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Article ; Online: Shared medical decision in prostate cancer screening in primary care: a systematic literature review of current evidence.

Lutaud, Romain / Ollivier, Quentin / Fierling, Thomas

2024

Abstract: Purpose: Prostate cancer screening has not significantly reduced mortality. International guidelines strongly endorse shared decision-making to navigate risks, emphasizing its crucial role prior to prescribing a prostate-specific antigen test. This ... ...

Abstract	Purpose: Prostate cancer screening has not significantly reduced mortality. International guidelines strongly endorse shared decision-making to navigate risks, emphasizing its crucial role prior to prescribing a prostate-specific antigen test. This study aims to provide insight into the current role of shared decision-making in primary care for prostate cancer screening and suggest ways to improve the process. Methods: PubMed, Cochrane, and Lissa databases were searched for following terms: 'prostate-specific antigen' or 'prostate cancer screening' combined with 'shared decision making', 'informed decision making' or 'decision support' and 'primary care'. All studies were screened by two independent reviewers. This systematic review followed the PRISMA guidelines. Results: Of 85 articles screened, 34 were included. Key findings included heterogenous and poor quality implementation of shared decision-making in practice, patients with limited knowledge of shared decision-making, clinicians infrequently discussing patients' views, decision aids that could be better integrated into practice, and finally, changes in care systems to support the expansion of shared decision-making in prostate cancer screening. Conclusion: Decision aids are essential tools in the informed decision-making process. Integrating these elements into practice would require training for doctors and adjustments to the healthcare system.
Language	English
Publishing date	2024-02-06
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	204048-7
ISSN	1573-2584 ; 0301-1623 ; 0042-1162
ISSN (online)	1573-2584
ISSN	0301-1623 ; 0042-1162
DOI	10.1007/s11255-024-03947-4
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Article ; Online: Dealing with the doctor shortage: a qualitative study exploring French general practitioners' lived experiences, difficulties, and adaptive behaviours.

Dumesnil, Hélène / Lutaud, Romain / Bellon-Curutchet, Julien / Deffontaines, Aliénor / Verger, Pierre

Family practice

2024

Abstract: Context: The shortage of general practitioners (GPs) is a growing concern in Europe, especially in France. This problem is likely to continue until the end of the 2020s.: Objectives: To study the GPs' perceptions of access to care in medically ... ...

Abstract	Context: The shortage of general practitioners (GPs) is a growing concern in Europe, especially in France. This problem is likely to continue until the end of the 2020s. Objectives: To study the GPs' perceptions of access to care in medically underserved areas (i.e. with low physician density), its consequences on their working conditions, and how they cope with the resulting difficulties. Methods: Semi-structured individual interviews were conducted between May and August 2021 of 29 GPs practising in areas of southeastern France with a low physician density or at risk of a doctor shortage. Purposive sampling was used to include profiles of diverse physicians and diverse rural and urban areas. The interviews, conducted with an interview guide, were transcribed and analysed thematically. Results: The participants described a serious degradation of access to care in their areas. These issues also concerned urban areas, where they were, according to the participants, underrecognized. The participants' workloads were rising, at a rate often perceived as unsustainable: many participants, including the youngest group, reported they were exhausted. Their principal source of dissatisfaction was their impression that they could not do their work correctly. Participants reported that these difficulties required them to improvise and adapt without any official or formal method to keep their practice manageable. Conclusion: These GPs were worried about the future of their profession and their patients. They expected strong measures by public policymakers and officials, but paradoxically seemed to have little interest in the solutions these officials are promoting.
Language	English
Publishing date	2024-03-24
Publishing country	England
Document type	Journal Article
ZDB-ID	605939-9
ISSN	1460-2229 ; 0263-2136
ISSN (online)	1460-2229
ISSN	0263-2136
DOI	10.1093/fampra/cmae017
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Article ; Online: The hydroxychloroquine debate: a therapeutic dilemma for general practitioners.

