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Micro et Nanomédecines translationnelles

Soutenance de Thèse de Mr Arthur Piraux

Introduction of pharmaceutical prescribing: a study of protocol dispensing in the management of uncomplicated cystitis in women in France

In France, as in other countries, the missions assigned to the community pharmacist are expanding rapidly; this is reflected in a paradigm shift from dispensing pharmacist to prescribing pharmacist. The objective of this research is to examine pharmaceutical prescribing, through the example of dispensing under protocol in the management of simple cystitis in women. This minor condition was chosen because of its prevalence and the large demand expressed by patients towards pharmacists. An analysis of its current management reveals a lack of compliance with current recommendations, which may lead to antibiotic resistance. A scoping review provided an overview of the deployment of pharmaceutical prescribing internationally. Effectiveness and efficiency were observed, but only in Canada and the United Kingdom.
The PharmaCyst' study will try to evaluate the efficacy of the management, by the community pharmacist, of women aged 18 to 65 years, with urinary functional signs. This study, conducted in the Loire region, France, will be
based on a protocol of dispensing and will result in the dispensing of an antibiotic without a medical prescription. The primary outcome will be the change in symptom intensity of the patients at 3 days of treatment, assessed
by the Acute Cystitis Symptom Score. This score is already internationally validated, and its French translation and linguistic validation were conducted during this work. Giving community pharmacists the possibility to conduct
clinical studies, but also to carry out a community activity alongside university teaching, are ways to improve the efficiency of the French health system in the long term.

Keywords: pharmaceutical prescription; dispensing under protocol; cystitis; pharmacist; new missions.

Directeur de Thèse: Pr.  Sébastien FAURE

Co-directrice de thèse: Pr. Aline RAMOND-ROQUIN