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The European Journal of Public Health Advance Access originally published online on December 26, 2007
The European Journal of Public Health 2008 18(3):312-316; doi:10.1093/eurpub/ckm118
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© The Author 2007. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Health Services Research

Prescribing patterns for upper respiratory tract infections in general practice in France and in the Netherlands

Sophia Rosman1, Marc Le Vaillant1, François Schellevis2, Pascal Clerc3, Robert Verheij4 and Nathalie Pelletier-Fleury1

1 Centre de Recherche Médecine, Science, Santé et Société (CERMES), Institut National de la Santé et de la Recherche Médicale (INSERM, France)
2 Department of General Practice, EMGO Institute, VU University Medical Centre, Amsterdam (Netherlands)
3 Société Française de Médecine Générale (SFMG, France) and
4 Netherlands Institute for Health Services Research (NIVEL, Netherlands)

Correspondence: Sophia Rosman, INSERM U 750- CERMES, 7, rue Guy Môquet, 94801 Villejuif, France, tel: + 33 1 49 58 36 57, e-mail: rosman{at}vjf.cnrs.fr

Received April 19, 2007 , accepted November 12, 2007

Background: France and the Netherlands are often presented as two contrasting countries with regard to drug prescriptions and consumption. This study aimed to analyse general practitioners’ (GP's) prescription patterns for upper respiratory tract infections (URTI). Methods: Data on diagnoses and prescriptions were derived from two databases recording daily electronic medical patient files: the ‘Société Française de Médecine Générale’ database (SFMG-DB) and the Dutch Landelijk Informatie Netwerk Huisatsenzorg database (LINH-DB). Logit regression models were developed to estimate and compare prescription patterns in both countries. We carried out a study including all the patients consulting for URTI in 2003. Results: French GPs had more URTI patients than their Dutch counterparts (372.1 URTI patients/GP versus 181.3). They prescribed higher volumes of URTI medications (3.55 per patient/year versus 0.82). Striking differences were observed in analgesic and symptomatic prescriptions (0.84 per patient/year versus 0.12 and 1.01 per patient/year versus 0.21, respectively). We did not observe important discrepancies in volume of antibiotic prescriptions (0.29 per patient/year in France versus 0.32). After adjustment for patient characteristics, the logit model showed that prescription patterns for antibiotic were quite similar and associated with a diagnosis of acute tonsillitis. Conclusion: The analysis per consultation in this study did not highlight important differences in antibiotic prescribing volumes and patterns. But symptomatic and analgesic prescriptions were significantly higher in the French database. This can be explained by differences in help-seeking behaviour, medication perception, status of OTC medications and remuneration system.


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