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Paturle C, Huguet M, Ferreira E, Mourad JJ. From guidelines to current practices: Suboptimal hypertension management in France. JOURNAL DE MEDECINE VASCULAIRE 2023; 48:174-180. [PMID: 38035923 DOI: 10.1016/j.jdmv.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023]
Abstract
In France, the prevalence of hypertension is higher than 30%. Although treatment guidelines have been well established over the last twenty years, the national blood pressure control rate is below the average of high-income countries. This observational study aimed to describe the antihypertensive prescription behaviours of primary care physicians (PCPs) in France and to assess their compliance with current French guidelines, focusing on three specific prescription issues and their potential repercussions on blood pressure control: treatment initiation, treatment renewal or change and type of triple therapy. Prescription data were retrieved using the IQVIA longitudinal patient database (LPD), which delivers real-world data insights from French primary care electronic medical records (EMR). The average number of prescribed therapeutic agents was 1.9 per patient, with 39.3% monotherapy prescriptions. Treatment initiation represented 7.2% of all antihypertensive prescriptions. At treatment initiation, 22.5% of patients were prescribed dual therapy. The proportion of treatment renewal in the same therapeutic class was 74.3% while the proportion of treatment change was 18.5%. Of these, only 6.3% of patients received an additional therapy. Lastly, 35.7% of triple therapies were consistent with the recommended combinations. In conclusion, this study provides evidence of therapeutic gaps in hypertension management in France. The low blood control rate may be attributed to PCPs' therapeutic inertia and lack of knowledge of treatment guidelines. All stakeholders should commit to rapid corrective action in order to provide patients with the best care.
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Affiliation(s)
- C Paturle
- Université Paris Cité, Paris, France
| | - M Huguet
- IQVIA, Tour D2, 17 bis, place des Reflets, 92099 La Défense cedex, France
| | - E Ferreira
- IQVIA, Tour D2, 17 bis, place des Reflets, 92099 La Défense cedex, France
| | - J-J Mourad
- Service de médecine interne, hôpital Franco-Britannique, 4, rue Kléber, 92300 Levallois-Perret, France.
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Brézin AP, Labbe A, Schweitzer C, Lignereux F, Rozot P, Goguillot M, Bugnard F, Dot C. Incidence of Nd:YAG laser capsulotomy following cataract surgery: a population-based nation-wide study - FreYAG1 study. BMC Ophthalmol 2023; 23:417. [PMID: 37845645 PMCID: PMC10578013 DOI: 10.1186/s12886-023-03134-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/12/2023] [Indexed: 10/18/2023] Open
Abstract
RATIONALE Nd:YAG (neodymium:yttrium-aluminum-garnet) capsulotomy (Nd:YAG-caps) is the gold standard for the treatment of PCO (Posterior Capsule Opacification). There is a lack of real-world data about Nd:YAG-caps use. PURPOSE This study's objectives were to estimate Nd:YAG-caps incidence in France, to describe the patient characteristics, and to analyze the time between surgeries and capsulotomies. SETTING The study was based on data extracted from the EGB database, a 1/97th sample representative of the French population. DESIGN observational, retrospective, cohort study using national claims data. METHODS French adult patients who underwent Nd:YAG-caps between 2014 and 2017 were selected. Main outcomes were the number of patients and procedures performed and the risk factors associated with early Nd:YAG-caps. RESULTS During the study period, Nd:YAG-caps were performed in 8,425 patients accounting for 10,774 procedures. The extrapolation to the French population led to estimate that 253.103 patients had Nd:YAG-caps, representing 312.103 procedures in 2017. The mean age at Nd:YAG-caps was 75.1 (± 10.2) years. About 36% of patients presented at least one ocular comorbidity. Nd:YAG-caps was performed within 2 years after surgery in 33.0% of patients and within one year in 9.8% of patients. Patients with Nd:YAG-caps within the first year (OR CI95 0.721 [0.673-0.772]) or in the first two years (OR CI95 0.721 [0.673-0.772]) were younger than patients with later Nd:YAG-caps and had a more frequent history of treated ocular diseases (OR 1.516 and 1.178, respectively). CONCLUSIONS This study brought new real-world and large-scale data regarding Nd:YAG-caps use and gave an updated insight into the patients' characteristics.
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Affiliation(s)
- Antoine P Brézin
- Department of Ophthalmology, Université Paris Cité, Cochin Hospital, APHP, 27 rue du faubourg Saint-Jacques, Paris, 75014, France.
