GPs' management of polypharmacy and therapeutic dilemma in patients with multimorbidity: a cross-sectional survey of GPs in France

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
Hélène CarrierPierre Verger

Abstract

GPs are confronted with therapeutic dilemmas in treating patients with multimorbidity and/or polypharmacy when unfavourable medication risk-benefit ratios (RBRs) conflict with patients' demands. To understand GPs' attitudes about prescribing and/or deprescribing medicines for patients with multimorbidity and/or polypharmacy, and factors associated with their decisions. Cross-sectional survey in 2016 among a national panel of 1266 randomly selected GPs in private practice in France. GPs' opinions and attitudes were explored using a standardised questionnaire including a case vignette about a female treated for multiple somatic diseases, sleeping disorders, and chronic pain. Participants were randomly assigned one of eight versions of this case vignette, varying by patient age, socioprofessional status, and stroke history. Backward selection was used to identify factors associated with GPs' decisions about drugs they considered inappropriate. Nearly all (91.4%) responders felt comfortable or fairly comfortable deprescribing inappropriate medications, but only 34.7% decided to do so often or very often. In the clinical vignette, most GPs chose to discontinue symptomatic medications (for example, benzodiazepine, paracetamol/tramado...Continue Reading

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Mar 4, 2015·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Carol SinnottColin P Bradley
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Mar 9, 2017·The European Journal of General Practice·Hannelore StormsNeree Claes
May 24, 2017·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Barbara ClyneUNKNOWN OPTI-SCRIPT study team
Oct 8, 2013·Journal of Comorbidity·José Almirall, Martin Fortin
Mar 14, 2018·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Anna CassellSimon Griffin

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Citations

May 19, 2021·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Karolina KuberskaJenni Burt
Sep 23, 2021·Scandinavian Journal of Primary Health Care·Naldy Parodi LópezSusanna M Wallerstedt

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