Interest of large electronic health care databases in addictovigilance: Lessons from 15 years of pharmacoepidemiological contribution

Dupui, Mathilde; Micallef, Joëlle; Lapeyre‐Mestre, Maryse

doi:10.1016/j.therap.2018.09.078

Cited by 17 publications

(15 citation statements)

References 57 publications

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“…The French National Health Insurance System databases contain comprehensive information on drug reimbursements for over 95% of people living in France [16]. Thus, the use of reimbursement databases such as the SNDS has become generalised in France for more than 10 years, particularly in the field of addiction [15,43]. We used data from the main scheme of French health insurance, which covers 87% of the French population, and includes unemployed and lowincome status people.…”

Section: Discussionmentioning

confidence: 99%

“…This health insurance scheme (namely, CNAMTS) is one of the 3 main French healthcare insurance systems. It is for salaried workers and covers 87% of the French general population; it also includes people with complementary coverage related to unemployment and low-income status [15]. The SNDS also includes information from the other 2 main French claim systems, which manage independent workers (self-employed professionals, namely, the RSI scheme), and farmers (namely MSA), as well as information from other, smaller systems.…”

Section: Design and Participantsmentioning

confidence: 99%

See 1 more Smart Citation

Primary Care of Opioid use Disorder: The End of “the French Model”?

Dupouy¹,

Maumus-Robert²,

Mansiaux³

et al. 2020

Eur Addict Res

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Background: In France, most patients with opioid use disorder (OUD) have been treated by buprenorphine, prescribed by general practitioners (GP) in private practice since 1996. This has contributed to building a 'French model' facilitating access to treatment based on the involvement of GPs in buprenorphine prescription. Objectives: Our study aimed to assess whether the involvement of primary care in OUD management has changed lately. Materials and Methods: Using data from the French National Health Insurance database, we conducted a yearly repeated crosssectional study (2009-2015) and described proportion of opioid maintenance treatment (OMT)-prescribing GPs and OMT-dispensing community pharmacies (CP); and number of patients by GP or CP. Results: Whereas the number of buprenorphine-prescribing GPs in private practice remained quite stable (decrease of 3%), a substantial decrease in buprenorphine initial prescribers among private GPs was observed. In 2009, 10.3% of private GPs (6,297 from 61,301 French private GPs) prescribed buprenorphine for the initiation of a treatment, whereas they were 5.7% (n = 3,539 from 62,071 private GPs) in 2015 (43.8% decrease). GPs issuing initial prescriptions of buprenorphine tended to care for a higher number of patients treated by buprenorphine (14.6 ± 27.1 patients in 2009 to 16.0 ± 35.4 patients in 2015). The number of CPs dispensing buprenorphine remained quite stable (decrease of 2%), while there was a 7.5% decrease in the total number of French CPs across the study period. Conclusions: Our results suggest that primary care providers seem less engaged in buprenorphine initiation in OUD patients, while CPs have not modified their involvement towards these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Design and Participantsmentioning

confidence: 99%

Primary Care of Opioid use Disorder: The End of “the French Model”?

Dupouy¹,

Maumus-Robert²,

Mansiaux³

et al. 2020

Eur Addict Res

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“…In addition to this passive monitoring subject to under-reporting, other sources of information have been developed to improve vigilance: systematic data collection on falsified prescriptions from pharmacies (''ordonnances suspectes indicateur d'abus possible'', OSIAP survey) [11,12] and on secure prescription forms for narcotic drug prescriptions (''antalgiques stupéfiants et ordonnances sécurisées'', ASOS survey) [13], systematic data collection from patients seen in addiction specialized structures (''observatoire des produits psychotropes illicites ou détournés de leur usage médicamenteux'', OPPIDUM survey) [14], analysis of toxicological data on chemical submission [15] or on deaths in a medico-legal framework (''décès en relation avec l'abus de médicaments et de substances'', DRAMES survey) [16]. Addictovigilance can broaden the assessment of the potential for abuse and dangerousness of substances by specific analyses on large databases from the national health data warehouse [17,18], or on ad hoc field studies [19][20][21][22][23][24]. The identification of a potential signal from one or more of the sources described above makes it possible to anticipate an emerging problem and to assess its magnitude using a multi-source approach ( Fig.…”

Section: Brief Reminder Of the French Addictovigilance Systemmentioning

confidence: 99%

Addictovigilance contribution during COVID-19 epidemic and lockdown in France

Lapeyre‐Mestre¹,

Boucher²,

Daveluy

et al. 2020

Therapies

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“…In France, BZDs and related Z drugs (such as zolpidem and zopiclone) are actively monitored by the ANSM 'addictovigilance' network, through national survey databases, spontaneous reports by health professionals, and health insurance reimbursement databases. 4 BZDs are legitimately obtained in pharmacies by GP prescriptions, but are also obtained through 'doctor shopping' and through illegal means. 5,6 The benefit-risk ratio of a long-term treatment is unfavourable.…”

Section: Bzds Consumption and The Public Health Problemmentioning

confidence: 99%