Dilemmatic situations between benzodiazepine prescription recommendations and practices in Uruguay
Nancy Calisto (Universidad de la República, Uruguay)
Andrea Bielli (Universidad de la República, Uruguay)
Lauren Predebon (Universidad de la República)
Paper short abstract:
This presentation analyzes some anxiety treatment strategies defined in Uruguayan public health system and their implementation difficulties at micro level. In benzodiazepine prescription practices recommendations about consumption time cannot be taken into account when the doctor meets the patient.
Paper long abstract:
This presentation analyzes some narratives of benzodiazepines prescribers and consumers in Uruguay, a small Latin American country where these psychopharmaceuticals have become easily available to the population. Drawing on a combination of document studies, focus groups and in-depth interviews with 73 benzodiazepine prescribers and users of public health care in Uruguay, we explore some narratives about prescription practices of benzodiazepines. In these narratives we found out that some treatment strategies fail on the micro level. Personalized practices focused on tailoring treatments to specific needs induce some patients to hold benzodiazepines consumption much longer than what the health policies establish. We found that the assumption of precision medicine about continuity between molecular individual characterizations to population-wide can be questioned, especially in certain social environments. There are some social and economic factors like domestic and neighborhood violence and deprivation, certain monoparental family configurations, performance requirements for workers and students and others that affect consumption practices of benzodiazepines and puts into question the medical practice as well as individual decisions about these drugs. The narratives of prescribers and consumers show dilemmatic situations that the doctors have to deal with when they continue prescribing a medicine bypassing what the treatment strategy recommendations says. This raises questions about how medical strategies are designed and how they can be truly customized.
Precision medicine at the crossroads: meeting the micro and macro, the molecular and social in new medical strategies