Therapie最新文献_第3页

Non-medical nitrous oxide misuse: From identifying a signal to unprecedented addictovigilance network communication 非医疗氧化亚氮滥用：从识别信号到前所未有的成瘾警戒网络通信。

IF 2.2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Therapie

Pub Date : 2025-03-01 DOI: 10.1016/j.therap.2024.10.057

Marylène Guerlais , Sylvie Deheul , FAN , Reynald Le Boisselier , Caroline Victorri-Vigneau

Addictovigilance is a French health monitoring system, composed of 13 centres distributed across the national territory, that aims to monitor cases of abuse, misuse, or use disorders related to psychoactive substances. Fulfilling these missions requires a regional network that ensures efficient information flow, dissemination to health authorities, and subsequent downward communication to prevent risks. This was illustrated through the example of nitrous oxide misuse. The Nantes Addictovigilance Centre, which is responsible for nitrous oxide monitoring, has highlighted the emergence of a signal from the very first cases. Since 2018, 6 national addictovigilance reports have subsequently been produced highlighting the increase in this signal in quantitative terms and in qualitative terms, with a diversification and worsening of complications (use disorders, neurological, psychiatric, cardiac and more recently thromboembolic). At the local and regional level, each addictovigilance centre has relayed information to its network, in a variety of ways, but also to the general public, particularly through the media. Studies have also been carried out to better quantify and qualify nitrous oxide consumption. These signals from addictovigilance data have been the subject of numerous national and international communications (health authorities, addictovigilance network, international scientific articles). They have also contributed to the promulgation of the French law of June 2021 aimed to prevent dangerous uses of nitrous oxide, and international reporting. The addictovigilance centres have made it possible to obtain an early, rapid and accurate signal with pharmacological and medical data. Nitrous oxide is an example of the wide potential of action of the French addictovigilance network, in all its fields of competence: training, specific collection, research and information.

成瘾警戒是法国的一个健康监测系统，由分布在全国各地的13个中心组成，旨在监测与精神活性物质有关的滥用、误用或使用障碍的案件。完成这些任务需要一个区域网络，以确保有效的信息流动、向卫生当局传播以及随后的向下沟通，以防止风险。这是通过一氧化二氮滥用的例子来说明的。负责一氧化二氮监测的南特成瘾警戒中心强调，从第一批病例中就出现了一个信号。自2018年以来，先后编写了6份国家成瘾警惕性报告，强调了这一信号在数量和质量方面的增加，并发症（使用障碍、神经、精神、心脏和最近的血栓栓塞）的多样化和恶化。在地方和区域一级，每个成瘾警戒中心都以各种方式向其网络传递信息，但也向公众传递信息，特别是通过媒体。还进行了研究，以更好地量化和限定一氧化二氮的消耗。来自成瘾警惕性数据的这些信号已成为许多国家和国际交流（卫生当局、成瘾警惕性网络、国际科学文章）的主题。他们还为颁布2021年6月旨在防止危险使用一氧化二氮的法国法律以及国际报告作出了贡献。成瘾监测中心使利用药理学和医学数据获得早期、快速和准确的信号成为可能。一氧化二氮是法国成瘾警戒网络在其所有权限领域的广泛行动潜力的一个例子：培训，具体收集，研究和信息。

{"title":"Non-medical nitrous oxide misuse: From identifying a signal to unprecedented addictovigilance network communication","authors":"Marylène Guerlais , Sylvie Deheul , FAN , Reynald Le Boisselier , Caroline Victorri-Vigneau","doi":"10.1016/j.therap.2024.10.057","DOIUrl":"10.1016/j.therap.2024.10.057","url":null,"abstract":"<div><div>Addictovigilance is a French health monitoring system, composed of 13 centres distributed across the national territory, that aims to monitor cases of abuse, misuse, or use disorders related to psychoactive substances. Fulfilling these missions requires a regional network that ensures efficient information flow, dissemination to health authorities, and subsequent downward communication to prevent risks. This was illustrated through the example of nitrous oxide misuse. The Nantes Addictovigilance Centre, which is responsible for nitrous oxide monitoring, has highlighted the emergence of a signal from the very first cases. Since 2018, 6 national addictovigilance reports have subsequently been produced highlighting the increase in this signal in quantitative terms and in qualitative terms, with a diversification and worsening of complications (use disorders, neurological, psychiatric, cardiac and more recently thromboembolic). At the local and regional level, each addictovigilance centre has relayed information to its network, in a variety of ways, but also to the general public, particularly through the media. Studies have also been carried out to better quantify and qualify nitrous oxide consumption. These signals from addictovigilance data have been the subject of numerous national and international communications (health authorities, addictovigilance network, international scientific articles). They have also contributed to the promulgation of the French law of June 2021 aimed to prevent dangerous uses of nitrous oxide, and international reporting. The addictovigilance centres have made it possible to obtain an early, rapid and accurate signal with pharmacological and medical data. Nitrous oxide is an example of the wide potential of action of the French addictovigilance network, in all its fields of competence: training, specific collection, research and information.</div></div>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"80 2","pages":"Pages 223-229"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From the first pilot initiatives in the early 1990s to the national OSIAP survey in the 2020s: More than 30 years of insight in medication diversion phenomenon in France 从 20 世纪 90 年代初的首批试点倡议到 20 世纪 20 年代的 OSIAP 全国调查：30 多年来对法国药物转用现象的洞察。

