References of "Vanmeerbeek, Marc"
     in
Bookmark and Share    
Full Text
Peer Reviewed
See detailIndexing grey multilingual literature in General Practice in the era of Semantic Web
Jamoulle, Marc ULg; Resnick, Melissa; Ittoo, Ashwin ULg et al

in The Grey Journal (2017, October 23)

voir abstract ci-dessous

Detailed reference viewed: 43 (1 ULg)
Full Text
Peer Reviewed
See detailAnalysis of definitions of General Practice/Family Medicine and Primary Health Care
Jamoulle, Marc ULg; Resnick, Melissa; Ittoo, Ashwin ULg et al

in British Journal of General Practice (2017)

Abstract Background There are numerous definitions of General Practice and Family Medicine (GP/FM) and Primary Health Care (PHC), but the distinction between the two concepts is unclear. Aim To conduct a ... [more ▼]

Abstract Background There are numerous definitions of General Practice and Family Medicine (GP/FM) and Primary Health Care (PHC), but the distinction between the two concepts is unclear. Aim To conduct a terminological analysis of a set of definitions of GP/FM and of PHC, to clarify what binds and what distinguishes these two concepts. Design The terms of 20 definitions were collected in two bags of words (one for GP/FM and one for PHC terms). A terminological analysis of these two bags of words was performed to prioritize the terms and analyze their world of reference. Methods The two collected bags of words were extracted with Vocabgrabber®, configured in two term butts using Wordle®, and further explored for similarities using Tropes®. The prioritized terms were analyzed using the Aristotelian approach to categorization of things. Results Although continuity of care (with person-centered approach and shared decision making) is the central issue of the two sets, the two sets of definitions differ greatly in content. The prioritized terms specific to GP/FM (community, medicine, responsibility, individual, problem, needs, ...) are different from prioritized terms specific to PHC (home, team, promotion, collaborator, engagement, neighborhood, medical center…). Conclusion Terminological analysis of the definitions for GP/FM and PHC shows two entities which are overlapping but distinct, necessitating a different taxonomic approach and different bibliographic search strategies. [less ▲]

Detailed reference viewed: 208 (2 ULg)
Full Text
Peer Reviewed
See detailA terminology in General Practice / Family Medicine to represent non-clinical aspects for various usages
Jamoulle, Marc ULg; Grosjean, Julien; Ittoo, Ashwin ULg et al

in R. Randell et al. (Ed.) Informatics for Health: Connected Citizen-Led Wellness and Population Health (2017, April 24)

Abstract. The hereby proposed terminology called “Q-Codes” can be defined as an extension of the International Classification of Primary Care (ICPC-2). It deals with non-clinical concepts that are ... [more ▼]

Abstract. The hereby proposed terminology called “Q-Codes” can be defined as an extension of the International Classification of Primary Care (ICPC-2). It deals with non-clinical concepts that are relevant in General Practice/Family Medicine (GP/FM). This terminology is a good way to put an emphasis on underestimated topics such as Teaching, Patient issues or Ethics. It aims at indexing GP/FM documents such as congress abstracts and theses to get a more comprehensive view about the GP/FM domain. The 182 identified Q-Codes have been very precisely defined by a college of experts (physicians and terminologists) from twelve countries. The result is available on the Health Terminology/Ontology Portal (http://www.hetop.org/Q) and formatted in OWL-2 for further semantic considerations and will be used to index the 2016 WONCA World congress communications. [less ▲]

Detailed reference viewed: 76 (11 ULg)
Full Text
See detailPratiques de coopération entre généralistes et médecins du travail
Vanmeerbeek, Marc ULg

Scientific conference (2017, March 09)

Detailed reference viewed: 22 (0 ULg)
Full Text
See detailApprentissage à l'examen clinique articulaire: la colonne vertébrale (1ère partie colonne cervicale)
Vanmeerbeek, Marc ULg; Dumont, Virginie ULg; Montrieux, Christian ULg

Learning material (2017)

Cette vidéo, à destination de tous les étudiants en médecine, reprend la démonstration de l'examen clinique la colonne cervicale que tout médecin devrait pouvoir pratiquer au minimum

