title: French Experience with Buprenorphine : Do Physicians Follow the Guidelines?
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.
authors.affiliation: Department of addictive disorders, ERCR SPURBO,, Université de Bretagne occidentale, Brest, France.
authors.forename: Morgane
authors.initials: M
authors.lastname: Guillou Landreat
authors.affiliation: Addiction psychiatry, CHU Nantes, Nantes, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Rozaire
authors.affiliation: Addiction department "Les Apsyades", Nantes, France.
authors.forename: Jean Yves
authors.initials: JY
authors.lastname: Guillet
authors.affiliation: Pharmacology department, Universitary Hospital Nantes, Nantes, France; EA 4275, Faculté de médecine Nantes, Nantes, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Victorri Vigneau
authors.affiliation: Department of general practice, ERCR SPURBO, Universitéde Bretagne occidentale, Brest, France.
authors.forename: Jean Yves
authors.initials: JY
authors.lastname: Le Reste
authors.affiliation: Pharmacology department, Universitary Hospital Nantes, Nantes, France; Addiction psychiatry, Universitary Hospital Nantes, Nantes, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Grall Bronnec
mesh_terms: D002047:Buprenorphine / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005602:France; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D058850:Opiate Substitution Treatment / Q000706:statistics & numerical data; D009293:Opioid-Related Disorders / Q000188:drug therapy; D010820:Physicians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
chemical_list: D002047:Buprenorphine