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Exposure to High Precariousness Prevalence Negatively Impacts Drug Prescriptions of General Practitioners to Precarious and Non-Precarious Populations: A Retrospective Pharmaco-Epidemiological Study

Author

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  • François Birault

    (Département de Médecine Générale, Faculté de Médecine et de Pharmacie, Université de Poitiers, F-86000 Poitiers, France
    Département de Médecine Générale, Maison de Santé Pluriprofessionnelle Universitaire des Couronneries, F-86000 Poitiers, France)

  • Lakshmipriva Le Bonheur

    (Département de Médecine Générale, Faculté de Médecine et de Pharmacie, Université de Poitiers, F-86000 Poitiers, France
    Département de Médecine Générale, Maison de Santé Pluriprofessionnelle Universitaire des Couronneries, F-86000 Poitiers, France)

  • Nicolas Langbour

    (Centre Hospitalier Henri Laborit, Unité de Recherche Clinique Pierre Deniker, F-86021 Poitiers, France
    Centre de Recherches sur la Cognition et l’Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, F-86021 Poitiers, France)

  • Sandivanie Clodion

    (Département de Médecine Générale, Maison de Santé Pluriprofessionnelle Universitaire des Couronneries, F-86000 Poitiers, France)

  • Nematollah Jaafari

    (Centre Hospitalier Henri Laborit, Unité de Recherche Clinique Pierre Deniker, F-86021 Poitiers, France
    Centre de Recherches sur la Cognition et l’Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, F-86021 Poitiers, France
    Département de Psychiatrie, Faculté de Médecine et de Pharmacie, Université de Poitiers, F-86000 Poitiers, France)

  • Marie-Christine Perault-Pochat

    (Laboratoire de Neurosciences Expérimentales et Cliniques, Institut National de la Santé et de la Recherche Médicale (INSERM U 1084), Université de Poitiers, F-86000 Poitiers, France
    Service de Pharmacologie Clinique et Vigilances, Centre Hospitalo-Universitaire de Poitiers, F-86021 Poitiers, France
    Centre Hospitalo-Universitaire de Poitiers, Institut National de la Santé et de la Recherche Médicale (INSERM CIC1402), Université de Poitiers, F-86021 Poitiers, France
    These authors contributed equally to this work.)

  • Bérangère Thirioux

    (Centre Hospitalier Henri Laborit, Unité de Recherche Clinique Pierre Deniker, F-86021 Poitiers, France
    Centre de Recherches sur la Cognition et l’Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, F-86021 Poitiers, France
    These authors contributed equally to this work.)

Abstract

(1) Background: Precarious patients are more difficult to care for due to low literacy rates and poor adherence to treatment and hospitalization. These difficulties have detrimental effects on general practitioners (GPs), deteriorating medical communication, advice, diagnoses, and drug prescriptions. To better understand how precariousness affects primary care, we tested whether, among GPs, exposure to high precariousness prevalence more severely impacts drug prescriptions to precarious and non-precarious populations compared to low precariousness prevalence. Materials and methods: This pharmaco-epidemiological study, using linear regression analyses, compared the defined daily dose of 20 drugs prescribed by GPs to precarious and non-precarious patients in four French regions with low and high precariousness prevalence in 2015. (2) Findings: Exposure to high precariousness prevalence significantly impacted the prescriptions of nine medications to precarious patients and two medications to non-precarious patients, and distributed into three interaction patterns. (3) Interpretation: The selective over-prescription of drugs with easy intake modalities to precarious patients probably reflects GPs’ attempts to compensate for poor patient compliance. In contrast, the under-prescription of drugs targeting fungal infections in precarious populations and diabetes and cardiovascular diseases in non-precarious populations was seemingly due to a breakdown of empathy and professional exhaustion, causing medical neglect.

Suggested Citation

  • François Birault & Lakshmipriva Le Bonheur & Nicolas Langbour & Sandivanie Clodion & Nematollah Jaafari & Marie-Christine Perault-Pochat & Bérangère Thirioux, 2022. "Exposure to High Precariousness Prevalence Negatively Impacts Drug Prescriptions of General Practitioners to Precarious and Non-Precarious Populations: A Retrospective Pharmaco-Epidemiological Study," IJERPH, MDPI, vol. 19(5), pages 1-23, March.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:5:p:2962-:d:763378
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    References listed on IDEAS

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