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Background: After a long phase without any propositions for real ambulatory training inside general practitioners' offices, general practice (GP) vocational training has begun to appear progressively and has been integrated into undergraduate medical programmes. The aim of this study was to provide an overview of GP vocational training and GP trainers in member countries of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) Europe. Method: We carried out this cross-sectional study between September 2018 and March 2020. The participants responded to a questionnaire in real-life conversations, video conferences or e-mail exchanges. The respondents included GP trainers, teachers and general practitioners involved in the GP curriculum recruited during European GP congresses. Results: Representatives from 30 out of 45 WONCA Europe member countries responded to the questionnaire. Based on their responses, there is a well-established period for GP internships in undergraduate medical programmes, but with varying lengths. The programmes for some countries offer an internship after students graduate from medical school but before GP specialisation to ensure the career choice of the trainees. After specialisation, private practice GP internships are offered; however, in-hospital GP internships are more common. GP trainees no longer have a passive role during their internships. GP trainers are selected based on specific criteria and in countries, they have to follow some teacher training programmes. In addition to income from medical appointments carried out by GP trainees, GP trainers from some countries receive additional remuneration from various organisations. Conclusion: This study collected information on how undergraduate and postgraduate medical students are exposed to GP, how GP training is organised and the actual status of GP trainers among WONCA Europe member countries. Our exploration of GP training provides an update of the data collected by Isabel Santos and Vitor Ramos in the 1990s and describes some specificities that can inspire other organisations to prepare young, highly qualified general practitioners. [ABSTRACT FROM AUTHOR]

Context Serious adverse events related to the use of domperidone and metoclopramide have been consistently reported in the literature for many years. This led to a restriction of their use in the early 2010s. Objective: The main objective was to analyse the evolution of antiemetic prescription rate in French general practise between 2006 and 2016. The secondary objectives were to highlight prescription transfers for metopimazine and to quantify the impact on health expenditures. Method: All patients from a representative sample of a national administrative claims database, the French national health insurance database, were included between 2006 and 2016. Trends in annual anti‐emetic prescription rates by general practitioners were analysed using logistic regression models adjusted for age, gender and the existence of cancer. The cost of theses changing prescription habits was quantified via Médic'AM, a public drug expenditure database. Results: Around 669 020 individuals were included with a mean 8‐year follow‐up; 48 634 patients received an anti‐emetic at least once between 2006 and 2016. Prescription rates for all antiemetics decreased significantly from 2.1% to 0.4%, especially for metoclopramide from 0.5% to 0.1%, for domperidone from 1.5% to 0.1% and for metopimazine from 0.4% to 0.2%, which is not in favour of prescription transfers. Expenses fell from 30 million euros in 2006 to 10 million in 2016. Conclusion: Decreases in anti‐emetic prescription rates and public health expenditures preceded the publication of official recommendations to reduce the use of metoclopramide and domperidone, without prescription transfers for metopimazine. [ABSTRACT FROM AUTHOR]

Résumé: Le zolpidem présente un risque élevé de pharmacodépendance, d'abus et d'usage détourné. De ce fait, depuis le 10 avril 2017, sa prescription se fait sur ordonnance sécurisée. À partir de la base de données Medic'AM, il semble que la réforme de prescription du zolpidem soit associée à une diminution importante des délivrances ambulatoires et à un report des délivrances sur le zopiclone. Le mois de la réforme, la baisse des délivrances du zolpidem a entraîné une diminution moyenne de 650 000 € puis de 242 500 € entre mai 2017 à avril 2019. Zolpidem is at high risk for drug dependence, abuse and misuse. As a result, since April 10, 2017, his prescription is made on a secure prescription. From the Medic'AM database, it appears that the reform of the prescription of zolpidem is associated with a significant decrease in outpatient dispensing and a postponement of dispensing on zopiclone. During the month of the reform, the drop in deliveries of zolpidem resulted in an average decrease of €650,000 and €242,500 between May 2017 and April 2019. [ABSTRACT FROM AUTHOR]