<?xml version="1.0" encoding="UTF-8"?><mets:mets xmlns:mads="http://www.loc.gov/mads/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:tef="http://www.abes.fr/abes/documents/tef" xmlns:metsRights="http://cosimo.stanford.edu/sdr/metsrights/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:dcterms="http://purl.org/dc/terms/" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mets="http://www.loc.gov/METS/">
    <mets:metsHdr ID="rennes1-ori-wf-1-21776" CREATEDATE="2025-10-30T11:16:24" LASTMODDATE="2025-10-30T11:16:25">
  <mets:agent ROLE="CREATOR">
            <mets:name>Université de Rennes</mets:name>
        </mets:agent>
</mets:metsHdr>
    <mets:dmdSec ID="desc_expr" CREATED="2025-10-30T11:16:24">
  <mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_desc_these">
            <mets:xmlData>
                <tef:thesisRecord>
     <dc:title xml:lang="fr">Ressenti des médecins généralistes depuis leur accès à la prescription du FreeStyle Libre® chez les diabétiques de type 2</dc:title>
     <dcterms:alternative xml:lang="en">General practitioners’ perceptions since gaining access to prescribing FreeStyle Libre® for patients with type 2 diabetes</dcterms:alternative>
     <dc:subject xml:lang="fr">FreeStyle Libre</dc:subject><dc:subject xml:lang="fr">Mesure du glucose en continu</dc:subject><dc:subject xml:lang="fr">Médecine Générale</dc:subject><dc:subject xml:lang="fr">Diabète de type 2</dc:subject><tef:sujetRameau><tef:vedetteRameauNomCommun>
						<tef:elementdEntree autoriteSource="Sudoc" autoriteExterne="234914823">Mesure du glucose en continu</tef:elementdEntree>
					</tef:vedetteRameauNomCommun><tef:vedetteRameauNomCommun>
						<tef:elementdEntree autoriteSource="Sudoc" autoriteExterne="171573994">Diabète non-insulinodépendant </tef:elementdEntree>
					</tef:vedetteRameauNomCommun><tef:vedetteRameauNomCommun>
						<tef:elementdEntree autoriteSource="Sudoc" autoriteExterne="086062751">Autosurveillance glycémique‎</tef:elementdEntree>
					</tef:vedetteRameauNomCommun><tef:vedetteRameauNomCommun>
						<tef:elementdEntree autoriteSource="Sudoc" autoriteExterne="027346390">Médecine -- Appareils et matériel‎</tef:elementdEntree><tef:subdivision autoriteSource="Sudoc" type="subdivisionDeSujet" autoriteExterne="061615315">Prescription médicale </tef:subdivision>
					</tef:vedetteRameauNomCommun><tef:vedetteRameauNomCommun>
						<tef:elementdEntree autoriteSource="Sudoc" autoriteExterne="027338215">Médecins généralistes‎</tef:elementdEntree>
					</tef:vedetteRameauNomCommun></tef:sujetRameau>
     <dcterms:abstract xml:lang="fr">Introduction : En 2023 la prescription du FreeStyle Libre®, jusqu’alors réservée aux spécialistes, a été étendue aux médecins généralistes, pour les diabétiques de type 2 sous insulinothérapie non intensifiée et dont l’équilibre glycémique n’est pas atteint. L’objectif de cette étude est d’évaluer le ressenti des médecins généralistes depuis cet accès à la prescription du dispositif.  Matériels et méthodes : Étude qualitative par entretiens semi-dirigés, réalisée entre février 2024 et août 2025 auprès de médecins généralistes installés en Ille-et-Vilaine (35) et ayant au moins un patient équipé du système FSL au sein de leur patientèle. L’analyse a suivi une approche thématique inductive.  Résultats : Quatorze médecins, âgés de 30 à 59 ans et exerçant dans des territoires variés ont été interrogés. La grande majorité des médecins accueillent positivement l’extension de prescription du FSL. Huit d’entre eux l’ont déjà initié, entourés d’autres professionnels de santé pour l’accompagnement de l’éducation thérapeutique des patients, et n’ont pas relevé de difficultés particulières. Certains souhaitent des modifications de son cadre de prescription pour toucher plus de patients. Plusieurs freins ont été cités à son utilisation et sa prescription (manque de connaissance et de formation, manque de données de morbi mortalité, absence de gestion de l’insulinothérapie ...).  Discussion - Conclusion : L’accès à la prescription du FSL est apprécié par les généralistes. Son initiation nécessite une éducation thérapeutique pouvant être en partie déléguée aux IDE (libéraux, ASALEE, IPA) et pharmaciens. Le cadre de prescription pourrait être amené à évoluer sur les prochaines années en fonction des résultats d’études ultérieures. Pour pallier aux freins de certains médecins, la réalisation d’une fiche synthèse ou de formations sur le dispositif semble intéressantes. </dcterms:abstract>
     <dcterms:abstract xml:lang="en">Introduction: In 2023, the prescription of FreeStyle Libre®, previously reserved for specialists, was extended to general practitioners, for type 2 diabetics on non-intensified insulin therapy and whose glycemic balance is not reached. The objective of this study is to assess the perceptions of general practitioners since this access to the prescription of the device. Materials and methods: Qualitative study by semi-structured interviews, carried out between February 2024 and August 2025 with general practitioners based in Ille-et-Vilaine (35) and having at least one patient equipped with the FSL system in their patient base. The analysis followed an inductive thematic approach. Results: Fourteen doctors, aged between 30 and 59 years and practicing in various territories, were interviewed. The majority of doctors welcome the extension of FSL prescription. Eight of them have already initiated it, surrounded by other health professionals to support the therapeutic education of patients, and have not noted any particular difficulties. Some want changes to its prescription framework to reach more patients. Several obstacles have been cited to its use and prescription (lack of knowledge and training, lack of morbidity and mortality data, lack of management of insulin therapy, etc.). 
Discussion - Conclusion: Access to FSL prescription is appreciated by general practitioners. Its initiation requires therapeutic education that can be partly delegated to nurses (self-employed, ASALEE, advanced practice nurses) and pharmacists. The prescribing framework may change over the next few years depending on the results of subsequent studies. To overcome the obstacles of some doctors, the production of a summary sheet or training on the system seems interesting. 
</dcterms:abstract>
     <dc:type>Electronic Thesis or Dissertation</dc:type><dc:type xsi:type="dcterms:DCMIType">Text</dc:type>
     <dc:language xsi:type="dcterms:RFC3066">fr</dc:language>
    </tef:thesisRecord>
            </mets:xmlData>
        </mets:mdWrap>
</mets:dmdSec>
    <mets:dmdSec ID="desc_edition" CREATED="2025-10-30T11:16:24">
  <mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_desc_edition">
            <mets:xmlData>
                <tef:edition><dcterms:medium xsi:type="dcterms:IMT">application/pdf</dcterms:medium><dcterms:extent>1 : 1225 Ko</dcterms:extent><dc:identifier xsi:type="dcterms:URI">https://ged.univ-rennes1.fr/nuxeo/site/esupversions/37a13cef-b0c9-49f1-9575-ca9c6381bf1d</dc:identifier></tef:edition>
            </mets:xmlData>
        </mets:mdWrap>
</mets:dmdSec>
    <mets:amdSec>
        <mets:techMD ID="admin_expr">
            <mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_admin_these">
                <mets:xmlData>
                    <tef:thesisAdmin>
                        <tef:auteur>
       <tef:nom>Deteix</tef:nom>
       <tef:prenom>Lucie</tef:prenom>
       
