis, Hélène. "Des études à la pratique médicale : questions que tout carabin en fin de cursus est en droit de se poser." Bordeaux 2, 1992. http://www.theses.fr/1992BOR2M124.
Rougé, Bugat Marie-Eve. "Place du médecin généraliste dans la nouvelle organisation des soins en cancérologie." Toulouse 3, 2014. http://thesesups.ups-tlse.fr/2628/.
The overall management of cancer patients requests general practitioners (GPs). GP takes part in prevention, screening, announcement and follow-up. Cancer patients' follow-up is divided into management of adverse effects of the disease and complications due to cancer itself. In Toulouse, the University Cancer Institute is about to open. Coordination between private practices and public hospital is key to ensure that all patients receive care and support from hospital bedside to home. Oncology and general practice will have to strengthen the ties and gain better understanding of eachother. The first part of the work is to explore the various phases of the diagnosis of cancer by GPs. The results indicate that the announcement of cancer is done in three phases: "pre-announcement " institutional announcement and "post-announcement". The second part is to investigate GP's role in informing patient and his family at the entry into palliative patients with lung cancer. 77% of patients saw their GP after the announcement of the initial diagnosis and 53 % expected prognostic information. GPs say they have difficulty in meeting the expectations of information for patients and their families in palliative situation. A third study was to understand the challenge for the GPs to identify older patients "frail" and "pre- frail". They are a target population can benefit from specific interventions to delay entry into dependency. These patients are at this stage, not yet seen by the geriatrician. Nearly a third of all cancers occur in people over 75 years. Walking speed has been tested and proved to be a decisive tool. In the fourth part, we developed sheets of adverse effects of anti-cancer chemotherapy and guidelines for GPs. The evaluation was conducted in three stages: collection of expectations, GPs opinion and sheets' utility. 200 GPs concerned with patients undergoing chemotherapy were interviewed. Over 70% have used them and found them useful. A draft alternate follow-up of patients with breast cancer in Midi- Pyrenees, fifth part of my thesis, was launched in 2010. The results of this prospective interventional study were obtained at the end of 2013. The monitoring model we proposed is disappointing. Oncologists adhere little device and GPs do not draw follow-up consultations systematically. Finally, in order to reduce inequalities between patient facing cancer, we developed a project to recognize cancer as occupational disease. This prospective and interventional project identifies these patients to rebuild their career (" Cursus Laboris ") and to assist in GP's approaches statement. All available records have been recognized as occupational disease. This thesis points out field actions that could improve cancer patient care. The main idea is to narrow the gap between oncology and general practice by putting GPs at the heart of french cancer care planning
Liberalotto, Nora Alejandra. "L'engagement des médecins généralistes à l’égard du dépistage des cancers féminins : un révélateur de leurs positionnements face aux transformations de leur contexte d’exercice." Paris, EHESS, 2012. http://www.theses.fr/2012EHES0014.
Employing an approach based on concepts and methods of symbolic interactionism, this thesis studies the general practitioners’ (GPs) commitment in the screening for breast and cervical cancers and seeks, in particular, to understand the implications, terms as well as reasons and beliefs that underlie their commitment. This research is based on a qualitative sociological approach, from which a corpus of various materials has been put together and analyzed. Data was generated through semi-structured interviews with GPs from various French regions. Methodologically, these interviews have been central, but not exclusive. In addition, other sources such as statistics, general and medical journals and official reports and legislation have been consulted. The analysis of this data allowed us to understand that the ways in which practitioners conceptualize and develop their interventions in these screening processes vary considerably, depending on various structural and subjective elements; some of which are likely to evolve throughout the physicians’ careers. Such diversity of attitudes resulting thereof seems contingent on the particular context of the French health care system, which gives GPs a considerable scope of individual autonomy to decide the content of their actions. Due to the fact that, since a few decades, this scope of autonomy tends to decrease, this study of the heterogeneity of GPs’ notions and practices towards women’s cancer screening appears to be significant of the ways in which GPs cope with the main issues that characterize their area of practice and challenge their autonomy as practitioners
Michel-Lepage, Audrey. "Améliorer la prescription médicamenteuse grâce à des mécanismes économiques?" Thesis, Aix-Marseille, 2016. http://www.theses.fr/2016AIXM2028.
