French general practitioners' attitudes and prescription patterns toward buprenorphine maintenance treatment: does doctor shopping reflect buprenorphine misuse?
This study investigated attitudes toward buprenorphine maintenance treatment (BMT) among general practitioners (GPs) and their maintained patients' propensity to turn to several prescribers (doctor shopping), among a sample of 345 GPs prescribing BMT in South-Eastern France. Survey data were anonymously matched to administrative data that provided information about GPs' patients. A simultaneous equation model suggests that GPs' attitude influenced doctor shopping, not the reverse. Doctor shopping was lower among GPs who reported inducting BMT with 8 mg of buprenorphine per day or more, and was higher for GPs endorsing a stringent attitude toward patients. Thus doctor shopping should not be understood exclusively as a deviant behaviour. It is partially physician-driven, and further research is needed to assess whether it reflects patients' dissatisfaction toward inappropriate care supply and the difficulty to establish a good therapeutic relationship between an opiate-dependent patient and a general practitioner.
Feroni
Isabelle
I
Regional Centre for Disease Control of South-Eastern France (ORS PACA) and INSERM Research Unit 379, Social Sciences Applied to Medical Innovation, Institut Paoli Calmettes, Marseille, France.
Peretti-Watel
Patrick
P
Paraponaris
Alain
A
Masut
Alain
A
Ronfle
Eleonore
E
Mabriez
Jean-Claude
JC
Obadia
Yolande
Y
D000328:Adult; D001291:Attitude of Health Personnel; D002047:Buprenorphine / Q000627:therapeutic use; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009292:Narcotic Antagonists / Q000627:therapeutic use; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology* / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology
D009292:Narcotic Antagonists; D002047:Buprenorphine