       <tef:dateNaissance>1998-07-19</tef:dateNaissance>
       <tef:nationalite scheme="ISO-3166-1">FR</tef:nationalite>
       <tef:autoriteExterne autoriteSource="Sudoc">297781464</tef:autoriteExterne>
       <tef:autoriteExterne autoriteSource="mailPerso">lucie.deteix1@gmail.com</tef:autoriteExterne>
      </tef:auteur>
                        <dc:identifier xsi:type="tef:NNT">2025URENM257</dc:identifier>
                        <dc:identifier xsi:type="tef:nationalThesisPID">http://www.theses.fr/2025URENM257</dc:identifier>
                        <dcterms:dateAccepted xsi:type="dcterms:W3CDTF">2025-11-18</dcterms:dateAccepted>
                        <tef:thesis.degree>
                            <tef:thesis.degree.discipline xml:lang="fr">médecine générale</tef:thesis.degree.discipline>
                            <tef:thesis.degree.grantor>
        <tef:nom>Universite de Rennes</tef:nom><tef:autoriteInterne>thesis.degree.grantor_1</tef:autoriteInterne>
        
        <tef:autoriteExterne autoriteSource="Sudoc">26693823X</tef:autoriteExterne>
       </tef:thesis.degree.grantor>
                            <tef:thesis.degree.level>Doctorat (thèse d'exercice)</tef:thesis.degree.level>
                        </tef:thesis.degree>
                        <tef:theseSurTravaux>non</tef:theseSurTravaux>
                        <tef:avisJury>oui</tef:avisJury><tef:directeurThese><tef:nom>Beuneux</tef:nom><tef:prenom>Frédéric</tef:prenom><tef:autoriteInterne>intervenant_1</tef:autoriteInterne><tef:autoriteExterne autoriteSource="Sudoc">075938200</tef:autoriteExterne></tef:directeurThese>
      