Antibiotic misuse and antibiotic resistance are increasing concern for international health authorities. The goal of my thesis is to assess the different incentives which would lead physicians to optimize their antibiotic prescriptions. The first part is a literature review analysing interactions between the agents of the French health system. I evaluate also financial and non-monetary incentives. The second and third parts illustrates the first one through empiric analyses, which have been published or sent to a review. The second part studies the use and the impact of diagnostic tests as a help for antibiotics prescribing, with on one hand the use of rapid diagnostic tests detecting tonsillitis, and on the other hand microbiological tests called Point-Of-care made at the patient bedside. The third part analyses the pay-for-performance program as a financial incentive for improving drugs prescriptions and notably antibiotics
Bessac, Alain. "Usage des antidépresseurs en médecine interne : étude à propos de 63 patients hospitalisés dans un service de médecine interne et ayant un traitement antidépresseur à leur entrée." Bordeaux 2, 2000. http://www.theses.fr/2000BOR2M112.
Guiraudet, Marie-Noe͏̈lle. "Prescriptions inappropriées en médecine générale : analyse de cent vingt observations recueillies au centre régional de pharmacovigilance de Bordeaux au cours de l'année 1996." Bordeaux 2, 1999. http://www.theses.fr/1999BOR2M020.
Pilorge, Céline. "Réguler le marché de ville du médicament français : Trois essais de microéconomie appliquée." Thesis, Paris Est, 2016. http://www.theses.fr/2016PESC0061/document.
This thesis addresses several issues: on the one hand, we focus on policies for controlling drug expenditures: on the other hand, we analyze the price competition on the OTC drugs market, in a context of drugs delisting policies.In recent years, some plans to affect change and improve prescribing practices are developed, with the emergence of physician profiling methods. The first chapter wonders about such a profiling in the current information system. Results show that outliers can be correctly identified; but to broaden profiling, we have to use some disease-specific indicators, or to improve information systems with diagnostic codes to define more general indicators.In addition to patient health, various sociological and economic factors may influence physician practices, including the competitive environment. The second chapter focuses on the unequal spatial distribution of general practitioners on drugs prescribing variability. Results are sensitive to the specification used for the medical density variable and suggest there is no effect of the density variation on the average prescribing cost per patient and per physician. However, this result reflects the sum of two opposite effects that cancel.In a context where the sale of OTC drugs outside pharmacies is controversial, the third chapter show there is no price competition between pharmacies on this market segment
Bully, David. "Les enfants d'Hippocrate : modèles professionnels et renouvellement générationnel en médecine générale." Thesis, Besançon, 2016. http://www.theses.fr/2016BESA1011.
In France, ever since the early 2000s, the discourse on medical shortages has become an issue and the geographical accessibility to primary health care has become a matter of public policy and regional planning. As a result of the gradual tightening of the numerus clausus and the attractiveness of the various forms of salaried activities, the decrease in the supply of primary care raises the question of private practitioners turnover. In addition, the fresh graduates in general medicine, who nevertheless chose a private practice, are turning away from vacant surgeries left by their predecessors, and show new expectations in terms of work organization.This thesis focuses on the issue of the liberal general practitioners turnover. It questions the newcomers' loss of interest for traditional exercise pattern from the new-comers, and shows that their generational affiliation is a possible interpretive key to understand the changes at work in the private practice of general medicine.The comparison between two generations of liberal General Practitioners, the incomers and the leavers, has helped to contextualize the choice of exercise of each group from their respective period of installation. While making a distinction between the socio-historical changes that affect the work sphere plus the family and personal world and those related to the medical field, particularly demographic changes, this perspective has shown how anchoring, in a particular context, shapes a specific link to work for a specific generation, and determines how to practice general medicine.Finally, inequalities in primary care available in Franche-Comté have raised issues that are discussed in this thesis as well as the tools given by the government to solve them. It provided the opportunity to question the representations that both generations of General Practitioners have about collective work, especially the balance between the incomers’ expectations who are taking up the craft and the concept of collective work which is supposed to be tomorrow’s mainstream
Decamp, Sabine. "Les représentations de la maladie chez les migrants : données anthropologiques à partir de la littérature, pour une meilleure prise en charge du migrant en médecine générale." Bordeaux 2, 2001. http://www.theses.fr/2001BOR2M059.
