Humbert de Freminville | Université Claude Bernard Lyon 1 (original) (raw)

Papers by Humbert de Freminville

HAL (Le Centre pour la Communication Scientifique Directe), Mar 1, 2018

BMC Primary Care, Jun 3, 2022

Background: To assess current practice regarding the management of rheumatoid arthritis patients ... more Background: To assess current practice regarding the management of rheumatoid arthritis patients among general practitioners of a French region, and their perception about the deployment of a multidisciplinary collaboration. Methods: A cross-sectional online survey was sent to the general practitioners of a French region. The questionnaire comprised of 3 sections to collect data regarding 1/demographics, 2/practice and knowledge in rheumatoid arthritis, and 3/perception about the deployment of a multidisciplinary collaboration. Results: 1/A total of 247 general practitioners (M/F ratio: 1.4; mean age: 46.7 years) completed the survey. 2/More than half of general practitioners believed that their role was very or extremely important in disease diagnosis (72.5%), and management of comorbidities (67.2%). Among respondents, 6.1% considered that they did not face any difficulty concerning the patient management and 61.5% had already identified causes of non-adherence. 3/A total of 151 (61.1%) general practitioners were willing to participate in a multidisciplinary programme to improve medication adherence in rheumatoid arthritis. Conclusions: General practitioners are motivated to contribute to an overall management of rheumatoid arthritis patients. Nevertheless, they need professional education about rheumatoid arthritis treatment and training in motivational interviews before getting involved in a multidisciplinary collaboration.

Revue du Rhumatisme, Dec 1, 2021

International Journal of Clinical Pharmacy, Nov 11, 2022

Background Poor adherence to prescribed antihypertensive medication is a major contributor to dis... more Background Poor adherence to prescribed antihypertensive medication is a major contributor to disparities in effective blood pressure control among Hispanics. The purpose of this study was to investigate the association between health literacy level and adherence to antihypertensive medications among Hispanic adults, who self-reported hypertension, controlling for potential covariates of adherence and/or health literacy. Methods We conducted a cross-sectional survey of 1355 Hispanic adults, primarily Dominicans, who self-reported hypertension. Antihypertensive medication adherence and health literacy were evaluated along with covariates, including sociodemographic characteristics, depression, anxiety, and sleep disturbance. Linear regression models were created for health literacy, each covariate, and adherence. Factors found to be significantly associated with adherence in the individual regression models at a p value of < 0.20 were included in a hierarchical multiple linear regression model. Results Overall, the majority of participants had low adherence levels to antihypertensive medications (88.4%; n = 1026) and inadequate health literacy (84.9%; n = 1151). When controlling for age, sex, birth country, education level, recruitment location, depression, anxiety, and sleep disturbance, having adequate as compared to inadequate health literacy was associated with a higher adherence score (b = 0.378, p = 0.043). The full model explained 13.6% of the variance in medication adherence (p value < 0.001), but the unique contribution of health literacy to the model was minimal (R 2 change = 0.003). Conclusions Tailored interventions considering health literacy are needed to support medication adherence in order to improve hypertension outcomes of Hispanics. Additional studies are needed to identify and prioritize factors in the development of targeted and effective adherence interventions for Hispanics with hypertension.

HAL (Le Centre pour la Communication Scientifique Directe), Jun 28, 2017

Contexte. Le médecin généraliste en France est concerné par la responsabilité médicale profession... more Contexte. Le médecin généraliste en France est concerné par la responsabilité médicale professionnelle (RCP), et s'inquiète d'une judiciarisation croissante de sa pratique. La loi n2002-303 formalise la jurisprudence concernant la responsabilité médicale et le droit des malades. La loi n2004-810 définit le médecin traitant et son champ d'application. L'objectif principal est d'évaluer la connaissance et les sources d'information des MG sur l'évolution de la RCP depuis ces deux lois. Les objectifs secondaires sont de savoir si ces lois ont modifié la pratique des MG sur l'information et la relation médecin-malade. Une enquête quantitative descriptive a été réalisée en région Rhône Alpes. Un courriel expliquant l'objectif de l'étude a été adressé à 2 362 médecins via la mailing liste de l'URPS. 299 médecins ont participé de façon anonyme. Les tests de chi2 et chi2 de tendance ont été utilisés. 47% des MG connaissent la loi n2002-303, sans me...

