Anticoagulants' Safety and Effectiveness in General Practice: A Nationwide Prospective Cohort Study.

Purpose: Most real-world studies on anticoagulants have been based on health insurance databases or performed in secondary care. The aim of this study was to compare safety and effectiveness between patients treated with vitamin K antagonists (VKAs) and patients treated with direct oral anticoagulants (DOACs) in a general practice setting.

Methods: The CACAO study (Comparison of Accidents and their Circumstances with Oral Anticoagulants) is a multicenter prospective cohort study conducted among ambulatory patients taking an oral anticoagulant.

Areas of improvement in anticoagulant safety. Data from the CACAO study, a cohort in general practice.

Background: Real-world studies on anticoagulants are mostly performed on health insurance databases, limited to reported events, and sometimes far from every-day issues in family practice. We assess the presence of data for safe monitoring of oral anticoagulants in general practice, and compare patients' knowledge of taking an anticoagulant between vitamin K antagonists (VKA) and direct anticoagulants (DOAC), and the general practitioner's perception of their adherence to anticoagulation.

Methods: The CACAO study is a national cohort study, conducted by general practitioners on ambulatory patients under oral anticoagulant.

Beliefs and attitudes of French family practitioners toward depression: the impact of training in mental health.

Objective: To study, in a sample of French Family Practitioners (FPs), beliefs and attitudes toward depression and how they vary according to training received in mental health.

Methods: The Depression Attitude Questionnaire (DAQ) was completed by 468 FPs from all regions of France, recruited by pharmaceutical company representatives to attend focus groups on the management of depression in general practice.

Results: A three-factor model was derived from the DAQ, accounting for 37.

[Drug treatment of cardiovascular risk factors over six years of following the French DESIR cohort].

Objective: To describe the treatment of cardiovascular risk factors within the context of a cohort study of adults, according to the risk estimated by the Framingham equation.

Method: This prospective study, DESIR, followed 1526 men and 1652 women for six years. At the time of the study's initiation, all participants were aged 35 to 65, and none were being treated for hypertension or dyslipemia.

[Improving care for depressed patients: what is added by GP's meetings?].

Purpose: To show what French GP's have to say about their management of depressed patients, and how to improve it.

Methods: GP's forum discussions, as peer groups, controlled by an independent moderator and recorded by another, both Gp's. Reports have been synthesised through a list of items, until saturation.

Center effect on ankle-brachial index measurement when using the reference method (Doppler and manometer): results from a large cohort study.

Background: The ankle-brachial index (ABI) is a simple and noninvasive tool used to detect peripheral arterial disease (PAD). We aimed to assess, in a French multicenter cohort, the center effect associated with arterial pressure (AP) and ABI measurements using the reference method and using a semiautomatic device.

Methods: This study included baseline and 9-year follow-up data from 3,664 volunteers of 10 health examination centers of the DESIR (Data from an Epidemiological Study on the Insulin Resistance) syndrome French cohort.

[BIRD: a large database using renal function parameters in France].

The incidence of End-stage renal disease increases in most Western countries including in France. Few data regarding the incidence of mild renal dysfunction are scarce in the general population. The aim of the present study (BIRD study) was to collect in a database the results of creatinine measurements in the general population from a large area (Région Centre), and assess the percentage of patients with mild renal dysfunction (using the Cockcroft formula).

[Guidelines and practices for type 2 diabetes. Patients' and doctors' preconceptions prevent effective patient education].

Background: Health insurance data show that general practitioners (GPs) do not strictly apply clinical practice guidelines for the management of patients with type 2 diabetes.

Method: The Health insurance fund of the Centre region assessed doctors' practices in diabetes management and found sharp disparities. Our study sought to explain these differences by questioning (through interviews and questionnaires) a cross-section of GPs and patients with diabetes.

ABCA1 single nucleotide polymorphisms on high-density lipoprotein-cholesterol and overweight: the D.E.S.I.R. study.

The adenosine triphosphate-binding cassette A1 (ABCA1) gene plays a key role in reverse cholesterol transport. Some ABCA1 gene polymorphisms have been associated with high-density lipoprotein-cholesterol (HDL-C) concentrations. The aim of this study was to assess the effect of three polymorphisms, C69T, G378C, and G1051A (R219K), on HDL-C levels and their interaction with BMI in more than 5000 French whites from the D.

Assessment of diabetes screening by general practitioners in France: the EPIDIA Study.

Aim: To audit Type 2 diabetes screening in general practice in France and to determine the frequency of undiagnosed diabetes in patients at high risk, after systematic screening and diagnosis.

Methods: For this study, 288 general practitioners volunteered to include all consecutive non-diabetic patients aged < 65 years who had at least two risk factors for diabetes, whatever the reason for consultation. If a plasma glucose had not been recorded in the previous 12 months, a fasting plasma glucose (FPG) was performed, with a second test if FPG >or= 7.

Avoidance of anticipated regret: the ordering of prostate-specific antigen tests.

Objective: When making decisions, people are known to try to minimize the regret that would be provoked by unwanted consequences of these decisions. The authors explored the strength and determinants of such anticipated regret in a study of physicians' decisions to order prostate-specific antigen (PSA) tests.

Methods: 32 US and 33 French primary care physicians indicated the likelihood they would order a PSA for 32 hypothetical men presenting for routine physical exams.

Why do primary care physicians in the United States and France order prostate-specific antigen tests for asymptomatic patients?

Purpose: To understand why many primary care physicians in the United States and France order prostate-specific antigen (PSA) tests routinely for their asymptomatic male patients despite "evidence-based" recommendations.

Methods: Thirty-two U.S.

[Study of the motivation of physicians participating in public health research].

In order to explore practitioners' motivations to participate in epidemiological research, a study was conducted among doctors who had been requested to provide clinical information on their patients included in the group study DESIR in the Inde and Loire regions of France. Six semi-structured individual interviews were carried out by two sociologists, and were then followed-up by 216 questionnaires, 80 of which were completed and analysed. Finally, 18 telephone interviews were conducted to complete the data collected.

Microalbuminuria and markers of the atherosclerotic process: the D.E. S.I.R. study.

The relationship between microalbuminuria and tissue-type plasminogen activator antigen (tPA-ag) and fibrinogen was evaluated in non-diabetic subjects. Subjects were participants of the D.E.

Managing type 2 diabetes in France: the ECODIA survey.

In order to describe the profile and medical management of type 2 diabetes patients in France, a descriptive cross-sectional survey was conducted in 1999 among a national random sample of 311 general practitioners and 51 specialists. A practitioner questionnaire was designed to collect information on a representative sample of 4,119 patients presenting with type 2 diabetes. Data collected included demographic and clinical information and a full description of diabetes management over a 6-month retrospective period.

[Consensus statement of an interdisciplinary group of French experts on modalities of diagnosis and medical treatment of Alzheimer's disease at a treatable stage].

A group of French expert met on the 7th and 8th of February 1998 in order to establish a consensus attitude for Alzheimer's disease diagnosis and treatment. Members were drawn from primary care, geriatrics, neurology and psychiatry. They used the consensus statement of the American Association for Geriatrics, the Alzheimer's Association and the American Geriatrics Society published in JAMA, in October 1997 as a source of data for further consideration.