title: Difficulties associated with outpatient management of drug abusers by general practitioners. A cross-sectional survey of general practitioners with and without methadone patients in Switzerland.
abstract: BACKGROUND
  In Switzerland, general practitioners (GPs) manage most of the patients receiving methadone maintenance treatment (MMT).
  
  
  METHODS
  Using a cross-sectional postal survey of GPs who treat MMT patients and GPs who do not, we studied the difficulties encountered in the out-patient management of drug-addicted patients. We sent a questionnaire to every GP with MMT patients (556) in the French-speaking part of Switzerland (1,757,000 inhabitants). We sent another shorter questionnaire to primary care physicians without MMT patients living in the Swiss Canton of Vaud.
  
  
  RESULTS
  The response rate was 63.3%. The highest methadone dose given by GPs to MMT patients averaged 120.4 mg/day. When asked about help they would like to be given, GPs with MMT patients primarily mentioned the importance of receiving adequate fees for the care they provide. Secondly, they mentioned the importance of better training, better knowledge of psychiatric pathologies, and discussion groups on practical cases. GPs without MMT patients refuse to treat these patients mostly for emotional and relational reasons.
  
  
  CONCLUSIONS
  GPs encounter financial, relational and emotional difficulties with MMT patients. They desire better fees for services and better training.
authors.affiliation: Policlinique Médicale Universitaire, Lausanne, Switzerland. Anne.Pelet@hospvd.ch
authors.forename: Anne
authors.initials: A
authors.lastname: Pelet
authors.forename: Jacques
authors.initials: J
authors.lastname: Besson
authors.forename: Alain
authors.initials: A
authors.lastname: Pécoud
authors.forename: Bernard
authors.initials: B
authors.lastname: Favrat
mesh_terms: D000553:Ambulatory Care / Q000191:economics; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000191:economics / Q000600:supply & distribution*; D008691:Methadone / Q000008:administration & dosage; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000191:economics; D016079:Refusal to Treat / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000628:therapy*; D011795:Surveys and Questionnaires; D013557:Switzerland
chemical_list: D008691:Methadone