[Does the duration of medical consultations have an impact on the prescription of psychotropic drugs? Cross-sectional study carried out in general practice on 2,896 procedures]

Abstract

The French are the biggest consumers of psychoactive drugs in Europe. French general practitioners were accused of being partly responsible: it was stressed that psychoactive drugs would be a means to cut down the consultation time considering that the duration of a consultation for French GPs is the longest in Europe. Could there be a link between the duration of the consultation, the diagnosis of mental disorder and the prescription of psychoactive drugs? A prospective study was made among 44 GPs who noted down three days of consultation in 2007. The 23 variables concerned the practitioners, the patients and the medical acts. The collecting was made on paper, the seizure with ETHNOS and the analysis mono and varied with STATA. The sample was made of 2896 acts. A mental disorder was present in 5% of the reasons for consultation and in 17% of the practitioners'diagnosis. For 38% of the cases including a psychic diagnosis, the problem arose during the consultation. 10% of psychological diagnosis was found in the consultations that lasted less than 15 minutes and 48% was found in the consultations that lasted more than 20 minutes. The prescription of psychoactive drugs was significantly associated with the duration of the consultation. Compared with consultations which lasted less than 10 minutes, an odd-ratio of 2.91 was found for a consultation lasting 20 minutes or more. The general practitioners participating in this study diagnose more breakdowns than their European colleagues whose consultations are of shorter duration. The prescription of psychoactive drugs is not higher for shorter medical consultations. Therefore the prescription of psychoactive drugs was not a means to cut the consultation short. The study was not dealing with the prescription being relevant; the door remains open for further research.