Doctor: Rémi Flicoteaux


Supervisors: Sylvie Chevret, Catherine Leport

Doctoral school: ED 393 Epidemiology and Biomedical Information Sciences, Université Paris Cité

Date of thesis defense: 09/2017

Jury: Sylvie Chevret, Catherine Leport, Bruno Laviolle, Jean-Claude Desenclos, Pierre Tattevin, Patrizia Carrieri, Loïc Josseran

Thesis summary:

In recent years there have been an increased interest in the scientific community for studying how patients conform, or not, to their corresponding prescribed or recommended therapies. Recent data from evaluation of vaccination policy made very clear that those behaviors have to be seen as a component of the strong relation that patients engage with their physician. They are also playing a strong role in the evaluation of treatment efficacy. Indeed the lack of measure and control of adherence to the evaluated intervention,especially in ambulatory medicine, can lead to major bias in the analysis that would give a measure of efficacy. In the context of influenza, those behaviors can have a strong impact on the epidemiology of the disease in a seasonal epidemic context and during pandemics.They concern both the acceptability of vaccination and the adherence to anti-viral therapy. We studied those dimensions through two studies, one survey of general practitioners upon the pandemic vaccinatio, and an analysis of patient adherence to antivirals. Due to its epidemic characteristics, influenza is concerned by global policies, and through those studies we discuss the relationship between those policies and patient’s adherence, and how they make a link between seasonal epidemic and pandemic.

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