Interaction between CYP2D6 inhibitor antidepressants and codeine: is this relevant?

Co-occurring pain impairs depression's prognosis. Selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) are first-line pharmacotherapies for depression and inhibit many cytochrome 2D6 enzymes. Codeine is a first-line treatment for pain and needs to be metabolized into morphine by cytochrome 2D6 to exert its analgesic effect.

Influence of socioeconomic status on antipsychotic prescriptions among youth in France.

Background: Recent studies analysing the trends in antipsychotic (AP) prescriptions for children and adolescents have raised concerns regarding the influence of socioeconomic status. Previous findings have also shown variable prescription rates for first-generation (FG) and second-generation (SG) APs.

Method: Our objectives were to assess the proportion of patients from low-income families receiving APs and the most commonly prescribed APs in France.

Inclusion of populations at risk of advanced melanoma in an opportunistic targeted screening project involving general practitioners.

Objective: The study objective was to measure the rates of inclusion of populations at risk of advanced melanoma in a pilot targeted screening project involving general practitioners.

Design: This cross-sectional database study compared the inclusion rates of patients who signed inclusion in a targeted screening project with those of patients who did not, during a period in which both groups of patients consulted investigators.

Setting: Data were extracted from the national healthcare insurance records in western France from 11 April to 30 October 2011.

Did the new French pay-for-performance system modify benzodiazepine prescribing practices?

Background: French general practitioners (GPs) were enrolled in a new payment system in January 2012. As part of a national agreement with the French National Ministry of Health, GPs were asked to decrease the proportion of patients who continued their benzodiazepine treatment 12 weeks after its initiation and to decrease the proportion of patients older than 65 who were prescribed long half-life benzodiazepines. In return, GPs could expect an extra payment of up to 490 euros per year.

Hypnotic prescription without face to face contact: a report from French family medicine.

Background: Guidelines suggest a review of hypnotic prescriptions every four weeks for zopiclone, zolpidem and zaleplon ('Z-drugs'). The lack of face-to-face consultation between the physician and the patient increases the potential of misuse and resultant dependence.

Objectives: To determine the proportion of long-term hypnotic Z-drug prescription issued without face-to-face consultation, and factors associated with such practice.

Epidemiological characterization of drug overconsumption: the example of antidepressants.

The authors present a pharmaco-epidemiological method for the characterization of drug overconsumption. Using the database of a French regional health insurance office, a comparison was made between patients receiving doses higher than recommended and all patients receiving normal doses of two antidepressant drugs (tianeptine and milnacipran). Logistic regression models were used to identify the variables related to overconsumption.

Pharmacoepidemiological characterization of psychotropic drugs consumption using a latent class analysis.

France has one of the highest recorded rates of psychotropic use of drugs compared with other European countries, especially for anxiolytics, hypnotics and antidepressants. The aim of this study was to characterize the use of three psychotropic drugs among the most prescribed in France (bromazepam, paroxetine, zolpidem) using reimbursement databases in real-life conditions. Individuals from a region affiliated to the French General Health Insurance Scheme, who had received at least two dispensings of bromazepam, paroxetine or zolpidem reimbursed between 1 January and 30 June 2008, were included.

[Creating and validating a tool able to detect fraud by prescription falsification from health insurance administration databases].

Goal: Make it possible to spot falsified prescriptions which were delivered and reimbursed.

Method: 1- Use health insurance administration data bases to single patients liable to suspicion of fraud (repeated presentations of the same prescription to several pharmacies the same day) 2- Attribution of a diagnosis of fraud, by the CEIP (Center of Evaluation and Information about Pharmacodependence) based on transferred data, and by the medical department analysis of the complete file, and convocation when applicable 3- Calculation of quantitative performance of the tool.

Results: We have singled 2030 patients.

[Reactivity and communication of Health Authorities toward health professionals: a public health priority].

Objective: evaluate the impact of Health Authorities' communication on medical practices through 2 examples: celecoxib, taking into account the recent countra indication related to cardio vascular risks; pergolide, taking into account the risk of cardiac valvulopathy.

Material And Method: Use of the Pays de Loire Health Insurance Administration data base to monitor the number of cardio vascular patients at risk who receive celecoxib, and cardiac surveillance of pergolide exposed patients.

Results: Communication from Health Authorities resulted in a major decrease (71.

Diuretic drug therapy monitoring in the elderly: a cohort study.

Background: Because the elderly are often treated by multiple-drug regimens, their iatrogenic risks are considerably raised. However, despite the serious side-effects that diuretic agents may have in this population, SPCs (summary of product characteristics) do not specify how often serum chemistry should be monitored. This study of long-term diuretic therapy prescription and monitoring in elderly patients was conducted by the Department of Clinical Pharmacology of the Nantes teaching hospital in collaboration with the medical department of the French national health insurance scheme.