Tennessel, Marianne. "Thérapies cognitivo-comportementales et médecine de ville : apports des concepts et techniques T.C.C. pour le médecin généraliste." Thesis, Toulouse 2, 2015. http://www.theses.fr/2015TOU20070/document.
Background: Mental health problems are prevalent in all countries and make up approximately one-third of consultations for general practitioners (GP) in large cities. In France, GPs provide service delivery to the majority of common psychopathological disorders. According to the National College of GP Educators, GPs are well suited to provide follow-up to these patients. Yet, many factors make this type of service delivery difficult: initial medical school training, the particularities of the French health system including a lack of networked service delivery, and poor communication between GPs and other health service providers, to name a few. These difficulties result in an over-usage of prescription psychotropic medications and this to the detriment of other types of therapies. Objectives: The objective of the current work is to better understand practices, attitudes and expectations of French GPs with regards to mental health treatment and the usage of CBT, an empirically validated approach to mental health problems that is still largely underutilized in France. Method: A study was implemented with the participation of French GPs. Results: The results show an overall need for better training of GPs. These results underline theoretical concepts in CBT and how they could provide a better foundation in both initial and continuing education of GPs, as well as how they could be integrated into the GP’s daily practice. Discussion: Limits of the work are presented along with a detailed inventory of CBT concepts that could be provided through an internet-based continuing education program for primary care doctors
Chevillard, Guillaume. "Dynamiques territoriales et offre de soins : l’implantation des maisons de santé en France métropolitaine." Thesis, Paris 10, 2015. http://www.theses.fr/2015PA100109/document.
France faces an old and persistent problem, which is geographical imbalance of general practitioners. This uneven distribution grows at a steady pace due to less attractive areas. New urban and rural areas are emerging with limited access to primary health care, while existing ones grow even bigger. Since 2008, the liberal primary care team (PCT) are financially supported by the public authorities. They hope this structure will attract and retain general practitioner in the aforementioned areas.This study aims to explore how the space and the territory contribute to the localisation of PCT and how these structures affect spaces and territories. Localisation and impact of PCT are studied at different level, using quantitative and qualitative approaches. Spatial analysis of PCT is based on several tools such as SIG and typology in synergy with field investigation in two French regions. Effects of PCT on general practitioner density are studied on a national scale comparing the evolution of this density in space with PCT and similar space without PCT. The results are completed with field investigation
Dumontet, Magali. "Féminisation, activité libérale et lieu d'installation : quels enjeux en médecine générale ? : Analyses micro-économétriques de l'offre de soins." Thesis, Paris 9, 2015. http://www.theses.fr/2015PA090023/document.
In the context of changes of general practice (uneven distribution of young general practitioners (GPs) across the country, strong feminisation), this thesis focuses on the determinants of the outpatient care supply of general practitioners. Using different micro-econometric analyses, firstly we want to understand the impact of feminization on the incomes of general practitioners and specifically on their private practice behaviours in terms of volume of care provided but also composition of the activity (consultations, home visits). Secondly, we study the determinants of the practice location choice within the region and we identify the levers that could improve the distribution of GPs in the area. Our results confirm that female GPs provide fewer services than male GPs and they also have a different composition of private practice activity. However, we show that male and female GPs adopt a similar practice location choice. Factors characterizing the place of installation as the characteristics associated with the supply of care, the demand for care, or equipment influence the practice location choice
Freyd, Louis. "Croyances et antidépresseurs : analyse du discours de patients, de psychiatres, de psychologues, de médecins généralistes et de représentants pharmaceutiques d'un centre hospitalier." Thèse, 2009. http://www.archipel.uqam.ca/2462/1/D1857.pdf.