Lutaud, Romain / Scronias, Dimiti / Ward, Jeremy / Verger, Pierre

European journal of public health

2021 Volume 31, Issue 2, Page(s) 283–285

Abstract: France has been at the epicenter of the worldwide debate about hydroxychloroquine, as the main advocacy for its use to treat COVID-19 comes from a research unit led by Didier Raoult in Marseille. Among a national panel of 2940 general practitioners, we ... ...

Abstract	France has been at the epicenter of the worldwide debate about hydroxychloroquine, as the main advocacy for its use to treat COVID-19 comes from a research unit led by Didier Raoult in Marseille. Among a national panel of 2940 general practitioners, we found that physicians in the areas most strongly affected by the epidemic or closest to the epicenter of the controversy reported that the hydroxychloroquine debate had made it difficult for them to deal with patients' treatment requests. Their adherence to official recommendations was also lower. It will be necessary to examine the conditions producing so strong a conflict.
MeSH term(s)	COVID-19/drug therapy ; COVID-19/epidemiology ; Female ; France/epidemiology ; General Practitioners/psychology ; General Practitioners/statistics & numerical data ; Guideline Adherence/statistics & numerical data ; Humans ; Hydroxychloroquine/therapeutic use ; Male ; Middle Aged ; Physician-Patient Relations ; Practice Guidelines as Topic
Chemical Substances	Hydroxychloroquine (4QWG6N8QKH)
Language	English
Publishing date	2021-02-13
Publishing country	England
Document type	Journal Article
ZDB-ID	1129243-x
ISSN	1464-360X ; 1101-1262
ISSN (online)	1464-360X
ISSN	1101-1262
DOI	10.1093/eurpub/ckab002
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Zs.A 3499: Show issues

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Article ; Online: Motivational interviewing for the management of child and adolescent obesity: a systematic literature review.

Lutaud, Romain / Mitilian, Eva / Forte, Jenny / Gentile, Gaetan / Reynaud, Rachel / Truffet, Camille / Bellanger, Thibault

BJGP open

2023 Volume 7, Issue 4

Abstract: Background: Among children or adolescents with obesity, 40-70.5% will remain obese as adults according to their paediatric body mass index (BMI). The recommended management involves changes in their nutritional habits (diet, physical activity, and ... ...

Abstract	Background: Among children or adolescents with obesity, 40-70.5% will remain obese as adults according to their paediatric body mass index (BMI). The recommended management involves changes in their nutritional habits (diet, physical activity, and sedentary lifestyle). Motivational interviewing (MI), a patient-centred consultation, has proven its worth in many fields where acting on behaviours is essential. Aim: To investigate the use and outcomes of MI in the management of children and adolescents who are overweight and obese. Design & setting: A systematic review evaluated MI in the management of children and adolescents who are overweight and obese. Method: PubMed, Web of Science, Cochrane Library, and CISMeF were searched between January 2022 and March 2022 for following terms: 'motivational interviewing', 'overweight or obesity', 'children or adolescent' to identify randomised controlled trials (RCTs). Inclusion criteria were interventions involving MI in children or adolescents who were commonly (polygenically) overweight or obese. Exclusion criteria were: studies before 1991; and articles not written in English or French. The first stage of the selection process was carried out by reading the titles and abstracts. A second stage was carried out by reading the complete studies. A secondary inclusion of articles was carried out following the reading of bibliographic references, mainly from systematic reviews and meta-analyses. The data were summarised in synthetic tables based on the Population, Intervention, Comparison, Outcomes, and Study (PICOS) tool. Results: From 444 articles the review identified 26 RCTs. Statistically significant results were found for all criteria (anthropometric and behavourial) in both children and adolescents. Quality of life and depression scores were also improved. Parental presence in the interview appeared to be essential for children, whereas for adolescents, the supportive involvement of parents outside of the interviews seemed more appropriate. The frequency and duration of the interventions played a major role in obtaining results, as did the number of people involved, and the diversity of the places where they are taken care of. Conclusion: MI seems promising for children and adolescents with overweight or obesity, within the framework of a comprehensive, multiprofessional, family management, carried out over a long period with regular consultations.
Language	English
Publishing date	2023-12-19
Publishing country	England
Document type	Journal Article
ISSN	2398-3795
ISSN (online)	2398-3795
DOI	10.3399/BJGPO.2022.0145
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Article ; Online: When the patient is making the (wrong?) diagnosis: a biographical approach to patients consulting for presumed Lyme disease.

