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International audience; Background : France is in Europe, the country in which the mortality due to potentially preventable causes is the highest. At the same time, French doctors receive no incentives to undertake prevention activities. This article examined the general practitioners' (GPs) determinants (characteristics, patient list and contextual factors) of cardiovascular prevention and vaccination carried out by GPs in their offices. METHODS: Data were collected from 105,726 patients followed by 86 GPs (observational study). A multilevel analysis with two levels: GP and patient (HLM) was performed. RESULTS: A high between-GP variability of the prevention activity is underlined in both domains. After controlling for patient characteristics, we observed a positive effect of the GP's workload (ORa=1.03) and of an elderly GP's patient list (ORa=1.04) on cardiovascular prevention, a positive effect of a patient list with a high level of health care consumption on vaccination activity (ORa=1.04). The significant influence of contextual factors is ever more demonstrative: the ORa is 1.3 times lower in cardiovascular prevention and 1.6 in vaccination when the density of GPs in the local community of the doctor's practice grows of one-point (1/1000); the ORa is two times lower in both cardiovascular prevention and vaccination for GPs having an urban practice. CONCLUSION: These results emphasize the need for taking into account contextual factors to implement prevention policies in primary care. But further studies of this type should be conducted by taking other variables into account in order to improve the proportion of variance explained in our models.

The purpose of this study was to determine the respective importance of herpes labialis and genitalis in patients consulting general practitioners and ascertain their knowledge and opinions concerning herpes labialis and genitalis in order to analyze patient behavior in case of flare-ups.A questionnaire was proposed to a representative sample of patients aged 15 years and older seen at consultation by 49 general practitioners participating in the General Medicine Observatory of the French Society of General Practitioners.Among the 4,403 patients who responded, a known history of herpes labialis was reported by 39. 9 p.100 and of herpes genitalis by 2.5 p.100. Their answers to the questions demonstrated insufficient knowledge of avoidable risks of herpes as a sexually transmitted disease, with very significant misunderstanding by men. Among the 1,711 patients who had experienced herpes labialis, 62.9 p.100 initiated self-medication, 29 p.100 preferred to wait and see and 7.5 p.100 sought medical assistance. Among the 108 patients who had experienced herpes genitalis, at the last flare-up 40 p.100 initiated self-medication, 7.5 p.100 preferred to wait and see and 52 p.100 sought medical assistance. The general practitioner was the first physician consulted for both types of herpes.This study illustrates the importance of herpes infections in the general medicine patients. It also confirms that new interventional strategies are needed both for health care and for health education.