IF 2.2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Therapie

Pub Date : 2025-03-01 DOI: 10.1016/j.therap.2024.10.053

Maryse Lapeyre-Mestre, Florence Fabre, Emilie Jouanjus, The French Addictovigilance Network

This article proposes to trace back the timeline of the monitoring of falsified medical prescriptions in France as part of the French Addictovigilance System's toolbox. It examines the genesis of the OSIAP survey (Suspect Prescriptions Indicator of Possible Abuse), which has been held at the national level since 2001 but was created in the early 1990s, and its development until the current situation with a continuously confirmed yearly increasing trend. Understanding the birth and development of OSIAP and some other Addictovigilance tools that continue to be useful after more than 30 years of existence requires to review key historical benchmarks including the principles and missions of the former French National Commission on Narcotic and Psychotropic Drugs. Even though the OSIAP survey is part of a specific toolbox developed and routinely explored by the Addictovigilance network in a multidimensional approach, it has also been the sole data source, which identified some problematic drug uses, such as the early detection of tropicamide eye drop misuse in France or the diversion of codeine cough syrups after July 2017. Nevertheless, findings obtained from this data source should be checked against other complementary sources. Close monitoring of falsified prescriptions should be maintained in France, and the recent evolutions are plaid for supporting this survey. It is still being determined whether the constant increase of false prescription forms recorded in the OSIAP survey results from an increase in the absolute number of falsified prescriptions or whether pharmacists have become more vigilant with time. Still, the acceleration of these falsifications is also in line with the deployment of teleconsultations and the democratisation of digital techniques such as copying prescriptions or generating false QR codes. The forging techniques will likely evolve again in the future, possibly by adapting to stricter requirements such as the implementation of dematerialised prescriptions.

本文旨在追溯作为法国药物滥用监控系统工具箱一部分的法国伪造处方监控工作的发展历程。文章研究了自 2001 年起在全国范围内开展的 OSIAP 调查（可能滥用的可疑处方指标）的起源，该调查于 20 世纪 90 年代初创立，并研究了其发展情况，直至目前持续确认的逐年增长趋势。要了解 OSIAP 和其他一些戒毒工具的诞生和发展历程（这些工具在 30 多年后仍然有用），需要回顾一些重要的历史基准，包括前法国国家麻醉品和精神药物委员会的原则和使命。尽管 OSIAP 调查是毒瘾警戒网络以多维方法开发和例行探索的特定工具箱的一部分，但它也是唯一的数据来源，发现了一些有问题的药物使用情况，如法国早期发现的托吡卡胺滴眼液滥用或 2017 年 7 月后可待因止咳糖浆的转移。然而，从这一数据来源获得的调查结果应与其他补充来源进行核对。法国应保持对伪造处方的密切监测，最近的演变为这项调查提供了支持。OSIAP 调查中记录的虚假处方不断增加，究竟是由于虚假处方的绝对数量增加，还是由于药剂师的警惕性随着时间的推移而提高，目前仍有待确定。不过，这些伪造现象的加速也与远程会诊的部署和数字技术的民主化（如复制处方或生成虚假二维码）相一致。未来，伪造技术很可能会再次演变，可能会适应更严格的要求，如实施非物质化处方。

{"title":"From the first pilot initiatives in the early 1990s to the national OSIAP survey in the 2020s: More than 30 years of insight in medication diversion phenomenon in France","authors":"Maryse Lapeyre-Mestre, Florence Fabre, Emilie Jouanjus, The French Addictovigilance Network","doi":"10.1016/j.therap.2024.10.053","DOIUrl":"10.1016/j.therap.2024.10.053","url":null,"abstract":"<div><div>This article proposes to trace back the timeline of the monitoring of falsified medical prescriptions in France as part of the French Addictovigilance System's toolbox. It examines the genesis of the OSIAP survey (Suspect Prescriptions Indicator of Possible Abuse), which has been held at the national level since 2001 but was created in the early 1990s, and its development until the current situation with a continuously confirmed yearly increasing trend. Understanding the birth and development of OSIAP and some other Addictovigilance tools that continue to be useful after more than 30 years of existence requires to review key historical benchmarks including the principles and missions of the former French National Commission on Narcotic and Psychotropic Drugs. Even though the OSIAP survey is part of a specific toolbox developed and routinely explored by the Addictovigilance network in a multidimensional approach, it has also been the sole data source, which identified some problematic drug uses, such as the early detection of tropicamide eye drop misuse in France or the diversion of codeine cough syrups after July 2017. Nevertheless, findings obtained from this data source should be checked against other complementary sources. Close monitoring of falsified prescriptions should be maintained in France, and the recent evolutions are plaid for supporting this survey. It is still being determined whether the constant increase of false prescription forms recorded in the OSIAP survey results from an increase in the absolute number of falsified prescriptions or whether pharmacists have become more vigilant with time. Still, the acceleration of these falsifications is also in line with the deployment of teleconsultations and the democratisation of digital techniques such as copying prescriptions or generating false QR codes. The forging techniques will likely evolve again in the future, possibly by adapting to stricter requirements such as the implementation of dematerialised prescriptions.</div></div>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"80 2","pages":"Pages 163-176"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

DRAMES and DTA databases: Complementary tools to monitor drug-related deaths in France DRAMES 和 DTA 数据库：法国监测毒品相关死亡的互补工具。

IF 2.2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Therapie

Pub Date : 2025-03-01 DOI: 10.1016/j.therap.2024.10.059

Bruno Revol , Théo Willeman , Marc Manceau , Véronique Dumestre-Toulet , Jean-Michel Gaulier , Alexandra Boucher , Célian Bertin , Hélène Eysseric-Guérin , Nathalie Fouilhé Sam-Laï , Compagnie nationale des biologistes et analystes experts (CNBAE), French Addictovigilance Network (FAN)

Introduction

The DRAMES (décès en relation avec l’abus de médicaments et de substances) registry is a French database of drug-related deaths (medications or illicit drugs) among drug users. The DTA (décès toxiques par antalgiques) registry is a French database of analgesic-related deaths among people without a history of drug abuse. Both registries are based on the collection of data on deaths for which forensic toxicology experts have performed analyses.

Material and methods

In the present study, we included drug- and analgesic-related deaths occurring from January 2013 to December 2022 in France. Subject demographic characteristics and medical history, forensic autopsy findings and toxicology reports were evaluated.

Results

Among drug users (DRAMES registry), opioids used alone or in combination were the main contributor to drug-related deaths in France, as they are in most countries. However, licit methadone was the leading cause of opioid-related deaths (ahead of heroin) during the study period. The main trend was the dramatic increase in cocaine-related mortality. Among medical users of analgesics (DTA registry), tramadol was the leading cause of deaths throughout this period.

Conclusion

A large-scale naloxone distribution program is urgently needed in France to prevent opioid overdoses, including among licit methadone users. However, our data do not support the hypothesis of an opioid crisis in France, although close monitoring is still required, particularly for oxycodone.

导言：DRAMES (décès en relation avec l'abus de médicaments et de substances) 登记系统是法国的一个数据库，记录吸毒者中与药物（药物或违禁药物）相关的死亡案例。DTA（décès toxiques par antalgiques）登记处是法国的一个数据库，用于统计无药物滥用史的人群中与镇痛剂相关的死亡案例。这两个登记处都以收集法医毒理学专家已进行分析的死亡数据为基础：在本研究中，我们纳入了 2013 年 1 月至 2022 年 12 月期间在法国发生的与药物和镇痛剂相关的死亡事件。我们对受试者的人口统计学特征、病史、法医尸检结果和毒理学报告进行了评估：在法国的吸毒者（DRAMES登记处）中，与大多数国家一样，单独或混合使用阿片类药物是导致毒品相关死亡的主要原因。然而，在研究期间，合法美沙酮是阿片类药物相关死亡的主要原因（排在海洛因之前）。主要趋势是与可卡因有关的死亡率急剧上升。在镇痛药医疗使用者（DTA 登记册）中，曲马多是这一时期的主要死因：结论：法国急需实施大规模纳洛酮发放计划，以防止阿片类药物过量，包括在美沙酮合法使用者中。不过，我们的数据并不支持法国阿片类药物危机的假设，但仍需密切监测，尤其是对羟考酮的监测。