BMC Primary Care

Background To assess current practice regarding the management of rheumatoid arthritis patients a... more Background To assess current practice regarding the management of rheumatoid arthritis patients among general practitioners of a French region, and their perception about the deployment of a multidisciplinary collaboration. Methods A cross-sectional online survey was sent to the general practitioners of a French region. The questionnaire comprised of 3 sections to collect data regarding 1/demographics, 2/practice and knowledge in rheumatoid arthritis, and 3/perception about the deployment of a multidisciplinary collaboration. Results 1/A total of 247 general practitioners (M/F ratio: 1.4; mean age: 46.7 years) completed the survey. 2/More than half of general practitioners believed that their role was very or extremely important in disease diagnosis (72.5%), and management of comorbidities (67.2%). Among respondents, 6.1% considered that they did not face any difficulty concerning the patient management and 61.5% had already identified causes of non-adherence. 3/A total of 151 (61.1...

Revue du Rhumatisme, 2021

L'Encéphale, 2021

In France, since the law of June 17, 1998, sexual offenders may be convicted to ambulatory mandat... more In France, since the law of June 17, 1998, sexual offenders may be convicted to ambulatory mandatory care, articulated with the justice. Twenty years after the implementation of this law, while social and technological developments have redefined certain aspects of delinquency, reference documents and practice guidelines remain to be updated. This is why the professionals of the main structures and associations dealing with perpetrators of sexual violence organized a public hearing under the sponsorship of the French Federation of Resource Centers for Sexual Violence Perpetrators (FFCRIAVS) according to the methodology and with the accompaniment of the High Authority of Health. This article presents the global methodology of the public hearing &amp;quot;Sexual Offenders: Prevention, Evaluation and Care&amp;quot; which was conducted on June 14 and 15, 2018. Thirty-three experts replied to27 questions and presented their conclusions to an Audition Committee and an audience of 200 persons representative of the civil and professional society. After a public debate, the hearing committee prepared a report in which they proposed propositions in order to better care for sexual offenders.

BMC health services research, Jan 27, 2015

Low health literacy is associated with higher health care utilization and costs; however, no larg... more Low health literacy is associated with higher health care utilization and costs; however, no large-scale studies have demonstrated this in the Veterans Health Administration (VHA). This research evaluated the association between veterans' health literacy and their subsequent VHA health care costs across a three-year period. This retrospective study used a Generalized Linear Model to estimate the relative association between a patient's health literacy and VHA medical costs, adjusting for covariates. Secondary data sources included electronic health records and administrative data in the VHA (e.g., Medical and DCG SAS Datasets and DSS-National Data Extracts). Health literacy assessments and identifiers were electronically retrieved from the originating health system. Demographic and cost data were retrieved from the VHA centralized databases for the corresponding patients who had VHA use in all three years. In a study of 92,749 veterans with service utilization from 2007-2009...

Les violences conjugales sont un enjeu majeur de santé publique. Les victimes consultent leur méd... more Les violences conjugales sont un enjeu majeur de santé publique. Les victimes consultent leur médecin plus fréquemment que la population générale. Ceux -ci sont particulièrement confrontés à ces violences dans le cadre de la rédaction des certificats de coups et blessures. Les objectifs de notre étude étaient d'étudier les représentations des médecins face à cette violence et leur impact sur leur prise en charge médico-légale. Nous avons réalisé une étude qualitative auprès de 20 médecins généralistes exerçant en libéral. Les entretiens individuels ont eu lieu de juillet à décembre 2013 dans la région Lyonnaise. Ils ont été retranscrits intégralement et codés de façon empirique. Un double codage a été réalisé sur la moitié des entretiens. La saturation des données a été obtenue au quinzième entretien. Résultats : Même si les médecins savent que les violences conjugales existent dans tous les milieux, il persiste une représentation de femme victime vulnérable et venant d'un m...

