How a novel programme for increasing awareness of health professionals resulted in a 14% decrease in patients using excessive doses of psychotropic drugs in western France

Introduction: Consumption of high doses of psychotropic drugs is a public health problem in France. The Center for Evaluation and Information on Pharmacodependence and the General Health Insurance System decided that it was time to begin a regional programme on excessive consumption in a French region. Purpose: The objectives of this programme were: (1) get health professionals (doctors and pharmacists) to realize that some of their patients were consuming excessive doses, and (2) achieve a decrease of excessive psychotropic drug use. In addition, in the course of the programme, we were able to gather some clinical data related to heavy consumers, and evaluate their possible addiction. Method: This study is based on data related to 497,821 psychotropic drug consumers. Psychotropic drugs consumers whose consumption had exceeded twice the maximum allowance during at least 3 months in the second half of 2002 were contacted and unless the patients objected, a report on their personal circumstances was sent to their doctor(s) and pharmacist(s). We determined a quantitative method for the assessment of the results. Results: Increasing awareness among the health professionals through this original programme resulted in a 14.1% decrease in the percentage of patients receiving excessive doses, a 66% decrease in the number of patients receiving more than twice the maximum recommended dose, among the selected cohort, and some rationalization of consumption as well as a decrease in the doctor shopping behaviour. Conclusions: Medical practices did evolve and health professionals became aware of the benefit of their preventive action on the decrease of drug addiction.