Methylphenidate: Gender trends in adult and pediatric populations over a 7year period.

Objective: Methylphenidate (MPH) is a prescription-stimulant medication which is authorized in France for two indications: attention-deficit hyperactivity disorder in children (aged≥6years) and narcolepsy in cases where modafinil is ineffective (for children and adults). MPH use has increased worldwide in the past 2 decades in children and adults. Different pharmacoepidemiological Europeans studies have described MPH patterns of use.

[Characteristics of subjects under opiate maintenance treatment in primary care using the OPEMA data 2013].

Aim: The objective of the study is to describe the characteristics of subjects under opiate maintenance treatment by general practionners (GPs).

Method: Data analysis from observatory for pharmacodependency in ambulatory medicine survey (observation des pharmacodépendances en médecine ambulatoire [OPEMA]) program in 2013 of the subjects under high dosage buprenorphine (HDB) and methadone prescribed or obtained illegally reported by GPs in France.

Results: Survey concerned consumers with 862, 433 and 429 of high dosage buprenorphine and respectively methadone.

Night shift decreases cognitive performance of ICU physicians.

Background: The relationship between tiredness and the risk of medical errors is now commonly accepted. The main objective of this study was to assess the impact of an intensive care unit (ICU) night shift on the cognitive performance of a group of intensivists. The influence of professional experience and the amount of sleep on cognitive performance was also investigated.

Use of a multi-state model in a claims database: illustration with methadone.

Purpose: In pharmacoepidemiology, one of the main concerns is analysis of drug exposure time. However, in real-life settings, patient's behavior is complex and characterized by drug exposure dynamics. Multi-state models allow assessing the probabilities of various patterns, instead of just continuous use and/or discontinuation.

New methadone formulation in France: results from 5 years of utilization.

Background: In France, methadone has historically been less accessible than buprenorphine. In 2008, a dry formulation (capsule) was introduced into the market, aimed in particular to improve methadone accessibility.

Objective: To describe the impact (prevalence of use, patient profiles and compliance with requirements) of the dry methadone formulation in France.

Detection of signals of abuse and dependence applying disproportionality analysis.

Introduction: Prescription drug abuse and dependence is a widespread phenomenon in many countries. The use of disproportionality measures in drug abuse surveillance is rarely performed.

Purpose: The aim of this study is to determine the occurrence of signals of abuse and dependence for different psychoactive drugs in real-life settings.

Maternal factors influencing the decision to breastfeed newborns conceived with IVF.

Objectives: The breastfeeding initiation rate is extremely disparate worldwide and remains low in France, with a breastfeeding initiation rate of 60.2%. Some studies have reported increased early parenting difficulties in women who conceived with in vitro fertilization (IVF).

[Use of generic high dose buprenorphine (HDB): about a qualitative survey].

Objective: Analyze the factors of the low use of buprenorphine (HDB) generic in France, studying heath care professionals' and patients' attitudes towards this substitution.

Methods: A qualitative method based on the realization of semi-directive conversations was held. 14 health care professionals and 10 patients were interviewed.

[Antipsychotic use in the cohort PACA-Alz in patients with Alzheimer's disease and other dementia in 2010].

Aim: The aim of the study was to identify and to characterize patients with Alzheimer's disease or related dementia describing antipsychotics and other psychotropic expositions.

Methods: The study was performed, in 2010, based on Provence-Alpes-Côte d'Azur region (PACA)-Corse Alz cohort included patients with dementia, with chronic condition 'Alzheimer disease or related disease' and/or had at least one delivery of Alzheimer's specific treatment, registered in the General Health Care System. Psychotropic drugs were extracted according anatomical, therapeutical and chemical code.

OPPIDUM surveillance program: 20 years of information on drug abuse in France.

It is important to assess drug abuse liability in 'real life' using different surveillance systems. Some are based on specific population surveys, such as individuals with drug abuse or dependence, or under opiate maintenance treatment, because this population is very familiar with drugs and is more likely to divert or abuse them. In France, an original surveillance system based on this specific population and called 'Observation of illegal drugs and misuse of psychotropic medications (OPPIDUM) survey' was set up in 1990 as the first of its kind.

Doctor shopping reveals geographical variations in opioid abuse.

Background: Prescription opioid abuse is not homogeneous due to varying patterns of use and different geographic preferences. Because doctor shopping is one of the main sources of diversion, it has previously been used to estimate drug abuse.

Objectives: The aim of this study was to describe and compare opioid abuse in 2008 using doctor shopping to estimate abuse in 3 French regions.

[Harm reduction centers ("CAARUD"): privileged places for warning signal detection in addictovigilance].

This study aims to describe profile and consumptions of subjects suffering a substance use disorder recruited in harm reduction centers (HRC, French "CAARUD", 156 included subjects in 7 centers) for the 2010 OPPIDUM survey, performed by the French CEIP-Addictovigilance network, in order to compare them to subjects included in ambulatory care centers (ACC, French "CSAPA", 3549 subjects included in 80 centers). Subjects recruited in HRC are younger and more precarious; they consume more illicit drugs, and prescription drugs known to be diverted (methylphenidate, morphine, ketamine,…). They consume less opiate maintenance treatment, antidepressants and psychotics.

[General Practitioners' Contribution to Dependence Assessment: the OPEMA Programme].

Aim. This study presents the OPEMA (Observation des pharmacodépendances en médecine ambulatoire) programme and the main results of its last annual survey (november 2010). Method.

[Cost-effectiveness of drugs modifications for inpatients hospitalised in acute care geriatric units].