{"title":"DRAMES and DTA databases: Complementary tools to monitor drug-related deaths in France","authors":"Bruno Revol , Théo Willeman , Marc Manceau , Véronique Dumestre-Toulet , Jean-Michel Gaulier , Alexandra Boucher , Célian Bertin , Hélène Eysseric-Guérin , Nathalie Fouilhé Sam-Laï , Compagnie nationale des biologistes et analystes experts (CNBAE), French Addictovigilance Network (FAN)","doi":"10.1016/j.therap.2024.10.059","DOIUrl":"10.1016/j.therap.2024.10.059","url":null,"abstract":"<div><h3>Introduction</h3><div>The DRAMES (<em>décès en relation avec l’abus de médicaments et de substances</em>) registry is a French database of drug-related deaths (medications or illicit drugs) among drug users. The DTA (<em>décès toxiques par antalgiques</em>) registry is a French database of analgesic-related deaths among people without a history of drug abuse. Both registries are based on the collection of data on deaths for which forensic toxicology experts have performed analyses.</div></div><div><h3>Material and methods</h3><div>In the present study, we included drug- and analgesic-related deaths occurring from January 2013 to December 2022 in France. Subject demographic characteristics and medical history, forensic autopsy findings and toxicology reports were evaluated.</div></div><div><h3>Results</h3><div>Among drug users (DRAMES registry), opioids used alone or in combination were the main contributor to drug-related deaths in France, as they are in most countries. However, licit methadone was the leading cause of opioid-related deaths (ahead of heroin) during the study period. The main trend was the dramatic increase in cocaine-related mortality. Among medical users of analgesics (DTA registry), tramadol was the leading cause of deaths throughout this period.</div></div><div><h3>Conclusion</h3><div>A large-scale naloxone distribution program is urgently needed in France to prevent opioid overdoses, including among licit methadone users. However, our data do not support the hypothesis of an opioid crisis in France, although close monitoring is still required, particularly for oxycodone.</div></div>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"80 2","pages":"Pages 197-204"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inputs of pharmacoepidemiology in addictovigilance: How do they fit together? 药物流行病学在成瘾警戒中的投入：它们是如何结合在一起的？

IF 2.2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Therapie

Pub Date : 2025-03-01 DOI: 10.1016/j.therap.2024.10.058

Thomas Soeiro , Amélie Daveluy , Caroline Victorri-Vigneau , Maryse Lapeyre-Mestre , Joëlle Micallef

The French Addictovigilance Network has been using data from the French Heath insurance since the late 1990s to assess prescription drug abuse. In this narrative review, we illustrate the inputs of pharmacoepidemiology in addictovigilance based on the experience of the French Addictovigilance Network. The review focuses on pharmacoepidemiology using the French National Health Data System. We propose three examples: the MEGADOSE study, which aimed to conduct the first nation-wide, systematic, repeated assessment of doctor shopping; the DANTE study, which aimed to assess trends in analgesic use, focusing on the prevalence of use and the demographic profiles of analgesic users by age and sex; and the ZORRO study, which aimed to assess the impact of secure prescription forms on the use of zolpidem and other sedatives. These examples show how pharmacoepidemiology fits in the multifaceted monitoring conducted by the French Addictovigilance Network and complements the other data sources of this framework. This approach improves signal detection, confirmation, and quantification. It also makes it possible to overcome the limitations of each data source taken individually.

