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Duprat Laura del Rocío

PhD student in Sociology at EHESS

Doctoral training "Santé, Populations et Politiques Sociales" (SPPS), EHESS

Contact : delrocioduprat(at)hotmail.com

Title of the thesis: Treating elderly: for a sociology of medical prescription

Under the supervision of Jean Paul Gaudillière and Boris Hauray

My research focuses on the medical work and the medicalization of old age.

This thesis proposes to make sociology of medical prescription based on the case of the elderly. The case of elderly is paradigmatic of the chronicity of the disease, polypathology as well as polypharmacy. This particular case will lead us to investigate the phenomenon of polypharmacy in relation to chronic diseases and to analyze how the polypharmacy has become evident in the "polypathological" elderly. The importance of this study relies on the observation of the current overmedication, on the gap between medical evidence, clinical practice and knowledge on the use of drugs and finally on the role of pharmaceutical marketing on prescribing practice.

Firstly, I will improve the understanding on the construction of knowledge about prescription in the elderly and how physicians integrate this knowledge into their practice. Secondly I will grasp the mechanisms by which this prescription is transformed in the interaction between several medical reasoning, the influence of pharmaceutical marketing as well as the demands of the elderly patients. Finally, I will observe how this prescription is received, appropriated and transformed by older people in their everyday environment.
To study this subject my work will be based on the intersection of three investigations. It analyses the history of knowledge on prescription through a literature review and a review of the French and Anglo-Saxon medical press since 1960. A second survey will be made on the basis of interviews among general practitioners to obtain a qualitative view of the act of prescribing, including analyzing how these physicians manage daily tension between medical evidence and clinical practice, the medical visit and the relationship with their elderly patients. From an ethnographic observation in nursing homes (Accommodation facility for elderly dependents), the third survey will provide a better understanding of the relationships of older people with their medications and more specifically the life of the drug in nursing homes.