Paul Vanderkam1, Stéphanie Gagey2, Pierre Ingrand3, Marie-Christine Perault-Pochat4, Yann Brabant2, Clara Blanchard2, Benoit Tudrej2, Nassir Messaadi5, Philippe Binder2. 1. Département de Médecine Générale, Faculté de Médecine, 6 rue de la Milétrie, TSA 51115, 86073, Poitiers, France; Unité de recherche clinique intersectorielle en psychiatrie, Centre hospitalier Henri-Laborit, 86021, Poitiers, France. Electronic address: paul.vanderkam@univ-poitiers.fr. 2. Département de Médecine Générale, Faculté de Médecine, 6 rue de la Milétrie, TSA 51115, 86073, Poitiers, France. 3. Epidémiologie et Biostatistiques, INSERM CIC-1402, Faculté de Médecine, 6 rue de la Milétrie, TSA 51115, 86073, Poitiers, France. 4. Pharmacologie Clinique et Vigilance, INSERM CIC-1402, Faculté de Médecine, 6 rue de la Milétrie, TSA 51115, 86073, Poitiers, France. 5. Département de Médecine Générale, Faculté de Médecine Lille 2 - Université de Médecine et de Droit, 59045, Lille, France.
Abstract
BACKGROUND: In France, buprenorphine is at once the most widely prescribed and the most commonly misused opioid maintenance treatment (OMT). Unlike other medicines, it is seldom prescribed as a generic drug. Several studies have underlined the influence of the patient's representations when choosing brand-name rather than generic forms. We aim to prove a link between these pejorative representations and misuse, a higher degree of addiction and a preference for brand-name products. METHODS: An observational study carried out at 11 sites in France using self-assessment questionnaires filled out in dispensing pharmacies by patients having come to them for buprenorphine delivery. RESULTS: Analysis was based on 806 usable questionnaires. There indeed exists a significant correlation between pejorative representations of OMT by means of buprenorphine, and a higher degree of addiction and misuse (p < .0001 for each). Preference for the brand-name product is correlated with the representation of OMT as a "trap" (p = .020). CONCLUSION: Our results underscore the existence of a link between patients' negative representations of their OMT and their drug-taking behavior. Prescribing physicians should consequently take these representations into account to more precisely identify the relevant behaviors and help their patients to evolve positively.
BACKGROUND: In France, buprenorphine is at once the most widely prescribed and the most commonly misused opioid maintenance treatment (OMT). Unlike other medicines, it is seldom prescribed as a generic drug. Several studies have underlined the influence of the patient's representations when choosing brand-name rather than generic forms. We aim to prove a link between these pejorative representations and misuse, a higher degree of addiction and a preference for brand-name products. METHODS: An observational study carried out at 11 sites in France using self-assessment questionnaires filled out in dispensing pharmacies by patients having come to them for buprenorphine delivery. RESULTS: Analysis was based on 806 usable questionnaires. There indeed exists a significant correlation between pejorative representations of OMT by means of buprenorphine, and a higher degree of addiction and misuse (p < .0001 for each). Preference for the brand-name product is correlated with the representation of OMT as a "trap" (p = .020). CONCLUSION: Our results underscore the existence of a link between patients' negative representations of their OMT and their drug-taking behavior. Prescribing physicians should consequently take these representations into account to more precisely identify the relevant behaviors and help their patients to evolve positively.