自 20 世纪 90 年代末以来，法国药物滥用警戒网络一直在使用来自法国医疗保险的数据来评估处方药滥用情况。在这篇叙述性综述中，我们将根据法国药物滥用警戒网络的经验，说明药物流行病学在药物滥用警戒方面的投入。回顾的重点是使用法国国家健康数据系统的药物流行病学。我们提出了三个实例：MEGADOSE 研究，旨在对医生购物进行首次全国性、系统性、重复性评估；DANTE 研究，旨在评估镇痛药使用趋势，重点关注镇痛药使用的普遍性以及按年龄和性别划分的镇痛药使用者的人口统计学特征；ZORRO 研究，旨在评估安全处方形式对唑吡坦和其他镇静剂使用的影响。这些例子说明了药物流行病学如何与法国毒瘾警戒网络开展的多方面监测相结合，并与该框架的其他数据来源相辅相成。这种方法改进了信号检测、确认和量化。它还可以克服每个数据源单独使用时的局限性。

{"title":"Inputs of pharmacoepidemiology in addictovigilance: How do they fit together?","authors":"Thomas Soeiro , Amélie Daveluy , Caroline Victorri-Vigneau , Maryse Lapeyre-Mestre , Joëlle Micallef","doi":"10.1016/j.therap.2024.10.058","DOIUrl":"10.1016/j.therap.2024.10.058","url":null,"abstract":"<div><div>The French Addictovigilance Network has been using data from the French Heath insurance since the late 1990s to assess prescription drug abuse. In this narrative review, we illustrate the inputs of pharmacoepidemiology in addictovigilance based on the experience of the French Addictovigilance Network. The review focuses on pharmacoepidemiology using the French National Health Data System. We propose three examples: the MEGADOSE study, which aimed to conduct the first nation-wide, systematic, repeated assessment of doctor shopping; the DANTE study, which aimed to assess trends in analgesic use, focusing on the prevalence of use and the demographic profiles of analgesic users by age and sex; and the ZORRO study, which aimed to assess the impact of secure prescription forms on the use of zolpidem and other sedatives. These examples show how pharmacoepidemiology fits in the multifaceted monitoring conducted by the French Addictovigilance Network and complements the other data sources of this framework. This approach improves signal detection, confirmation, and quantification. It also makes it possible to overcome the limitations of each data source taken individually.</div></div>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"80 2","pages":"Pages 205-211"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The French Addictovigilance Network – A multidisciplinary successful journey in the protection of public health 法国成瘾警戒网络——保护公众健康的多学科成功之旅。

IF 2.2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Therapie

Pub Date : 2025-03-01 DOI: 10.1016/j.therap.2024.11.009

Ana Carmona Araújo

Since the beginning of the century, the USA have been experiencing an opioid epidemic characterised by high levels of prescription opioid use. While extensive North American literature on the topic has been published and several public health measures implemented attempting to address the problem, in Europe addiction research, especially literature focusing on misuse of medicines, lags far behind. France is an exception: it is the only European country that has established a nationwide specific system to monitor misuse of legal and illegal psychoactive substances, an activity that has been named addictovigilance. Thanks to the combined use of several data sources, the French addictovigilance system has, in its three decades of existence, proven to be effective in the early identification and assessment of addictovigilance signals, providing real-world evidence to support the conception and monitoring of public health measures to minimise the health risks posed by psychoactive substance misuse in France.

自本世纪初以来，美国一直在经历阿片类药物的流行，其特点是处方阿片类药物的使用水平很高。虽然北美已经发表了大量关于这一主题的文献，并实施了一些公共卫生措施，试图解决这一问题，但在欧洲，成瘾研究，特别是侧重于药物滥用的文献远远落后。法国是一个例外：它是唯一一个在全国范围内建立了专门系统来监测合法和非法精神活性物质滥用的欧洲国家，这项活动被称为“成瘾警惕”。由于综合使用了几种数据来源，法国成瘾警戒系统在其存在的三十年中，已被证明在早期识别和评估成瘾警戒信号方面是有效的，提供了真实的证据，以支持公共卫生措施的概念和监测，以尽量减少法国精神活性物质滥用造成的健康风险。

引用次数: 0

Monitoring opioid analgesic misuse, abuse and dependence: What to the data from addictovigilance tell us about the situation in France? 监测阿片类镇痛药的误用、滥用和依赖：来自成瘾警惕性的数据告诉我们法国的情况是什么？

IF 2.2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Therapie

Pub Date : 2025-03-01 DOI: 10.1016/j.therap.2024.11.008

Maryse Lapeyre-Mestre , Celian Bertin , Constança Jalles , Thomas Soeiro , Joëlle Micallef , Anne Roussin

