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Les pratiques médicales de sevrage du patient alcoolo-dépendant. Influence de la conférence de consensus de 1999

Abstract : Objectives: in the context of the heterogeneity of prescription and modalities of withdrawal of alcohol-dependent patients, the Soci6t6 Française d'Alcoologie organized a consensus conference in 1999 in order to promote clinical practice guidelines, especially first-line outpatient withdrawal, drug recommendations, and psychosocial support. In the absence of an integrated device for evaluation of the impact of the conference, the purpose of this article was to try to detect, five years after publication of these guidelines, a favourable evolution of clinical practice in the field of withdrawal both in general practice and in specialized structures. Method: this study was based on comparative statistical analysis of data derived from the medical charts of patients undergoing outpatient (326) or inpatient withdrawal (153) in 1999 and 2005. Results: an increased commitment of general practitioners was observed between 1999 and 2005. The absolute number of weaned patients doubled (49/97) and their proportion compared to patients declared to be alcohol-dependent increased from 42% to 47%. A trend to-wards harmonization of withdrawal practices was also observed with, for example, a non-significant increase of prescription of benzodiazepines (BZD, 56.3% in 1999, 64.9% in 2005). Similarly, psychosocial support was set up for 25% of patients versus 13%. A very high level of compliance with guidelines was observed for withdrawal conducted in specialized units. The rate of prescription of BZD alone or in combination with other drugs increased from 64.8% in 1999 to 97.5% in 2005, and the mean duration of treatment decreased from 13.2 to eight days. Discussion: apart from the methodological limitations, the discussion emphasizes the different types of patients seen by general practitioners and specialized units, as well as the specificity and complementarity of their respective practices.
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https://hal-cnrs.archives-ouvertes.fr/hal-03478600
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Submitted on : Tuesday, December 14, 2021 - 8:40:10 AM
Last modification on : Friday, December 17, 2021 - 9:53:46 AM

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  • HAL Id : hal-03478600, version 1

Citation

Martine Bungener, C Despres, Lise Demagny. Les pratiques médicales de sevrage du patient alcoolo-dépendant. Influence de la conférence de consensus de 1999. Alcoologie et addictologie, Issy-les-Moulineaux : Princeps éd., 2011, 33 (4), pp.333-344. ⟨hal-03478600⟩

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