title: [General medicine management of superficial venous thrombosis of the lower limbs: A survey in Saône-et-Loire].
abstract: BACKGROUND
  For a long time, superficial venous thrombosis (SVT) of the lower limbs was considered as benign. Due to lack of clear scientific evidence, its treatment was heterogeneous and even potentially deleterious. Since 2010, several major studies have highlighted the seriousness of SVT, and prophylactic doses of fondaparinux have proven their efficacy for this indication. While the French recommendations have not yet taken on board all this data, has practice already changed?
  
  
  OBJECTIVE
  To describe in general practice the usual management of suspected SVT.
  
  
  METHODS
  A descriptive cross-sectional study of general practitioners in Saône-et-Loire. Each doctor taking part was asked to note on a paper questionnaire the details of the last patient in whom they suspected SVT. Data collected included: clinical presentation, diagnostic and therapeutic management and follow-up of the patients.
  
  
  RESULTS
  Between 01/01/2014 and 31/03/2014, 88 doctors out of 443 contacted (20%) completed the questionnaire. According to the information they provided, 36 physicians (40.9% [95% CI: 30.6-50.2]) searched for an associated pulmonary embolism. Eighty-two physicians (93.2% [95% CI: 87.9-98.4]) prescribed a venous compression ultrasound (CUS) exploration. Twelve etiological assessments were carried out (13.6% [95% CI: 6.5-20.8]) of which 6 (6.8%) appeared to be justified. 64 (72.7%) of the patients were given an anticoagulant therapy (heparin or fondaparinux), including 15 (17%) at a prophylactic dose and 49 (55.7%) at a curative dose. Forty-nine doctors (55.7% [95% CI: 45.3-66.1]) prescribed a CUS follow-up.
  
  
  CONCLUSIONS
  General practitioners seem to have adapted their diagnostic practices to the data highlighting the potential seriousness of SVT. The treatment they give, however, remains very variable and potentially deleterious, in particular due to a high rate of treatments given at curative doses.
authors.affiliation: Département de médecine générale, université Jean-Monnet, 10, rue Tréfilerie, 42100 Saint-Étienne, France. Electronic address: ccedric42100@aol.com.
authors.forename: C
authors.initials: C
authors.lastname: Cartal
authors.affiliation: Service de médecine vasculaire et thérapeutique, groupe de recherche sur la thrombose (EA 3065), hôpital Nord, CHU de Saint-Étienne, université Jean-Monnet, 42100 Saint-Étienne, France.
authors.forename: L
authors.initials: L
authors.lastname: Bertoletti
authors.affiliation: Service de médecine vasculaire et thérapeutique, groupe de recherche sur la thrombose (EA 3065), hôpital Nord, CHU de Saint-Étienne, université Jean-Monnet, 42100 Saint-Étienne, France.
authors.forename: H
authors.initials: H
authors.lastname: Décousus
authors.affiliation: CIC-épidémiologie clinique, Inserm CIE3, EA3065, département de médecine générale, université Jean-Monnet, 42100 Saint-Étienne, France.
authors.forename: P
authors.initials: P
authors.lastname: Frappe
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D000077425:Fondaparinux; D005602:France / Q000453:epidemiology; D058005:General Practitioners / Q000523:psychology / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D007866:Leg / Q000098:blood supply*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011134:Polysaccharides / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis; D012307:Risk Factors; D053828:Stockings, Compression; D011795:Surveys and Questionnaires; D018608:Ultrasonography, Doppler / Q000706:statistics & numerical data; D020246:Venous Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D000893:Anti-Inflammatory Agents; D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; D010975:Platelet Aggregation Inhibitors; D011134:Polysaccharides; C036309:fibrin fragment D; D006493:Heparin; D000077425:Fondaparinux
keywords: Attitudes and health practices; Attitudes et pratiques en santé; Connaissances; General practice; Knowledge; Médecine générale; Superficial venous thrombosis; Thrombose veineuse superficielle