| | - Antoine Labbe
- Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France
| | - Cédric Schweitzer
- Department of Ophthalmology, CHU Bordeaux, Univ. Bordeaux, ISPED, INSERM, U1219 - Bordeaux Population Health Research Centre, Bordeaux, F-33000, France
| | | | - Pascal Rozot
- Department of Ophthalmology, Juge Clinic, Marseille, France
| | | | | | - Corinne Dot
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
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Marche JC, Bannay A, Baillot S, Dauriac-Le Masson V, Leveque P, Schmitt C, Laprévote V, Schwan R, Dobre D. Prevalence of severe cardiovascular disease in patients with schizophrenia. Encephale 2021; 48:125-131. [PMID: 34024498 DOI: 10.1016/j.encep.2021.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/20/2021] [Accepted: 02/24/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES We assessed the prevalence of severe cardiovascular (CV) disease requiring hospitalization among patients with schizophrenia in France. METHOD We included patients hospitalized with schizophrenia or psychotic disorder during 2015, in five French psychiatric hospitals. Patients with CV disease were defined as those with a correspondent ICD-10 code during a hospital stay in any general hospital, five years before or three years after the psychiatric hospitalization. CV disease included myocardial infarction (MI), stroke, heart failure (HF), coronary artery disease (CAD) or peripheral artery disease. Risk factors such as hypertension, obesity and diabetes were recorded. RESULTS In total, 4424 patients with schizophrenia were included. Overall, 203 (4,6%) patients were diagnosed with CV disease, 93 (2.1%) with CAD, 86 (1.9%) with HF and 49 (1.1%) with stroke. The prevalence of hypertension, obesity and diabetes was 11.3%, 9.7% and 7.8%. The median (interquartile range) age of patients with MI and diabetes was 57 (49-70) and 56 (48-66) years. CONCLUSION Patients with schizophrenia develop severe CV disease requiring hospitalization at an early age. These severe events are associated with a high prevalence of risk factors. Early screening and treatment of CV disease and risk factors is important to improve life expectancy and quality of life of these patients.
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Affiliation(s)
- J-C Marche
- Psychiatry and Clinical Psychology Service (G06), Psychotherapeutic Center of Nancy, 1, rue Dr-Archambault, BP 11010, 54521 Laxou cedex, France; University of Lorraine, Lorraine, France.
| | - A Bannay
- Department of Evaluation and Medical Informatics, CHRU-Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
| | - S Baillot
- Department of Evaluation and Medical Informatics, CHRU-Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
| | - V Dauriac-Le Masson
- Department of Medical Informatics, GHU Paris "Psychiatrie & Neurosciences", 1, rue Cabanis, 75014 Paris, France
| | - P Leveque
- Department of Medical Informatics, Ravenel Hospital Center, 1115, avenue René-Porterat, 88500 Mirecourt, France
| | - C Schmitt
- Department of Medical Informatics, Jury Hospital Center, centre hospitalier de Jury, BP 75088, 57073 Metz cedex 3, France
| | - V Laprévote
- Grand Nancy Hospital-university Center for Adult Psychiatry and Addictology, Psychotherapeutic Center of Nancy, 1, rue Dr-Archambault, BP 11010, 54521 Laxou cedex, France; University of Lorraine, Lorraine, France; Inserm U1114, France
| | - R Schwan
- Department of Medical Informatics and Clinical Research and Investigation Unit, Psychotherapeutic Center of Nancy, 1, rue Dr-Archambault, 54520 Laxou, France; University of Lorraine, Lorraine, France; Inserm U1254, France
| | - D Dobre
- Department of Medical Informatics and Clinical Research and Investigation Unit, Psychotherapeutic Center of Nancy, 1, rue Dr-Archambault, 54520 Laxou, France
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Petit G, Jury V, Lamballerie M, Duranton F, Pottier L, Martin J. Salt Intake from Processed Meat Products: Benefits, Risks and Evolving Practices. Compr Rev Food Sci Food Saf 2019; 18:1453-1473. [DOI: 10.1111/1541-4337.12478] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/14/2019] [Accepted: 06/19/2019] [Indexed: 01/11/2023]
Affiliation(s)
- Gaëlle Petit
- ONIRIS ‐ Ecole Nationale VétérinaireAgroalimentaire et de l'alimentation Nantes‐Atlantique Rue de la Géraudière, BP 62241 44322 Nantes Cedex France
- GEPEA ‐ Laboratoire de Génie des Procédés ‐ Environnement – Agroalimentaire ‐ MAPS2 ‐ Matrices Aliments Procédés Propriétés Structure – Sensoriel 44322 Nantes Cedex France
| | - Vanessa Jury
- ONIRIS ‐ Ecole Nationale VétérinaireAgroalimentaire et de l'alimentation Nantes‐Atlantique Rue de la Géraudière, BP 62241 44322 Nantes Cedex France
- GEPEA ‐ Laboratoire de Génie des Procédés ‐ Environnement – Agroalimentaire ‐ MAPS2 ‐ Matrices Aliments Procédés Propriétés Structure – Sensoriel 44322 Nantes Cedex France
| | - Marie Lamballerie
- ONIRIS ‐ Ecole Nationale VétérinaireAgroalimentaire et de l'alimentation Nantes‐Atlantique Rue de la Géraudière, BP 62241 44322 Nantes Cedex France
- GEPEA ‐ Laboratoire de Génie des Procédés ‐ Environnement – Agroalimentaire ‐ MAPS2 ‐ Matrices Aliments Procédés Propriétés Structure – Sensoriel 44322 Nantes Cedex France
| | | | - Laurence Pottier
- ONIRIS ‐ Ecole Nationale VétérinaireAgroalimentaire et de l'alimentation Nantes‐Atlantique Rue de la Géraudière, BP 62241 44322 Nantes Cedex France
- GEPEA ‐ Laboratoire de Génie des Procédés ‐ Environnement – Agroalimentaire ‐ MAPS2 ‐ Matrices Aliments Procédés Propriétés Structure – Sensoriel 44322 Nantes Cedex France
| | - Jean‐Luc Martin
- Ifip‐Institut du PorcPôle viandes et charcuteries 7 Avenue du Général de Gaulle 94700 Maisons‐Alfort France
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