Lutaud, Romain / Verger, Pierre / Peretti-Watel, Patrick / Eldin, Carole

Family practice

2022

Abstract: Background: Media coverage of Lyme disease (LD) has led to an increase in consultations for presumed LD in Europe. However, LD is confirmed in only 10%-20% of patients, with a significant number remaining in a diagnostic dead-end.: Objectives: To ... ...

Abstract	Background: Media coverage of Lyme disease (LD) has led to an increase in consultations for presumed LD in Europe. However, LD is confirmed in only 10%-20% of patients, with a significant number remaining in a diagnostic dead-end. Objectives: To reach a deeper understanding of how patients themselves contribute to the diagnostic process. To describe the genesis of the LD hypothesis in care pathways. Methods: In 2019, 30 patients from a prospective cohort consulting in the infectious diseases department at University Hospital in Marseille for presumed LD were recruited for semistructured interviews. The inclusion criteria were: suffering from subjective symptoms for 6 months, no clinical or paraclinical argument suggesting current LD. The patients' medical trajectories were collected using a biographical approach. Results: The diagnosis of LD was primarily triggered by identification with personal testimonies found on the Internet. Most of patients were leading their own diagnostic investigation. The majority of participants were convinced they had LD despite the lack of medical evidence and the scepticism of their referring GP. Conclusion: GPs should first systematically explore patients' aetiologic representations in order to improve adherence to the diagnosis especially in the management of medically unexplained symptoms. Long COVID-19 syndrome challenge offers an opportunity to promote active patient involvement in diagnosis.
Language	English
Publishing date	2022-10-21
Publishing country	England
Document type	Journal Article
ZDB-ID	605939-9
ISSN	1460-2229 ; 0263-2136
ISSN (online)	1460-2229
ISSN	0263-2136
DOI	10.1093/fampra/cmac116
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Zs.A 2021: Show issues

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Article ; Online: COVID-19 patient experiences in prehospital pathways: a processual approach using life-events calendar method and state sequence analysis shows detrimental delays.

Lutaud, Romain / Cortaredona, Sebastien / Delorme, Lea / Peretti-Watel, Patrick / Mirouse, Juliette / Borg, Manon / Cattaneo, Lucie / Thery, Didier / Gentile, Gaetan / Pradier, Christian / Irit, Touitou / Brouqui, Philippe / Tardieu, Sophie / Carles, Michel / Gentile, Stéphanie

Family medicine and community health

2024 Volume 12, Issue 1

Abstract: Objectives: To our best knowledge, no study in France has comprehensively investigated the prehospital history of patients admitted for severe cases of COVID-19. 'Patients' voice is an excellent means to capture data on primary care pathways.We aimed to ...

