ID: HR19-546
Presenting author: Fiorant DI NINO
Fiorant DI NINO, Gauthier Waeckerlé
The microstructure is based on a new approach to medical practice. Its principle consists of a pluriprofessional care team based in a single location: the office of the general practitioner. The team is composed by the general practitioner, a psychologist and a social worker who were previously spread out in various institutions. The psychologist and social worker receive patients in the office of the general practitioner half a day per week. All three work together to ensure the medical and the psycho-social support of users with addictive behavior. The area of expertise of the microstructure includes all disorders related to the use of illicit substances, drugs, cannabis, tobacco, games,… .
In 2018, RMS Alsace consisted of 14 medical offices covering the region, representing 26 GPs, 7 psychologists and 4 social workers. Nowadays, 10 other french region created the same networks. More than 60 GPs are involved, and 2000 patients followed by the pluriprofessional teams.
Concerning Hepatitis C, we showed that the training of microstructures teams and their participation in the HCV study has allowed to determine HCV serology for 80% of drug users followed by the network. In 88% of cases, serology was complemented by the determination of HCV RNA. The treatment was performed in 40% of HCV-RNA positive patients. These results, more favorable than those reported in the literature, showed that the microstructures are ready to prescription and monitoring the new DAAs against HCV as soon as it will become possible for them.
This confirmed that continuous education for health professionals has a positive impact on patients health. This study also shows that among users of psychoactive substances, microstructures follow up is relevant because the economic and social problems must be dealt at the same time than medical problems to allow improved health problem, a lower priority for them.