The opioid epidemic has emerged in the USA in the late 1990s and widespread to Canada, Australia, and the UK to a lesser extent in the more recent years. At the European level, several studies performed in different European countries have highlighted that prescription opioid use increased substantially over the last decade, and several proxies for misuse show a parallel increasing trend. The French addictovigilance experience on opioid analgesics is a good example of a specific dedicated monitoring, taking into account in a global and multisource perspective, patterns of utilization, population involved in problematic use, ways of acquisition and health complications. The added value of this data triangulation is illustrated by the recent data on tramadol and oxycodone. The addictovigilance monitoring is particularly relevant to identify early signals of potential problematic use and to assess the impact of campaigns for opioid analgesics rational use and regulatory changes.

阿片类药物流行于20世纪90年代末在美国出现，近年来在较小程度上蔓延到加拿大、澳大利亚和英国。在欧洲一级，在不同欧洲国家进行的几项研究强调，处方阿片类药物的使用在过去十年中大幅增加，滥用的几个替代指标显示出平行增加的趋势。法国在阿片类镇痛药成瘾警戒方面的经验是一个很好的例子，从全球和多来源的角度考虑到具体的专门监测、使用模式、涉及问题使用的人口、获取方式和健康并发症。最近关于曲马多和羟考酮的数据说明了这种数据三角化的附加价值。成瘾警惕性监测对于识别潜在问题使用的早期信号以及评估阿片类镇痛药合理使用和监管变化运动的影响尤其相关。

引用次数: 0

[Prevention of opioid misuse and overdose risk and distribution of naloxone: Current practices, needs and prospects among dispensing pharmacists]. [阿片类药物滥用和过量风险的预防和纳洛酮的分布：配药药师的现状、需求和前景]。

IF 2.2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Therapie

Pub Date : 2025-02-28 DOI: 10.1016/j.therap.2025.02.006

Armelle Chan Soc Foh, Salim Mezaache, Franck Turlure, Nathalie Fredon, Stéphane Pichon, Laurent Peillard, Joelle Micallef, Elisabeth Frauger

Introduction: Opioids are essential medicines, but their use is associated with risks. The POP program "Prevention and risk reduction of Opioid-related overdoses in the PACA region" aims to improve the management of patients at risk of overdose and the distribution of naloxone. We have conducted a survey of pharmacist with the aim was to assess their knowledge, practices, difficulties and needs concerning the management of opioid users and overdose prevention and naloxone diffusion, and to propose training materials adapted to their needs.

Materials and methods: In the context of POP programme, pharmacists were approached via an online questionnaire (February-March 2024) and semi-structured interviews (April 2024).

Results: A total of 107 pharmacists completed the questionnaire and 10 took part in the interviews. Seventy-four per cent said they had encountered patients with opioid misuse disorders. Awareness of the Prescription Opioid Misuse Index was low (92%). Only 37% of pharmacists said they were aware of the availability of take-home naloxone, and 87% were uncomfortable with the advice associated with it is dispensing. Actions in the event of misuse included contacting the prescriber (76%), refusing to dispense (76%), and adapting or splitting dispensing (60%). In terms of needs, 95% were interested in training, 44% in practical tools, and 41% in documents for patients. Based on the needs expressed, information and outreach actions were carried out.

Conclusion: The results highlight the need to improve pharmacists knowledge on overdose risk and naloxone. Regular training and the dissemination of practical tools are essential.

阿片类药物是基本药物，但其使用与风险相关。POP项目“PACA区域阿片类药物相关过量的预防和风险降低”旨在改善对有过量风险的患者的管理和纳洛酮的分配。我们对药师进行了调查，目的是评估他们在阿片类药物使用者管理、过量预防和纳洛酮扩散方面的知识、做法、困难和需求，并提出适合他们需求的培训材料。材料与方法：在POP项目背景下，通过在线问卷（2024年2月- 3月）和半结构化访谈（2024年4月）与药师进行接触。结果：共107名药师完成问卷，10名药师参与访谈。74%的人表示，他们遇到过阿片类药物滥用障碍患者。处方阿片类药物滥用意识指数较低（92%）。只有37%的药剂师说他们知道可以带回家的纳洛酮，87%的药剂师对配药建议感到不舒服。发生误用时采取的措施包括联系处方医师（76%）、拒绝配药（76%）以及调整或分开配药（60%）。在需求方面，95%的人对培训感兴趣，44%的人对实用工具感兴趣，41%的人对患者的文件感兴趣。根据所表示的需要，开展了宣传和外联行动。结论：药师对纳洛酮用药过量风险的认识有待提高。定期培训和传播实用工具是必不可少的。