Abstract	Objectives: To our best knowledge, no study in France has comprehensively investigated the prehospital history of patients admitted for severe cases of COVID-19. 'Patients' voice is an excellent means to capture data on primary care pathways.We aimed to identify clusters of COVID-19 hospitalised patients with similar prehospital symptom sequences, and to test whether these clusters were associated with a higher risk of poor clinical outcomes. Design: Cross-sectional online survey using life-event calendars. Setting: All patients hospitalised for COVID-19 between September 2020 and May 2021 in the Infectious Disease Departments in Nice and in Marseilles in France. Participants: 312 patients responded to the survey. Main outcome measures: From the day of symptom onset to the day of hospitalisation, we defined a symptom sequence as the time-ordered vector of the successive symptom grades (grade 1, grade 2, grade 3). State sequence analysis with optimal matching was used to identify clusters of patients with similar symptom sequences. Multivariate logistic regressions were performed to test whether these clusters were associated with admission to intensive care unit (ICU) and COVID-19 sequelae after hospitalisation. Results: Three clusters of symptom sequences were identified among 312 complete prehospital pathways. A specific group of patients (29%) experienced extended symptoms of severe COVID-19, persisting for an average duration of 7.5 days before hospitalisation. This group had a significantly higher probability of being admitted to ICU (adjusted OR 2.01). They were less likely to know a loved one who was a healthcare worker, and more likely to have a lower level of education. Similarly, this group of patients, who were more likely to have previously visited the emergency room without exhibiting severe symptoms at that time, may have been inclined to postpone reassessment when their health worsened.Their relatives played a decisive role in their hospitalisation. Conclusion and relevance: This study highlights the negative impact of delayed hospitalisation on the health outcomes of French patients with severe COVID-19 symptoms during the first wave and underscores the influence of socioeconomic factors, such as lower education levels and limited connections to the medical field, on patients' experiences.
MeSH term(s)	Humans ; COVID-19/therapy ; SARS-CoV-2 ; Cross-Sectional Studies ; Patient Outcome Assessment ; Emergency Medical Services
Language	English
Publishing date	2024-01-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2986753-8
ISSN	2009-8774 ; 2305-6983
ISSN (online)	2009-8774
ISSN	2305-6983
DOI	10.1136/fmch-2023-002447
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Article ; Online: French General Practitioners Frequently See Patients with Long-COVID.

Davin-Casalena, Bérengère / Lutaud, Romain / Scronias, Dimitri / Guagliardo, Valérie / Verger, Pierre

Journal of the American Board of Family Medicine : JABFM

2021 Volume 34, Issue 5, Page(s) 1010–1013

Abstract: A second epidemic has appeared among some patients infected with COVID-19 persistent disorders, commonly called "long COVID syndrome." Our study sought to identify the proportion of French GPs dealing with patients with potential long COVID syndrome and ... ...

Abstract	A second epidemic has appeared among some patients infected with COVID-19 persistent disorders, commonly called "long COVID syndrome." Our study sought to identify the proportion of French GPs dealing with patients with potential long COVID syndrome and their symptoms in an online cross-sectional questionnaire-based survey among a representative national panel of GPs. The majority (53.8%) reported at least 1 patient with COVID-19 and persistent symptoms, and 33% 2 or more such patients. Their most frequent symptoms were respiratory difficulties (60.6%), psychological distress (42.8%), and anosmia-dysgeusia (40.8%). Long COVID syndrome's recognition, management, and rehabilitation are priorities requiring effective coordination between primary and secondary care.
MeSH term(s)	COVID-19/complications ; Cross-Sectional Studies ; General Practitioners ; Humans ; SARS-CoV-2 ; Surveys and Questionnaires
Language	English
Publishing date	2021-09-17
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2239939-2
ISSN	1558-7118 ; 1557-2625
ISSN (online)	1558-7118
ISSN	1557-2625
DOI	10.3122/jabfm.2021.05.210142
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Zs.A 2626: Show issues

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Article ; Online: COVID-19 patient experiences in prehospital pathways

Patrick Peretti-Watel / Sébastien Cortaredona / Christian Pradier / Gaetan Gentile / Stéphanie Gentile / Philippe Brouqui / Michel Carles / Romain Lutaud / Lea Delorme / Juliette Mirouse / Manon Borg / Lucie Cattaneo / Didier Thery / Touitou Irit / Sophie Tardieu

Family Medicine and Community Health, Vol 12, Iss

a processual approach using life-events calendar method and state sequence analysis shows detrimental delays

2024 Volume 1

Abstract: Objectives To our best knowledge, no study in France has comprehensively investigated the prehospital history of patients admitted for severe cases of COVID-19. ‘Patients’ voice is an excellent means to capture data on primary care pathways.We aimed to ... ...

Abstract	Objectives To our best knowledge, no study in France has comprehensively investigated the prehospital history of patients admitted for severe cases of COVID-19. ‘Patients’ voice is an excellent means to capture data on primary care pathways.We aimed to identify clusters of COVID-19 hospitalised patients with similar prehospital symptom sequences, and to test whether these clusters were associated with a higher risk of poor clinical outcomes.Design Cross-sectional online survey using life-event calendars.Setting All patients hospitalised for COVID-19 between September 2020 and May 2021 in the Infectious Disease Departments in Nice and in Marseilles in France.Participants 312 patients responded to the survey.Main outcome measures From the day of symptom onset to the day of hospitalisation, we defined a symptom sequence as the time-ordered vector of the successive symptom grades (grade 1, grade 2, grade 3). State sequence analysis with optimal matching was used to identify clusters of patients with similar symptom sequences. Multivariate logistic regressions were performed to test whether these clusters were associated with admission to intensive care unit (ICU) and COVID-19 sequelae after hospitalisation.Results Three clusters of symptom sequences were identified among 312 complete prehospital pathways. A specific group of patients (29%) experienced extended symptoms of severe COVID-19, persisting for an average duration of 7.5 days before hospitalisation. This group had a significantly higher probability of being admitted to ICU (adjusted OR 2.01). They were less likely to know a loved one who was a healthcare worker, and more likely to have a lower level of education. Similarly, this group of patients, who were more likely to have previously visited the emergency room without exhibiting severe symptoms at that time, may have been inclined to postpone reassessment when their health worsened.Their relatives played a decisive role in their hospitalisation.Conclusion and relevance This study highlights the negative ...
Keywords	Medicine (General) ; R5-920
Subject code	616
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Book ; Online: The Hydroxychloroquine Debate

Lutaud, Romain / Scronias, Dimitri / Ward, Jeremy / Verger, Pierre

A Therapeutic Dilemma for General Practitioners

2020

Abstract: ... bitstream/2027.42/156030/1/Lutaud main article.pdf ... Description of Lutaud main article.pdf : Main article ...

Abstract	Purpose France has been at the epicenter of the worldwide debate about hydroxychloroquine, as the main publications advocating its use to treat COVID-19 come from a research unit led by Didier Raoult in Marseille. The objective of this study was to determine the impact of this debate on the opinions and practices of French primary care physicians. Methods At the peak of the pandemic in France, we conducted an online cross-sectional questionnaire survey among a national panel of 2940 self-employed PCPs. The questionnaire assessed their trust in the health authorities, their opinions about the official guidelines for the management of patients with COVID-19, and any difficulties in dealing with these patients requesting prescriptions for hydroxychloroquine. Results In all, 1200 PCPs (40.8%) completed the questionnaire. We found that physicians in the areas most strongly affected by the epidemic (40%) or closest to the epicentre of the controversy (50%) reported that the hydroxychloroquine debate had made it difficult for them to deal with patients' treatment requests. Their overall adherence to official recommendations was also lower (RR=0.61). Reported difficulties were less frequent among PCPs in group compared with solo practices (RR=0.67). Conclusions The hydroxychloroquine debate created dilemmas for a significant portion of PCPs in a context of undermined trust in the health authorities. In due course, it will be necessary to examine the conditions producing so strong a conflict to ensure better preparation not only for health management but also for knowledge production in the not unlikely event of a future epidemic. https://deepblue.lib.umich.edu/bitstream/2027.42/156030/1/Lutaud main article.pdf Description of Lutaud main article.pdf : Main article
Keywords	COVID-19 ; coronavirus ; primary care ; hydroxychloroquine ; Epidemiology ; Health Sciences ; covid19
Subject code	300
Language	English
Publishing date	2020-07-09
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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