[Drug prescription and pharmacovigilance in spa therapy: a comparative study at a 20-year interval (1987 versus 2007)].

Objectives: Spa therapy is often considered as a dedicated period for a global treatment of patients. However, the prescription behaviours of spa physicians remain largely unknown.

Methods: A postal questionnaire concerning drug prescriptions during spa therapy and occurrence of adverse reactions to spa therapy was sent to the 95 spa physicians of South West of France.

Results: Seventy physicians answered to the survey. During spa period, most of them (67%) could associate drug prescription in complement of spa therapy. Drugs most often prescribed were analgesic (80%), non steroidal anti-inflammatory (57%) and antiinfectious (37%) drugs. Fifty nine per cent of the spa physicians could suppress part of the usual drug treatment of the patients. Spa related drugs which were the most often suppressed were anti-arthrosic and veinotonic drugs. Spa physicians could also modify or suppress drugs unrelated to the purpose of spa therapy, mainly psychotropics (anxiolytics or hypnotics), statins, diuretics or hypoglycemics (in case of inefficacy or adverse drug reactions). Spa physicians modified more drug prescriptions related to spa therapy than those unrelated to the purpose of spa therapy. Most of the spa physicians (77%) did observe adverse reactions to spa treatments. For 53% of the physicians, these adverse reactions could be "serious". The 2007 results were compared to those obtained during a similar survey performed 20 years before (1987).

Conclusion: Spa therapy is often associated with change in drug prescriptions, with mainly a decrease in the number of prescribed drugs. Adverse reactions to spa therapy are rare and mainly "unserious". However, their imputability remains difficult to establish, thus justifying the need of a specific vigilance in spa therapy ("SpaVigilance").