Table 2.

Main areas of improvement of information and training for users and health professionals for medicines. Round table recommendations.

Prevention of misuse
Topic	Target audience	Suggested method	Examples
Education/training/general acculturation	Secondary school pupils/school pupils	Introduce medicines in primary and secondary education (topic to be introduced in the health department)
		Promote education to media and information	Eduscol: https://entreleslignes.media/
	Health studies’ students	Reinforce education about medicines in health studies (medicine, pharmacy, dentistry, midwifery, physiotherapy, nursing, etc.)	Medicine modules in PAS/LAS (Specific Health Access Pathway/Degree with “Health Access” option); therapeutic sessions in objective and structured clinical examinations (ECOS) in second year of studies
	Patients and carers	Implement university training for patient partners in patient associations; promote therapeutic education Collaborative work on patient leaflets	University degree from the Francophone Union of Patient Partners: https://ufpp.fr/formations-de-l-ufpp.html; work on e-leaflets: https://www.ema.europa.eu/en/news/key-principles-use-electronic-product-information-eu-medicines)
	General population	Train the public (open access public service training/information platform)
Information
	Journalists	Promote scientific journalism within editorials	Initiative d’Epsilon: https://www.epsiloon.com/common/cms/charte
	Professional societies	Communicate with the wider public	Initiative from Société française de pharmacologie et de thérapeutique: https://sfpt-fr.org/covid19
	Regional Pharmacovigilance Centres, Regional Addiction Vigilance Centres National Agency for the Safety of Medicines and Health Products	Promote information of professionals and patients in medicines, their adverse effects and their proper use, enable direct access for patients to information; remind professionals that the efficacy and safety of a medicine is conditional, without exception, on compliance with the SPC	https://www.rfcrpv.fr/contacter-votre-crpv; https://addictovigilance.fr/bulletin/; https://base-donnees-publique.medicaments.gouv.fr; https://ansm.sante.fr/dossiers-thematiques/covid-19-vaccins/covid-19-suivi-hebdomadaire-des-cas-deffets-indesirables-des-vaccins; https://ansm.sante.fr/dossiers-thematiques/medicaments-et-grossesse; https://ansm.sante.fr/actualites/antalgiques-opioides-lansm-publie-un-etat-des-lieux-de-la-consommation-en-france
	Companies	Communicate with the wider public in a concerted way with agencies	Antibiotics: proper use, medical visit charter (communication on risk minimisation measures, surveys of medical visits), escalation of non-MA cases. