[Prescription of phosphorus, calcium and magnesium: Choice of the millimole unit to establish the equivalence of doses between oral and injectable forms]. / Prescription de phosphore, calcium et magnésium : choix de l'unité millimole pour établir l'équivalence des apports entre les formes orales et injectables.

OBJECTIVES: Information available on the packaging of drugs indicated for patients electrolytes replenishment differs from one manufacturer to another. They relate, for example, the unit chosen to express elemental electrolyte concentration. These differences constitute a risk factor for medication errors. This article proposes a clinical decision support tool which defines dose equivalences between the oral and injectable formulation galenic forms for medications providing phosphorus, calcium and magnesium and a calculated replenishment ratio. METHODS: The amounts of elemental electrolyte were determined from the information contained on the packaging and the summaries of product characteristics. Only the specialties of our hospital drug formulary were studied. For each element, the replenishment ratio was determined from published data. RESULTS: Equivalence tables were created for the phosphorus, calcium and magnesium between oral and injectable formulation. A clinical decision support tool was developed from these data. CONCLUSION: The use of this tool is a first way to reduce the risk of medication errors. It remains to determine the conditions for its dissemination and evaluation. This issue raises the questions of the exclusive use of the millimole unit on packaging and for prescription, and that of the integration of this type of tool into prescription software and decision support systems.

[General practical survey of individual prostate cancer screening]. / Etude de pratique des médecins généralistes concernant le dépistage individuel du cancer de la prostate.

OBJECTIVE: To assess the practices of general practitioners in the Auvergne region concerning individual prostate cancer screening, to compare these practices with published guidelines and to identify those points that are most difficult to perform. MATERIAL: An anonymous postal survey using a predefined questionnaire was conducted among 1339 general practitioners in the Auvergne region identified by the URSSAF file on 1st January 2006. This was a declarative survey with no individual financial reward. The questionnaire comprised three aspects: general practitioner identification criteria, screening practices and the doctors' opinion concerning guidelines. RESULTS: The participation rate was 49.1: 98.3% of general practitioners declared that they proposed screening and 89.5% declared that they proposed screening to all men within certain age limits, from 50 to 75 years in 80.8% of cases. Only 4.6% of doctors provided complete preliminary information to their patients. Among the doctors,75.6% combined digital rectal examination and total PSA assay, but in the presence of an abnormality, only 10.5% referred their patients directly to an urologist without prescribing other complementary investigations (first- or second-line). Finally, 53.5% of doctors considered that published guidelines were adapted to their clinical practice. CONCLUSION: Individual prostate cancer screening is massively proposed, but differences are observed between the doctors' reported practices and official guidelines. This study emphasizes the need to provide patients with clear and complete information and to improve the general practitioners' knowledge on screening tests and patient referral in the case of positive screening tests.