Exposure to High Precariousness Prevalence Negatively Impacts Drug Prescriptions of General Practitioners to Precarious and Non-Precarious Populations: A Retrospective Pharmaco-Epidemiological Study

François Birault, Lakshmipriva Le Bonheur, Nicolas Langbour, Sandivanie Clodion, Nematollah Jaafari, Marie-Christine Perault-Pochat and Bérangère Thirioux
Additional contact information
François Birault: Département de Médecine Générale, Faculté de Médecine et de Pharmacie, Université de Poitiers, F-86000 Poitiers, France
Lakshmipriva Le Bonheur: Département de Médecine Générale, Faculté de Médecine et de Pharmacie, Université de Poitiers, F-86000 Poitiers, France
Nicolas Langbour: Centre Hospitalier Henri Laborit, Unité de Recherche Clinique Pierre Deniker, F-86021 Poitiers, France
Sandivanie Clodion: Département de Médecine Générale, Maison de Santé Pluriprofessionnelle Universitaire des Couronneries, F-86000 Poitiers, France
Nematollah Jaafari: Centre Hospitalier Henri Laborit, Unité de Recherche Clinique Pierre Deniker, F-86021 Poitiers, France
Marie-Christine Perault-Pochat: Laboratoire de Neurosciences Expérimentales et Cliniques, Institut National de la Santé et de la Recherche Médicale (INSERM U 1084), Université de Poitiers, F-86000 Poitiers, France
Bérangère Thirioux: Centre Hospitalier Henri Laborit, Unité de Recherche Clinique Pierre Deniker, F-86021 Poitiers, France

IJERPH, 2022, vol. 19, issue 5, 1-23

Abstract: (1) Background: Precarious patients are more difficult to care for due to low literacy rates and poor adherence to treatment and hospitalization. These difficulties have detrimental effects on general practitioners (GPs), deteriorating medical communication, advice, diagnoses, and drug prescriptions. To better understand how precariousness affects primary care, we tested whether, among GPs, exposure to high precariousness prevalence more severely impacts drug prescriptions to precarious and non-precarious populations compared to low precariousness prevalence. Materials and methods: This pharmaco-epidemiological study, using linear regression analyses, compared the defined daily dose of 20 drugs prescribed by GPs to precarious and non-precarious patients in four French regions with low and high precariousness prevalence in 2015. (2) Findings: Exposure to high precariousness prevalence significantly impacted the prescriptions of nine medications to precarious patients and two medications to non-precarious patients, and distributed into three interaction patterns. (3) Interpretation: The selective over-prescription of drugs with easy intake modalities to precarious patients probably reflects GPs’ attempts to compensate for poor patient compliance. In contrast, the under-prescription of drugs targeting fungal infections in precarious populations and diabetes and cardiovascular diseases in non-precarious populations was seemingly due to a breakdown of empathy and professional exhaustion, causing medical neglect.

Keywords: precarious populations; reimbursed drug prescriptions; defined daily dose; primary care; treatment observance; medical efficiency; exhaustion; burnout; empathy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/19/5/2962/pdf (application/pdf)
https://www.mdpi.com/1660-4601/19/5/2962/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:5:p:2962-:d:763378

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().