Detailed reference viewed: 33 (2 ULg)
Full Text
See detailApprentissage à l'examen clinique articulaire: le genou
Dumont, Virginie ULg; Montrieux, Christian ULg; Vanmeerbeek, Marc ULg

Learning material (2017)

Cette vidéo, à destination de tous les étudiants en médecine, reprend un bref rappel anatomique de l'articulation du genou . Elle se poursuit par une démonstration de l'examen clinique du genou que tout ... [more ▼]

Cette vidéo, à destination de tous les étudiants en médecine, reprend un bref rappel anatomique de l'articulation du genou . Elle se poursuit par une démonstration de l'examen clinique du genou que tout médecin devrait pouvoir pratiquer au minimum. [less ▲]

Detailed reference viewed: 21 (2 ULg)
Full Text
See detailApprentissage à l'examen clinique articulaire: la colonne vertébrale ( 2ème partie: colonne lombo-sacrée)
Vanmeerbeek, Marc ULg; Montrieux, Christian ULg; Dumont, Virginie ULg

Learning material (2017)

Cette vidéo, à destination de tous les étudiants en médecine, reprend la démonstration de l'examen clinique la colonne lombo sacrée que tout médecin devrait pouvoir pratiquer au minimum

Detailed reference viewed: 32 (1 ULg)
Full Text
See detailApprentissage à l'examen clinique articulaire: l'épaule
Montrieux, Christian ULg; Vanmeerbeek, Marc ULg; Dumont, Virginie ULg

Learning material (2017)

Cette vidéo, à destination de tous les étudiants en médecine, reprend un bref rappel anatomique de l'articulation de l'éapule . Elle se poursuit par une démonstration de l'examen clinique de l'épaule que ... [more ▼]

Cette vidéo, à destination de tous les étudiants en médecine, reprend un bref rappel anatomique de l'articulation de l'éapule . Elle se poursuit par une démonstration de l'examen clinique de l'épaule que tout médecin devrait pouvoir pratiquer, au minimum [less ▲]

Detailed reference viewed: 16 (0 ULg)
Full Text
Peer Reviewed
See detailEtude transfrontalière des besoins de formation en Education Thérapeutique du Patient souffrant de diabète et/ou d’obésité pour le personnel médical et paramédical : enquête par méthode du groupe nominal
Pétré, Benoît ULg; Ketterer, Frédéric ULg; Vanmeerbeek, Marc ULg et al

in Presse Médicale (2016), 45(10), 351-361

INTRODUCTION: The design of continuous training programs in therapeutic patient education (ETP) should be inspired by needs shown by the professionals concerned in terms of mobilization or acquisition of ... [more ▼]

INTRODUCTION: The design of continuous training programs in therapeutic patient education (ETP) should be inspired by needs shown by the professionals concerned in terms of mobilization or acquisition of skills in this domain. The objective of this study is to analyze needs expressed by healthcare professionals (HP) involved in patients' management presenting a type 2 diabetes (T2D) and/or obesity and to compare them with the existing recommendations. METHODS: One hundred and five PS (general practitioners, dietitians and nurses) of 3 frontier regions of French-speaking European countries (France, Belgium and Grand duchy of Luxembourg) were questioned in 12 monodisciplinary groups according to the technique of the nominal group. Needs expressed by the participants were classified in the categories of the reference table of skills to dispense TPE (National Institute for Health Prevention and Education [INPES], 2013). RESULTS/DISCUSSION: Among needs expressed by HP, 52 % of the votes targeted relational skills, 10 % of the skills relative to the biomedical techniques, 20 % of the skills relative to the educational techniques and 11 %, those of organization and the coordination. Seven percent of the proposals were out of the categories of the INPES. Results do not allow to establish profiles of skills according to the studied region or profession. The recognition of the TPE by the French legislation does not seem to influence in a major way the data. CONCLUSION: The needs expressed by PS in the context of this study are focused on the relation HP/patient that is the heart of the TPE. It would however be necessary to raise awareness among HP in the acquisition of the other skills which concern in particular the animation of group, the interprofessional coordination, the consideration of the environment or more generally the procedures. [less ▲]

Detailed reference viewed: 195 (61 ULg)
Full Text
See detailGuide de rédaction du TFE en médecine générale
Vanmeerbeek, Marc ULg; Felgueroso-Bueno, François; Lafontaine, Jean-Baptiste

