In 2024, antibiotic prescriptions by general practitioners in France increased by 6.2%. France has become the second largest consumer of antibiotics in Europe, despite many awareness campaigns. The ICARE study, conducted among general practitioners in Franche-Comté, assessed the volume of antibiotic prescriptions after one year of using a rapid diagnostic test to measure CRP.At the same time, an ancillary qualitative study was conducted to analyse general practitioners' use of this rapid diagnostic test during consultations.The qualitative study was conducted through semi-structured interviews with 25 general practitioners recruited after a reasoned sampling process. Data analysis was based on the grounded theory approach.Rapid CRP testing in the doctor's office represents an evolution in medical practice and responds to the need to remove uncertainty and provide an objective result to guide patient care. The use of this tool improves the quality of care and contributes to the rational prescription of antibiotics. It strengthens the doctor-patient relationship by helping to educate patients on the proper use of antibiotics and improving adherence to the medical care offered. However, its effective use remains correlated with its acceptability by general practitioners, who must embrace this rapid diagnostic test.Enhancing personal fulfilment through the use of a tool and responding to professional motivations (the shift towards evidence-based medicine) are driving greater uptake among general practitioners. A medico-economic study would provide arguments in favour of continuing the use of rapid diagnostic test and rolling it out on a larger scale.

Being a caregiver and acting as an interpreter is a combination of two roles: the duty to help one's loved one is coupled with the need to transmit information between the doctor and the person being cared for. The complexity of these intertwined roles raises questions about communication challenges.To study the experiences of caregivers acting as interpreters in order to explore the different dimensions of assistance in situations of language barriers, and to understand the impact of these experiences on their health and quality of life.Qualitative study. Ten semi-structured interviews were conducted with caregivers acting as interpreters by a researcher. Data analysis was carried out using an interpretive phenomenological approach.Like a savior, the caregiver acting as an interpreter assumes the transgenerational responsibility of caring for their non-native-speaking relative, whose vulnerability is compounded by the language barrier. Their mission is built and established in filial love and familial duty. The challenges are numerous, notably finding the right balance of closeness in the caregiving relationship, and their appropriate role, as a neutral interpreter, in medical consultations. The narcissistic reward of caregiving is uncertain: sometimes the devaluation fuels disappointment and burdens the caregiver, who seeks recognition; at other times, the rewards reinforce the caregiver's development of quasi-professional skills.The right balance of closeness in the triangular relationship between doctor, patient, and interpreter reveals three positions in the discourse: patient-centered, physician-centered, and interpreter-centered. The link between care and dependence is close when it comes to the transmission of information: between empowering the person being cared for and maintaining control through censorship, filtering, or the complete disclosure of information by the caregiver.Preserving the autonomy of the person being cared for, requires a delicate balancing act in the dual role of caregiver and interpreter. The caregiver acting as an interpreter’s introspection on their experiences seems to strengthen their sense of self-worth. Providing them with a space for discussion and the exchange of best practices to reflect on these challenges appears beneficial. It also seems relevant to examine the dynamics associated with the post-caregiving period.

A young adult caregiver is a person between the ages of 18 and 25 who regularly helps someone in their circle to cope with a physical or mental illness or disability. Few studies in France have examined their experiences.The primary objective is to understand the experiences of young adult caregivers in order to monitor them in general practice. The secondary objective is to identify the specific characteristics of this population that should be taken into account in general practice consultations.Qualitative study with semi-structured individual interviews, inspired by grounded theory. It was conducted with eight young adults aged between 18 and 25 who were caregivers according to the MACA-YC 18 score categories. Recruitment was carried out using posters displayed in locations frequented by students and through caregiver associations on social media.The assistance provided has multiple consequences on the life of the young adult caregiver: consequences on their physical and mental health, on their development and personal growth, on their family, relationships, and place in society. This leads to overinvestment in the person being cared for and a desire to escape.This work has resulted in an explanatory model in the form of a diagram. Many different and varied concepts have been addressed in which the general practitioner plays a key role. However, this population is not very visible and is often overlooked. Strengths: originality in a topical and under-researched field. Diverse recruitment of caregivers and their pathologies. Limitations: few participants aged between 18 and 20 with relatives only within the family.Other projects to improve screening and more comprehensive care, particularly through general practitioners, would appear to be necessary to improve the experience of young adult caregivers.

Early childhood caries is a very common condition. Poor oral health can have multiple consequences in children. General practitioners play a fundamental role in follow-up and can have a decisive role in the prevention of pediatric oral health problems, even though they may not feel competent.The objective of this study is to determine whether providing an information sheet leads to an improvement in general practitioners’ satisfaction and perceived competence in the management of oral and dental pathologies.We developed guideline-based information sheets that are both concise and clear. A Microsoft Forms questionnaire was created and distributed electronically to practicing general practitioners. At the end of the survey, they received the summary sheets. A second questionnaire was administered 4 to 6 months after the first. The data were analyzed using pivot tables.31 general practitioners responded to the first questionnaire, and 24 to the second. 55% of respondents frequently addressed oral health. 52% of the participants reported frequently feeling unsettled by the topic, and 55% stated that they felt uncomfortable with it. Half of the respondents frequently referred children to a dentist. Self-assessment of satisfaction and competence regarding pediatric oral and dental pathologies revealed a mean score of 4/10. The mean score attributed to physicians’ perceived need for training was 7.35/10. More than 90% of the sample acknowledged the usefulness of the questionnaire. After 6 months, satisfaction and perceived competence remained stableThe material addresses a genuine need for training in routine clinical practice. The number of participants was insufficient to allow extrapolation of the results. Most respondents were clinical trainers, who are likely to be more involved in continuing medical education and teaching.Oral and dental pathologies represent a major issue in pediatrics. The tool developed was considered useful by the physicians and wider dissemination would likely lead to improved management of these conditions.