      
                        
                        <tef:oaiSetSpec>ddc:610</tef:oaiSetSpec>
                        
                    <tef:MADSAuthority authorityID="intervenant_1" type="personal"><tef:personMADS><mads:namePart type="family">Beuneux</mads:namePart><mads:namePart type="given">Frédéric</mads:namePart></tef:personMADS></tef:MADSAuthority><tef:MADSAuthority authorityID="thesis.degree.grantor_1" type="corporate"><tef:personMADS><mads:namePart>Universite de Rennes</mads:namePart><mads:description>Sciences et technologie, medecine, pharmacie, odontologie, droit, economie, gestion, philosophie</mads:description></tef:personMADS></tef:MADSAuthority></tef:thesisAdmin>
                </mets:xmlData>
            </mets:mdWrap>
        </mets:techMD><mets:techMD ID="file_1"><mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_tech_fichier"><mets:xmlData><tef:meta_fichier>
     <tef:encodage>ASCII</tef:encodage>
     <tef:formatFichier>PDF</tef:formatFichier>
     
     
     
     <tef:taille>1254076</tef:taille>
    </tef:meta_fichier></mets:xmlData></mets:mdWrap></mets:techMD>
        
        <mets:rightsMD ID="dr_expr_thesard">
            <mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_droits_auteur_these">
                <mets:xmlData>
                    <metsRights:RightsDeclarationMD>
                        <metsRights:Context CONTEXTCLASS="GENERAL PUBLIC">
                            <metsRights:Permissions DISCOVER="true" DISPLAY="true" COPY="true" DUPLICATE="true" MODIFY="false" DELETE="false" PRINT="true"/>
                        </metsRights:Context>
                    </metsRights:RightsDeclarationMD>
                </mets:xmlData>
            </mets:mdWrap>
        </mets:rightsMD>
        <mets:rightsMD ID="dr_expr_univ">
            <mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_droits_etablissement_these">
                <mets:xmlData>
                    <metsRights:RightsDeclarationMD>
                        <metsRights:Context CONTEXTCLASS="GENERAL PUBLIC">
                            <metsRights:Permissions DISCOVER="true" DISPLAY="true" COPY="true" DUPLICATE="true" MODIFY="false" DELETE="false" PRINT="true"/>
                        </metsRights:Context>
                    </metsRights:RightsDeclarationMD>
                </mets:xmlData>
            </mets:mdWrap>
        </mets:rightsMD>
        <mets:rightsMD ID="dr_version">
            <mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_droits_version">
                <mets:xmlData>
                    <metsRights:RightsDeclarationMD>
                        <metsRights:Context CONTEXTCLASS="GENERAL PUBLIC">
                            <metsRights:Permissions DISCOVER="true" DISPLAY="true" COPY="true" DUPLICATE="true" MODIFY="false" DELETE="false" PRINT="true"/>
                        </metsRights:Context>
                    </metsRights:RightsDeclarationMD>
                </mets:xmlData>
            </mets:mdWrap>
        </mets:rightsMD>
    </mets:amdSec>
    <mets:fileSec>
  <mets:fileGrp ID="FGrID1" USE="archive"><mets:file ID="FID1" ADMID="file_1" MIMETYPE="application/pdf" USE="maitre"><mets:FLocat LOCTYPE="URL" xlink:href="https://ged.univ-rennes1.fr/nuxeo/site/esupversions/37a13cef-b0c9-49f1-9575-ca9c6381bf1d"/></mets:file></mets:fileGrp>
 </mets:fileSec>
    <mets:structMap TYPE="logical">
        <mets:div DMDID="desc_expr" ADMID="dr_expr_thesard dr_expr_univ admin_expr" TYPE="THESE" CONTENTIDS="http://ori-oai-search.univ-rennes1.fr/uid/rennes1-ori-wf-1-21776/oeuvre">
            <mets:div ADMID="dr_version" TYPE="VERSION_COMPLETE" CONTENTIDS="http://ori-oai-search.univ-rennes1.fr/uid/rennes1-ori-wf-1-21776/oeuvre/version">
                <mets:div DMDID="desc_edition" TYPE="EDITION" CONTENTIDS="http://ori-oai-search.univ-rennes1.fr/uid/rennes1-ori-wf-1-21776/oeuvre/version/edition">
                    <mets:fptr FILEID="FGrID1"/>
                </mets:div>
            </mets:div>
        </mets:div>
    </mets:structMap>
</mets:mets>