Learning material (2016)

Detailed reference viewed: 486 (13 ULg)
Full Text
Peer Reviewed
See detailCollaborative Care regarding major depressed patients: A review of guidelines and current practices
Van den Broeck, Kris; Remmen, Roy; Vanmeerbeek, Marc ULg et al

in Journal of Affective Disorders (2016), 200

Major Depressive Disorder (MDD) is a severe and common mental disorder. A growing body of evidence suggests that stepped and/or collaborative care treatment models have several advantages for severely ... [more ▼]

Major Depressive Disorder (MDD) is a severe and common mental disorder. A growing body of evidence suggests that stepped and/or collaborative care treatment models have several advantages for severely depressed patients and caretakers. However, despite the availability of these treatment strategies and guidance initiatives, many depressive patients are solely treated by the general practitioner (GP), and collaborative care is not common. In this paper, we review a selected set of international guidelines to inventory the best strategies for GPs and secondary mental health care providers to collaborate when treating depressed patients. Additionally, we systematically searched the literature, listing potential ways of cooperation, and potentially supporting tools. We conclude that the prevailing guidelines only include few and rather vague directions regarding the cooperation between GPs and specialised mental health practitioners. Inspiring recent studies, however, suggest that relatively little efforts may result in effective collaborative care and a broader implementation of the guidelines in general. [less ▲]

Detailed reference viewed: 16 (3 ULg)
See detailReduction of the treatment gap for problematic alcohol use in Belgium
Mistiaen, Patriek; Kohn, Laurence; Mambourg, Françoise et al

Report (2016)

1.1 Background Alcohol consumption is a widespread phenomenon in western societies and it is a significant cause of morbidity and mortality. Problematic alcohol use affects an estimated 3.6% of the ... [more ▼]