LYON1-BU Santé (693882101) / SudocSudocFranceF

La traçabilité des produits de santé représente un des moyens de sécurisation de la prise en char... more La traçabilité des produits de santé représente un des moyens de sécurisation de la prise en charge des patients, au regard des risques liés à leur utilisation y compris leur falsification. Alors que l'usage du Datamatrix a été rendu obligatoire pour la traçabilité des médicaments sur le marché français et qu'un projet de sérialisation se met en place pour la traçabilité de l'ensemble des médicaments commercialisés en Europe dans un objectif de lutte contre la falsification, des solutions différentes sont envisageables pour les autres produits de santé. Les technologies en matière de traçabilité connaissent notamment un nouvel essor en matière de codage sans contact. Pour les professionnels de santé, il s'agit alors de déterminer quelles solutions choisir en fonction de leurs objectifs et des problèmes qu'ils rencontrent : code-barres linéaire, Datamatrix ou RFID ? Toutes ces solutions se valent-elles ? Cette mise au point dresse un état des lieux de la situation...

Journal of Market Access & Health Policy, 2019

Background: Pain management in emergency departments is a complex objective. The absence of a car... more Background: Pain management in emergency departments is a complex objective. The absence of a care pathway or a high level of activity complicates diagnostic or analgesic therapeutic strategies. Medical innovation can impact both individual practices and the functioning of an emergency department. Objective: We then wanted to understand how medico-economic studies on pain were carried out in an emergency department. Study design: We reviewed the literature of the last 20 years (between 1998 and 2018). Setting: Of 846 titles screened, a total of 268 abstracts qualified for further screening, and 578 titles were excluded. A total of 14 studies qualified for inclusion in the review. Studies on medicoeconomics in an emergency department are very diverse. None of the methods used are identical; the studies differ in their very nature (prospective, retrospective, cost-effectiveness, etc.) and the determination of emergency room costs differs according to the part of the world studied. In addition, organizational impact is rarely measured, although it is an essential dimension for choosing or not a medical innovation.

European Journal of Oncology Nursing, 2018

Immunosuppressive therapy following pediatric hematopoietic stem cell transplantation is essentia... more Immunosuppressive therapy following pediatric hematopoietic stem cell transplantation is essential for the patient's prognosis, as the antibioprophylaxis and the isolation measures. But medication adherence is suboptimal for children and adolescents, from 52 to 73% in literature. The aim of this study is to provide an understanding of medication adherence after pediatric allogeneic stem cell transplantation (SCT), by identifying facilitators and barriers. Method: Semi-structured interviews were conducted by a pharmacist with caregivers and healthcare providers in a pediatric centre. Four topics were discussed: transplantation, posttransplantation therapies, caregivers' experience and the healthcare system. Interviews were audiotaped, transcribed and analysed by inductive approach. Findings: Semi-structured interviews with 15 caregivers and 21 healthcare providers identified factors of medication adherence and hygiene measures. The long-term nature of therapy and difficult transitions of care were identified as major barriers. Recognizing the benefits of medication and parental involvement are facilitators. Furthermore, caregivers expressed the need to take into consideration the family entity. They would like also to receive earlier information from healthcare providers before hospital discharge. Those needs were not always identified by healthcare providers. Conclusion: This analysis revealed barriers and facilitators to the medication adherence and to the care. It demonstrated similarities and differences between caregivers and healthcare providers' perceptions and has thereby initiated an improvement process of the healthcare system. As part of this process, medical and paramedical healthcare providers at this French pediatric centre are currently working on a support program for post-alloSCT hospital-home transition.

Journal of Forensic Sciences, 2010

La prise en charge medicamenteuse (PECM) est un processus complexe comprenant de nombreuses etape... more La prise en charge medicamenteuse (PECM) est un processus complexe comprenant de nombreuses etapes : prescription, preparation, dispensation, approvisionnement, transport, detention et stockage, administration, information du patient, surveillance du traitement. Elle est encadree par plusieurs referentiels : l’arrete du 6 avril 2011, les criteres 8.h, 20.a, 20.a bis et 20.b du manuel de certification de la Haute autorite de sante et le contrat de bon usage. Afin de realiser une evaluation complete de la PECM, nous avons construit une grille d’audit avec des criteres harmonisant les trois referentiels sus cites. Les personnels concernes par chaque critere ont ete interroges. Selon leur reponse, le niveau de conformite a ete attribue au travers de quatre propositions : conforme, partiellement conforme, non conforme, non concerne. Parmi les reponses obtenues, nous avons observe 73 % de conformites, 17 % de conformites partielles, 7 % de non conformites et 3 % de non concernes. Les prin...