Multimorbidity is a global issue that places a significant burden on patients, healthcare providers, and the healthcare systems. Clinical guidelines and digital systems focus on single-disease management, leaving GPs to manage multimorbidity with limited support. In healthcare, digital twins(DT) are evolving digital models of patients, organs, or processes that continuously integrate real-time data, enabling simulation, prediction, and personalization of clinical decision-making. Hospital-based specialties have demonstrated the usefulness of DTs in predicting clinical outcomes and assisting in patient-specific decision-making.To appraise how DTs are being used across various clinical specialties To evaluate how this technology can be used in multi-morbidity in primary care(PC). To identify potential barriers to the adaptation of this technology.This commentary reflects the author's perspective, based on existing literature and recent developments in digital health.Potential role: Personalised care in multimorbidity: DTs can simulate interactions between drugs and diseases. Decision support: Prediction of patient risk and response to treatment. Patient engagement: Sharing DT visualisations with patients regarding their health trajectory. Workflow and resource optimisation.   Challenges to adaptation: Ethical concerns regarding patient privacy and risk of misuse of data. Increased clinician workload. Worsening health inequalities.  Data integration: Most healthcare data remains fragmented. Computational costs.Current applications of DTs in healthcare: 3D DTs of heart are being used to facilitate simulation of arrhythmias, personalised ablation procedures, risk assessment, and recurrence prediction.  DT models have been proposed that could prioritise patients requiring urgent care, recommend treatment, and suggest optimal time to step down from critical care.  DTs are being utilised in hospital workflow optimization to analyse patient flow and clinical demand patterns. DTs can be used in virtual clinical trials, resulting in accelerated drug development with minimal patient safety risk. They can forecast tumor growth and evolution, assisting clinicians in understanding disease trajectory.DTs warrant revolutionary changes in healthcare. With their introduction in PC, they can help with management of multimorbidity and shared decision-making with patients. However, there are potential barriers complicating its adoption. Efforts are needed to establish feasible and adaptable models of DTs that can be safely incorporated into PC, for the benefit of PC workforce and patients.

Self-medication is a common practice that has been poorly studied in France. However, its prevalence is estimated at 67% worldwide. It can have a significant impact on patients due to drug interactions and adverse effects. Despite good practice recommendations, there is no validated French tool for studying it. Yet exploring it is essential in primary care in order to understand patients' practices.To create a validated tool for self-medication study : the AutomédiQ self-questionnaire.A three step patient-centered method was used. First, the tool was created using a nominal group and validated by an expert group. Second, user testing was conducted with patients recruted from two community pharmacies and two general practices. It was conducted in two stages : patients answered the questionnaire using the “think-aloud method” and were invited to provide feedbacks after completion. Finally, with the contribution of a social psychologist, the tool was validated through an eDelphi method involving international french-speaking experts.AutomédiQ was designed as an online self-questionary accessible via QR code or web link. The nominal group composed of 17 professionals  designed an initial questionnaire with 28 questions. The expert group's review narrowed the questionnaire down to 17 questions by transforming 11 questions into sub-questions exploring the methods, habits and determinants of self-medication. Four testing cycles were conducted, including three with patients. Finally the eDelphi process involved two cycles with the participation of 15 international experts in self-medication, questionnaire design and primary healthcare. This process led to the validation of the final version of AutomediQ.AutomédiQ's strength lies in its original design, which follows a rigorous approach and a validated method. It was developed with a focus on future patients. However, it does have some weaknesses. It focuses on pain to ensure acceptable length of completion. It will require a method adapted for people with limited computer skills and adjustments according to the national contexts of French-speaking countries.AutomédiQ is the first validated self-questionnaire in French for studying self-medication for pain. An initial project using AutomédiQ is planned to assess its usability in large scale. Numerous studies will follow to shed light on self-medication practices.

In France, there are around 11 millions caregivers. Despite this number, the society’s interest in caregivers is recent. Moreover, there are 2,2 millions dependent adults between 20 and 60. And there are only studies about how caregivers of dependent elderlies feel.Seeks how caregivers of under 60 years old dependent adults feel.This is a qualitative study, done by semi-directed interviews of 10 caregivers, after recruitment by purposive sampling.Caregivers are new beings in evolution, especially because of the modifications of their relationships with the patient and medical staff. This produces changes in their personality with a state of hypervigilance and concerns about the future. Caregivers develop an ambivalence between their burden, inducing exhaustion, and total devotion towards the patient. But also caregiving leads them to be positive and develop their resilience. Their new status has a lot of consequences on their health, career, family and hobbies. Caregivers need to adapt their life every day. They become patient’s experts and find helps around them. They regret the lack of respite solution.Our study is the first to study caregivers of under 60 years old dependent adults. There are many similarities between our study and the one about caregivers of dependent elderlies but also some specificities in our results, especially ambivalence.The need of rest is a major requirement in the caregivers’ life. They deplore the lack of these offers. They note the importance of best information on existing aids, with the creation of a single contact and administrative simplification.