Purpose: Polypharmacy in the elderly increases the risk of adverse drug reactions and leads to increased medical costs. There is little data currently available on drug modification and cost reduction during hospitalization in a geriatric unit. The aims of this study were to analyse drug modification during hospitalization in a geriatric care unit and to evaluate the repercussions in terms of cost reduction.

Estimated magnitude of diversion and abuse of opioids relative to benzodiazepines in France.

Introduction: Prescription drug abuse is a major concern in several countries. France appears to be particularly prone to the abuse of opiate maintenance treatment (OMT) opioids and benzodiazepines (BZD), whereas the abuse of opioid analgesics (OA) is less commonly reported. To estimate the extent of psychoactive drug abuse, the French drug agency relies on different methods measuring various diversion indicators used as proxies for the detection of abuse/misuse: suspicion of abuse/dependence, illegal acquisition by patients seen in specialized care centers, prescription forgery and doctor shopping.

Misuse of buprenorphine maintenance treatment since introduction of its generic forms: OPPIDUM survey.

Purpose: The purpose of the study was to compare, using data from Observation of Illicit Psychotropic Substances or Non-medical Used Medications (OPPIDUM) surveys, first, the profile of buprenorphine users and their modalities of buprenorphine use from 2006 to 2008 and, second, two subgroups: brand-name and generic buprenorphine users in 2008.

Methods: OPPIDUM is an annual, nationwide, multicentric, cross-sectional survey, including buprenorphine users followed in specialised centres dedicated to drug dependence. The evolution of the profile during three consecutive years (2006, 2007 and 2008) was analysed using Cochran-Armitage test for trend.

Evolution of opioids reimbursement since 2004 from the National Database of the General Health Insurance System.

Objective: This study aims at evaluating trends in the consumption of opioids over the last years to assess the impact of public health measures on the management of pain and opiate addiction in France.

Methods: The evolution of opioids consumption was analysed by using the national database of the General Health Insurance System in France between 2004 and 2008.

Results: During the study period, the reimbursed quantities of opioids used for pain management have increased by 13%, except for dextropropoxyphene that has decreased by 9%.

Monitoring of benzodiazepine diversion using a multi-indicator approach.

Fourteen benzodiazepine (BZD) or BZD-like medications were analyzed with three data sources aiming to assess prescription drug abuse for the year 2008. After a descriptive analysis, a principal component analysis was carried out to explore correlations between seven indicators obtained by different methods using these three different data sources and to compute a composite score of diversion for these drugs. For all the indicators, flunitrazepam appears first with much higher values than the other drugs, whereas clonazepam appears in the second or third place.

[Post-marketing surveillance systems for psychoactive prescription drug abuse].

Drugs affecting the central nervous system form a unique group of products for surveillance because they could be misused, abused or diverted. Considering the characteristics of this behaviour that is often concealed, specific post-marketing surveillance systems have been developed to monitor abuse of prescription drugs in some countries. The purpose of this review is to list and to describe post-marketing surveillance systems, according their methodology, in France and in foreign countries.

Which psychoactive prescription drugs are illegally obtained and through which ways of acquisition? About OPPIDUM survey.

The objective of the study was to determine which psychoactive prescription drugs are illegally obtained and through which ways of acquisition. OPPIDUM is an annual national study. It is based on specialized care centers that included subjects presenting a drug dependency or under opiate maintenance treatment.

Patterns of methylphenidate use and assessment of its abuse and diversion in two French administrative areas using a proxy of deviant behaviour determined from a reimbursement database: main trends from 2005 to 2008.

Background: Methylphenidate is a psychostimulant drug indicated for the treatment of attention-deficit hyperactivity disorder (ADHD). Its abuse and diversion have been previously described in specific populations, such as students; however, few studies investigating abuse and diversion among the overall population are available.

Objectives: The aim of this study was to describe patterns of methylphenidate use and to explore the magnitude of its abuse and diversion in two French administrative areas using data from a reimbursement database.

Assessment of abuse of tianeptine from a reimbursement database using 'doctor-shopping' as an indicator.

Doctor-shopping is a patient behaviour characterized by simultaneous consultations of several physicians during the same period. Some case reports have described an abuse of tianeptine, an atypical antidepressant. Our objective was to assess the extent of abuse of this drug with a method quantifying doctor-shopping in comparison with other antidepressants and benzodiazepines (BZD).

Evidence of clonazepam abuse liability: results of the tools developed by the French Centers for Evaluation and Information on Pharmacodependence (CEIP) network.

Recent observations suggest the existence of clonazepam abuse. To determine its importance in France, a quantitative and systematic synthesis of all clonazepam data of several epidemiological tools of the Centers for Evaluation and Information on Pharmacodependence (CEIP) network has been performed in comparison with data on others benzodiazepines (BZD). Data on clonazepam and other BZD have been analysed from different epidemiological tools: OSIAP survey that identifies drugs obtained by means of falsified prescriptions, Observation of Illegal Drugs and Misuse of Psychotropic Medications (OPPIDUM) survey that describes modalities of use and data from regional French health reimbursement system.

Which indicators can public health authorities use to monitor prescription drug abuse and evaluate the impact of regulatory measures? Controlling High Dosage Buprenorphine abuse.

Background: Two methods have been recently developed from a drug reimbursement database to provide useful indicators for public health authorities concerning the abuse potential of psychotropic drugs. The doctor-shopping indicator (DSI) measures the proportion of the drug obtained by doctor shopping among the overall quantity of the drug reimbursed and the clustering method reveals subgroups of deviant patients.

Objective: The objective of the study was to analyze and compare indicators resulting from these two methods, applied to High Dosage Buprenorphine (HDB) (a product well-known to be diverted in France), in order to determine which public health authorities needs they answer.