{"title":"[Prevention of opioid misuse and overdose risk and distribution of naloxone: Current practices, needs and prospects among dispensing pharmacists].","authors":"Armelle Chan Soc Foh, Salim Mezaache, Franck Turlure, Nathalie Fredon, Stéphane Pichon, Laurent Peillard, Joelle Micallef, Elisabeth Frauger","doi":"10.1016/j.therap.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.therap.2025.02.006","url":null,"abstract":"<p><strong>Introduction: </strong>Opioids are essential medicines, but their use is associated with risks. The POP program \"Prevention and risk reduction of Opioid-related overdoses in the PACA region\" aims to improve the management of patients at risk of overdose and the distribution of naloxone. We have conducted a survey of pharmacist with the aim was to assess their knowledge, practices, difficulties and needs concerning the management of opioid users and overdose prevention and naloxone diffusion, and to propose training materials adapted to their needs.</p><p><strong>Materials and methods: </strong>In the context of POP programme, pharmacists were approached via an online questionnaire (February-March 2024) and semi-structured interviews (April 2024).</p><p><strong>Results: </strong>A total of 107 pharmacists completed the questionnaire and 10 took part in the interviews. Seventy-four per cent said they had encountered patients with opioid misuse disorders. Awareness of the Prescription Opioid Misuse Index was low (92%). Only 37% of pharmacists said they were aware of the availability of take-home naloxone, and 87% were uncomfortable with the advice associated with it is dispensing. Actions in the event of misuse included contacting the prescriber (76%), refusing to dispense (76%), and adapting or splitting dispensing (60%). In terms of needs, 95% were interested in training, 44% in practical tools, and 41% in documents for patients. Based on the needs expressed, information and outreach actions were carried out.</p><p><strong>Conclusion: </strong>The results highlight the need to improve pharmacists knowledge on overdose risk and naloxone. Regular training and the dissemination of practical tools are essential.</p>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Encephalopathy associated with equimolar mixture of oxygen and nitrous oxide (EMONO) abuse: A case report. 滥用等摩尔混合氧和氧化亚氮（EMONO）引起的脑病：1例报告。

IF 2.2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Therapie

Pub Date : 2025-02-27 DOI: 10.1016/j.therap.2025.02.005

Nathan Pierrat-Maury, Serghei Banari, Tanguy Taillefer de Laportalière, Anne Roussin, Louis Richaud, Etienne Very, François Montastruc

引用次数: 0

Pharmacodynamic interaction between ginger and antiplatelet drugs: A case report. 生姜与抗血小板药物的药效学相互作用：1例报告。

IF 2.2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Therapie

Pub Date : 2025-02-17 DOI: 10.1016/j.therap.2025.02.004

Layal El Aridi, Hélène Jantzem, Corinne Guihard, Myriam Marteil, Greta Gourier

引用次数: 0

Validation of in-hospital diagnosis codes in one French hospital and out-hospital algorithm to identify skin ulcers in healthcare databases in France. 验证一家法国医院的院内诊断代码和在法国医疗保健数据库中识别皮肤溃疡的院外算法。

IF 2.2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Therapie

Pub Date : 2025-02-12 DOI: 10.1016/j.therap.2025.02.003

Clément Jambon-Barbara, N'dah Mathieu Ouattara, Claire Bernardeau, Frédéric Olive, Sophie Blaise, Jean-Luc Cracowski, Charles Khouri

Purpose: This study has two main objectives: 1/ to validate the International Classification of Diseases, 10th revision (ICD-10) diagnostic codes of skin ulcer in one French hospital using medical charts; 2/ to validate an out-hospital algorithm against ICD-10 codes using a healthcare database.

Methods: We first validated in-hospital ICD-10 codes for pressure, diabetic and vascular skin ulcers using the Grenoble University Hospital medical charts. Secondly, we assessed the validity of an out-hospital algorithm using dressing reimbursements, medical exams and comorbidities to identify skin ulcers using the French "échantillon généraliste des benéficiaires" database. We then compared the type of skin ulcers in patients hospitalized 1 year around the out-hospital skin ulcer identification date. We calculated specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV).