1.1 Background Alcohol consumption is a widespread phenomenon in western societies and it is a significant cause of morbidity and mortality. Problematic alcohol use affects an estimated 3.6% of the population between 15 and 64 years of age worldwide. The Belgian health survey found that 10% of the Belgian population has a problematic alcohol use. However, only a small proportion of people with a problematic alcohol use seeks or receives treatment. A European study (including Belgium) found that only 8% of persons with an alcohol problem had consulted some form of professional assistance in the past year. A Belgian study found that 12.8% of persons with an alcohol use problem indicated they searched for help in the year after the problem started but 61% did so in later years with a mean delay of 18 years. So, many people who could profit from help/assistance do not seek or receive it and there is a long delay. It may be concluded that there is a large ‘treatment gap’. 1.2 Research aim To analyse explanations for the treatment gap and to find ways and interventions, including facilitators and barriers in applying these, to improve the treatment rate of people with problematic alcohol use in Belgium. 1.3 Methods This study applied 3 research approaches: • Review of the international and Belgian literature o Medline, EMBASE, Cochrane Library and Psychinfo and grey literature sources were searched in summer 2014 for review studies and for Belgian primary studies with date limit >2000 and written in English, Dutch, French or German o Literature was categorized into barriers/facilitators for seeking/starting treatment in individuals with problematic alcohol use, in care professionals and in society and into interventions for reducing the treatment in the mentioned three groups o Only descriptive analyses of the literature were appliedQualitative research by interviews with persons with an alcohol use problem (n=14), and interviews and focus groups with care professionals, and experts in the alcohol field (n=60) o To identify the factors on a personal, organisational and societal level that impede or facilitate the screening and advice given by professionals, initiation of treatment, and treatment-uptake by individuals with AUP; o To understand the complex interactions between those factors; o To identify the interventions/measures the surveyed individuals and professionals would consider effective in reducing the treatment gap from the point of view of the professionals and patients. • Delphi study with persons with an alcohol use problem, care professionals, policy makers and experts (total across groups n= 35) in the alcohol field to check acceptability and priority of recommendations for improvement of the treatment o Two rounds by online questionnaire were planned and a face to face meeting afterwards with Delphi-participants to discuss results of previous rounds and to reach final agreement 1.4 Results In the literature study 85 relevant reviews and 22 Belgian primary studies were included. It was found that individuals with AUP follow a long road before seeking help. Main barriers along the road are denial of the problem, belief that alcohol problems may improve on their own, desire to handle problems on their own, thinking that treatment is ineffective or uncomfortable, dislike of the prevalent group, fear of stigma, lack of financial resources and other. Next it was found that care professionals face also many barriers to initiate a kind of intervention; common mentioned barriers are lack of time and lack of knowledge and confidence. Also it appeared there is a societal/public stigma towards people with a problematic alcohol use, causing a barrier for affected persons to seek help. Several effective interventions targeted at easing patient barriers and help them to seek treatment or initiate behaviour change were found: Screening-brief interventions-referral to treatment (SBIRT) by health care professionals, internet based screening and awareness programs,stigma reducing interventions. Also a large amount of research was found to overcome these impediments. Main intervention for patients is making them aware of their problem, e.g. by screening on alcohol use and motivational brief interventions. Main interventions for professionals is to train and to motivate them to screen and give brief interventions; however, all reviews stated as well that there was a lot of diversity in training formats and intensity, making it difficult to synthetize the results and to define the optimum duration and format of such initiatives. Interventions at a societal level are less clear The qualitative study revealed that several barriers as well as facilitators are experienced by individuals with AUP and professionals. It appears that the treatment gap is a multiple phenomenon. Some elements are related to the individuals with an AUP, some others to the health professionals, and, more globally, in the socioeconomic context. Four main themes could be deduced from the interviews: individuals with AUP go through a long and stepped (however not always a linear) process before becoming aware of and recognising their problem; relatives (at home or in the social network) and colleagues (at work) play an important role along the persons’ trajectory; professionals lack the time, knowledge, skills and proper attitudes and they pass the buck when it comes to tackling the AUP; and the origin and treatment of AUP are largely influenced by societal habits and views. It appeared that more information is needed among the general population about alcohol-related problems and healthcare professionals’ knowledge on the topic, and the skills to manage it properly should be enhanced. In addition contextual and societal barriers have to be tackled. The Delphi-study resulted in a general consensus on all proposals, based on the literature and the qualitative study. But it was stressed that it is necessary to implement the proposals simultaneously to enhance synergy. 1.5 Conclusion The three research approaches confirmed each other and showed that the treatment gap for persons with problematic alcohol use is a multi-layered problem (individuals with AUP, their relatives, professionals, care system and general society). There are effective interventions to lower the treatment gap, but to obtain maximal effectiveness measures have to be taken at all levels in simultaneous way. [less ▲]

Detailed reference viewed: 37 (11 ULg)
Full Text
Peer Reviewed
See detailGeneral practice patients treated for substance use problems: a cross-national observational study in Belgium.
Boffin, Nicole; Antoine, Jerome; Moreels, Sarah et al

in BMC Public Health (2016), 16(1), 1235

BACKGROUND: General Practitioners (GPs) are well placed to care for patients with (chronic) substance use problems. This pilot was carried out to study the feasibility and usefulness of a continuous ... [more ▼]

BACKGROUND: General Practitioners (GPs) are well placed to care for patients with (chronic) substance use problems. This pilot was carried out to study the feasibility and usefulness of a continuous surveillance of substance use problems among general practice patients. The objectives were (i) to describe variables with missing values exceeding 1% and whether patients were reported without substance-related problems; (ii) the profile and the magnitude of the patient population that is treated for substance use problems. METHODS: Observational study by the Belgian Network of Sentinel General Practices (SGP) in 2013. Baseline (at the first encounter) and 7-month follow-up data were reported of all patients treated for substance use problems. Two main measurements were type of substance use and patient status at follow-up. Multiple logistic regression analysis was used to examine patient status at follow-up. RESULTS: Of 479 patients, 47.2% had problems with alcohol alone, 20.3% with prescription drugs, 16.7% with illicit drugs other than heroin or methadone and 15.9% with heroin or methadone. Problems with alcohol alone were more prevalent in Flanders (53.0%; 95% confidence interval (CI) 46.8-59.1%) than in Wallonia-Brussels (39.8%; 95% CI 33.1-46.8%), while problems with heroin or methadone were more prevalent in Wallonia-Brussels (27.0%; 95% CI 21.1-33.5%) than in Flanders (7.1%; 95% CI 4.3-10.9%). At follow-up, 32.8% of the patients had dropped out, 29.0% had discontinued GP treatment and 38.2% had continued GP treatment. Overall, 32.4% of 479 patients had continued GP treatment for substance use problems during the study period. In Wallonia-Brussels, this proportion was higher (42.7%; 95% CI 35.9-49.6%) than in Flanders (24.3%; 95% CI 19.2-29.8%). CONCLUSIONS: A continuous surveillance of the general practice population treated for substance use problems seems to be feasible and useful. The latter is suggested by the specific profile and the relative magnitude of the population. Inter-regional health system differences should be taken into account to estimate the epidemiology of substance use problems among general practice patients. [less ▲]

