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Health insurance representatives’ visits to general practitioners: A qualitative study using semi-structured
Florian Hurteau1, Océane Paneccasio1, Jérôme Nguyen-Soenen2
1Ont contribué également à cet article Nantes Université, Département de médecine générale, F-44000 Nantes, France.
Introduction:
In the DeprescrIPP-DAM trial, health insurance representatives (HIRs) conducted visits to general practitioners (GPs) to raise awareness on the need to deprescribe proton pump inhibitors (PPIs) and to present strategies for engaging in the deprescribing process. This study aimed to explore HIRs’ interactions and experiences during these interventions.
Methods:
A qualitative study was conducted using semi-structured interviews with 12 voluntary HIRs. Data were analyzed using a grounded theory approach.
Results:
HIRs demonstrated the ability to balance the objectives of medical control and support for healthcare professionals. They adapted their approach by drawing on their internal resources and training to communicate effectively with GPs while maintaining relationships of trust. In the DeprescrIPP-DAM trial, innovative training and flexibility of the intervention were identified as key factors for effectiveness. However, the professional identity of the HIRs may have posed challenges in the context of tensions between GPs and the national health insurance system at the time of the trial. HIRs also identified several barriers to deprescribing, including the role of other medical specialties, GPs’ workload, and patient resistance.
Conclusion:
More flexible training approaches, greater involvement of other medical specialists, and the implementation of regular audits with individualized feedback to GPs could enhance future HIR-led PPI deprescribing interventions.