Results: The performances of ICD-10 codes for identifying patients with vascular, diabetic and pressure ulcers were all superior to 70%. The out-hospital identification of skin ulcers selected very different patients, younger and with less comorbidities than those hospitalized for skin ulcers. In patients hospitalized 1 year before or after the first dispensation of wound dressings, the concordance with ICD-10 codes was modest. Indeed, patients are wrongly classified as pressure ulcers, vascular ulcers and diabetic foot ulcers in respectively 27.7%, 52.0% and 48.8% of skin ulcers.

Conclusion: We found that performances of the in-hospital identification of pressure, vascular and diabetic foot ulcers were high allowing to use them to conduct observational studies in healthcare databases. However, outpatient identification retrieved heterogeneous performance, we therefore advise researchers using the latter to perform a sensitivity analysis restricted to hospitalized patients.

目的：本研究有两个主要目的：1/利用医学图表验证法国一家医院《国际疾病分类》第十版（ICD-10）皮肤溃疡诊断代码；2/使用医疗保健数据库根据ICD-10代码验证院外算法。方法：我们首先使用格勒诺布尔大学医院的医疗图表验证了医院内关于压力、糖尿病和血管性皮肤溃疡的ICD-10代码。其次，我们利用法国的“ )”数据库，利用敷药报销、医学检查和合并症来识别皮肤溃疡，评估了院外算法的有效性。然后，我们比较了院外皮肤溃疡确诊日期前后住院1年的患者的皮肤溃疡类型。计算特异性、敏感性、阳性预测值（PPV）和阴性预测值（NPV）。结果：ICD-10编码对血管性、糖尿病性和压疮患者的识别率均优于70%。皮肤溃疡的院外鉴定选择了非常不同的患者，比那些因皮肤溃疡住院的患者年轻，合并症少。在首次配用伤口敷料前后1年住院的患者中，与ICD-10编码的一致性不高。确实，在皮肤溃疡中，患者被错误分类为压疮、血管溃疡和糖尿病足溃疡的比例分别为27.7%、52.0%和48.8%。结论：我们发现医院内对压力、血管和糖尿病足溃疡的识别性能很高，可以在医疗数据库中使用它们进行观察性研究。然而，门诊识别检索异质性表现，因此，我们建议研究人员使用后者进行仅限于住院患者的敏感性分析。

{"title":"Validation of in-hospital diagnosis codes in one French hospital and out-hospital algorithm to identify skin ulcers in healthcare databases in France.","authors":"Clément Jambon-Barbara, N'dah Mathieu Ouattara, Claire Bernardeau, Frédéric Olive, Sophie Blaise, Jean-Luc Cracowski, Charles Khouri","doi":"10.1016/j.therap.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.therap.2025.02.003","url":null,"abstract":"<p><strong>Purpose: </strong>This study has two main objectives: 1/ to validate the International Classification of Diseases, 10th revision (ICD-10) diagnostic codes of skin ulcer in one French hospital using medical charts; 2/ to validate an out-hospital algorithm against ICD-10 codes using a healthcare database.</p><p><strong>Methods: </strong>We first validated in-hospital ICD-10 codes for pressure, diabetic and vascular skin ulcers using the Grenoble University Hospital medical charts. Secondly, we assessed the validity of an out-hospital algorithm using dressing reimbursements, medical exams and comorbidities to identify skin ulcers using the French \"échantillon généraliste des benéficiaires\" database. We then compared the type of skin ulcers in patients hospitalized 1 year around the out-hospital skin ulcer identification date. We calculated specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV).</p><p><strong>Results: </strong>The performances of ICD-10 codes for identifying patients with vascular, diabetic and pressure ulcers were all superior to 70%. The out-hospital identification of skin ulcers selected very different patients, younger and with less comorbidities than those hospitalized for skin ulcers. In patients hospitalized 1 year before or after the first dispensation of wound dressings, the concordance with ICD-10 codes was modest. Indeed, patients are wrongly classified as pressure ulcers, vascular ulcers and diabetic foot ulcers in respectively 27.7%, 52.0% and 48.8% of skin ulcers.</p><p><strong>Conclusion: </strong>We found that performances of the in-hospital identification of pressure, vascular and diabetic foot ulcers were high allowing to use them to conduct observational studies in healthcare databases. However, outpatient identification retrieved heterogeneous performance, we therefore advise researchers using the latter to perform a sensitivity analysis restricted to hospitalized patients.</p>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0