Detailed reference viewed: 20 (3 ULg)
Full Text
Peer Reviewed
See detailPratiques hospitalières et de médecine générale d’éducation thérapeutique –l’exemple du diabète et de l’obésité en Belgique
Pétré, Benoît ULg; Degrange, Sophie ULg; Tittaferante, Séverine et al

in Santé Publique : Revue Multidisciplinaire pour la Recherche et l'Action (2016), 28

Detailed reference viewed: 70 (29 ULg)
Full Text
Peer Reviewed
See detailSearching for consensus among physicians involved in the management of sick-listed workers in the Belgian health care sector: a qualitative study among practitioners and stakeholders
Vanmeerbeek, Marc ULg; Govers, Patrick ULg; Schippers, Nathalie ULg et al

in BMC Public Health (2016), 16

Background In Belgium, the management of sick leave involves general practitioners (GPs), occupational health physicians (OPs) and social insurance physicians (SIPs). A dysfunctional relationship among ... [more ▼]

Background In Belgium, the management of sick leave involves general practitioners (GPs), occupational health physicians (OPs) and social insurance physicians (SIPs). A dysfunctional relationship among these physicians can impede a patient’s ability to return to work. The objective of this study was to identify ways to improve these physicians’ mutual collaboration. Methods Two consensus techniques were successively performed among the three professional groups. Eight nominal groups (NGs) gathered 74 field practitioners, and a two-round Delphi process involved 32 stakeholders. Results From the results, it appears that two areas (reciprocal knowledge and evolution of the legal and regulatory framework) are objects of consensus among the three medical group that were surveyed. Information transfer, particularly electronic transfer, was stressed as an important way to improve. The consensual proposals regarding interdisciplinary collaboration indicate specific and practical changes to be implemented when professionals are managing workers who are on sick leave. The collaboration process appeared to be currently more problematic, but the participants correctly identified the need for common training. Conclusions The three physician groups all agree regarding several inter-physician collaboration proposals. The study also revealed a latent conflict situation among the analysed professionals that can arise from a lack of mutual recognition. Practical changes or improvements must be included in an extended framework that involves the different determinants of interdisciplinary collaboration that are shown by theoretical models. Collaboration is a product of the actions and behaviours of various partners, which requires reciprocal knowledge and trust; collaboration also implies political and economic structures that are led by public health authorities. [less ▲]

Detailed reference viewed: 33 (6 ULg)
Full Text
See detailPour une vision intégrée du prévenir et du guérir
Vanmeerbeek, Marc ULg

Scientific conference (2015, October 02)

Detailed reference viewed: 35 (0 ULg)
Full Text
Peer Reviewed
See detailDe la maladie chronique à la multimorbidité : quel impact sur l’organisation des soins de santé ?
Belche, Jean ULg; Berrewaerts, Marie-Astrid ULg; Ketterer, Frédéric ULg et al

in Presse Médicale (2015)

Healthcare systems are concerned with the growing prevalence of chronic diseases. Single disease approach, based on the Chronic Care Model, is known to improve specific indicators for the targeted disease ... [more ▼]

Healthcare systems are concerned with the growing prevalence of chronic diseases. Single disease approach, based on the Chronic Care Model, is known to improve specific indicators for the targeted disease. However, the co-existence of several chronic disease, or multimorbidity, within a same patient is the most frequent situation. The fragmentation of care, as consequence of the single disease approach, has negative impact on the patient and healthcare professionals. A person centred approach is a method addressing the combination of health issues of each patient. The coordination and synthesis role is key to ensure continuity of care for the patient within a network of healthcare professionals from several settings of care. This function is the main characteristic of an organized first level of care. [less ▲]

Detailed reference viewed: 89 (28 ULg)
Full Text
See detail“Up To Date” Use of psychoactive substances in adults: Prevention and Treatment by general practitioners and Occupational physicians; DATa retriEval
Vanmeerbeek, Marc ULg; Remmen, Roy; Godderis, Lode et al

Report (2015)

1 Contexte En 2013, 6% de la population belge âgée de 15 ans ou plus avait une consommation excessive d’alcool. La notion de consommation excessive se réfère aux normes de l’Organisation mondiale de la ... [more ▼]

1 Contexte En 2013, 6% de la population belge âgée de 15 ans ou plus avait une consommation excessive d’alcool. La notion de consommation excessive se réfère aux normes de l’Organisation mondiale de la Santé (OMS), qui admet comme raisonnable une consommation de deux unités d’alcool par jour pour une femme, et de trois unités pour un homme. Le chiffre de consommation excessive monte à 13% si on considère la consommation hebdomadaire, pour laquelle l’OMS considère que plus de 14 unités d’alcool pour une femme, et plus de 21 unités pour un homme sont nocives pour la santé. Si l’on se réfère à la consommation problématique découlant des réponses au questionnaire CAGE, un instrument de dépistage de l’abus chronique d’alcool, ce sont 10,5% de la population qui sont concernés (14,6% des hommes et 6,3% des femmes) . De plus, 15% des personnes interrogées avaient déjà consommé du cannabis et 5% une autre drogue illégale. Environ 15% de la population avaient consommé des substances psychoactives au cours des deux semaines précédant l’enquête : hypnotiques (9%), tranquillisants (7%) et antidépresseurs (6%) ; les femmes consommaient plus que les hommes (20% contre 10%). Dans le monde du travail, les données internationales rapportent une utilisation fréquente de substances psychoactives liée au contexte de travail, entrainant une majoration du risque d’accident et une perte de productivité. En Belgique, 15% des travailleurs boivent trop, par rapport aux normes de l’OMS. Les données manquent cependant pour les autres substances, mais le taux de consommation dans la population générale est probablement extrapolable à la population au travail. Parmi l’offre diversifiée de soins ambulatoires, les médecins généralistes (MG) apparaissent comme des acteurs importants tant pour la détection que pour la prise en charge des problèmes en raison de leur place de première ligne dans le système de santé. De façon similaire, on attend des médecins du travail (MT) un rôle de promoteurs de la santé et de la sécurité sur les lieux de travail, y compris en ce qui concerne les usages problématiques de substances (Convention Collective de Travail n° 100). Les données manquent quant à l’attitude, le comportement, ou les connaissances par rapport aux usages problématiques par ces deux acteurs. Peu de choses sont connues quant à leurs ressources et leurs stratégies pour gérer ces problèmes, de même que concernant leur intérêt ou leurs attitudes en ce domaine. 1.1 Objectifs Le consortium UP TO DATE a cherché à donner la parole à ces médecins pour comprendre leur point de vue sur la question. De plus, les autres professionnels du domaine ont été interrogés pour savoir s’ils considéraient les MG et les MT comme des partenaires utiles et fiables. Cette étude a porté sur l’ensemble du territoire, dans les deux communautés linguistiques principales du pays. L’objectif de cette recherche était de savoir : 1) quelles est la demande de soins en première ligne ? 2) quelle est l’étendue de l’investissement des MG et des MT dans le domaine des abus de substances ? 3) quelles ressources utilisent-ils pour fournir une réponse appropriée à tous les types de demandes auxquelles ils sont confrontés ? Le consortium de recherche a utilisé tant des méthodes qualitatives que quantitatives pour atteindre ses objectifs. 1.2 Précisions Les enquêtes dans les deux professions, MG et MT, ont toujours considéré la prise en charge de la population adulte, dans les limites d’âge de la population active, soit de 18 à 65 ans. De cette façon, les enquêtes dans les deux professions médicales ont pu être conduites de façon symétrique. Les substances considérées étaient l’alcool, les hypnotiques, les tranquillisants et les drogues illégales. Parmi ces dernières, il est rapidement apparu que le cannabis devait faire l’objet d’un traitement différencié. La notion d’« usage problématique » fait référence à la définition donnée par la Public Health Association de Colombie britannique, dans laquelle l’usage des substances se situe sur un continuum (figure 1). De façon plus concrète, les définitions suivantes sont d’application dans ce document: • Dans la population générale, une consommation est problématique lorsqu’elle dépasse les recommandations de l’Organisation Mondiale de la Santé (OMS) : en moyenne, moins de 14 unités/semaine pour une femme et moins de 21 unités/semaine pour un homme, pas de binge drinking; deux jours ou plus sans alcool/semaine ; • Pour les hypnotiques et les tranquillisants, une consommation est problématique lorsqu’elle n’a pas été prescrite par un médecin, ou lorsqu’elle est consommée à une dose supérieure à la dose prescrite ; • Enfin, le mésusage des drogues illégales a été considéré tel lorsqu’une demande d’aide est formulée par le patient/travailleur, ou par son entourage, par un médecin ou par décision de justice. 1.3 Méthodes Le travail a été divisé en sept volets. 1.3.1 Revue de littérature Une revue systématique a été faite sur les recommandations internationales à propos du dépistage et de l’intervention, pour les MG et les MT. Les modèles de référence et de collaboration ont également été recherchés, entre MG et MT d’une part, entre ces praticiens et les centres spécialisés d’autre part. 1.3.2 Caractéristiques de la population consultant en médecine générale et présentant un abus de substances. Des données sur l’usage problématique de substances et sur le statut d’emploi des personnes identifiées ont été recueillies en collaboration avec les MG du réseau des médecins vigies, coordonné par l’Institut scientifique de Santé publique (ISP). 1.3.3 Attitudes et expériences des MG (volet 3) et des MT (volet 4) en matière de détection, d’approche et de gestion des abus de substances Ces deux volets de l’étude, construits de façon symétrique dans les deux professions, avaient pour but de décrire les attitudes et les expériences des médecins de terrain, dans différents contextes de travail. 1.3.3.1 Étude qualitative L’étude qualitative a servi d’approche exploratoire. Elle a cherché à comprendre en profondeur le point de vue des médecins, qu’ils prennent ou non en charge des patients qui ont un usage problématique de substances. Afin d’obtenir une vue complète et précise de leurs points de vue, le modèle intégré de changement de Hein De Vries (I-Change Model) a été utilisé pour construire le guide d’entretien et réaliser l’analyse thématique des transcriptions d’entretiens. 1.3.3.2 Étude quantitative Un questionnaire a été diffusé auprès d’un échantillon représentatif des MG et des MT afin de trianguler les résultats de l’analyse qualitative et identifier des profils particuliers de médecins. Le même modèle théorique a été conservé pour des raisons de cohérence entre les parties qualitative et quantitative de l’étude. 1.3.4 Vue en miroir Différents professionnels impliqués eux aussi dans la gestion des abus de substances ont été interrogés sur leur collaboration (existante ou souhaitée) avec les MG et les MT. Les propositions d’amélioration ont été recueillies par la méthode des groupes nominaux, organisés à cet effet de façon monodisciplinaire. Les professions interrogées appartenaient au monde des soins (psychiatres, psychologues, travailleurs sociaux), au monde du travail (représentants des employeurs, syndicalistes, conseillers en prévention internes et externes) ou au monde de la justice (services judiciaires et de protection de la jeunesse). 1.3.5 Comparaison internationale Ce volet a tenté de retrouver dans la littérature scientifique publiée des expériences ayant fait leurs preuves à l’étranger quant à une amélioration de l’implication des MG et des MT dans la gestion des abus de substances. 1.3.6 Valorisation Afin de diffuser les résultats des volets précédents auprès des médecins de terrain et des décideurs, et de confronter ces résultats à leurs expériences pratiques, des rencontres locales ont été organisées par les chercheurs en suivant la méthode LSI (Large Scale Intervention). Une rencontre finale a été organisée à Bruxelles le 23 janvier 2015 au SPF Emploi, Travail et Concertation sociale pour l’ensemble des acteurs et des décideurs. [less ▲]

Detailed reference viewed: 68 (13 ULg)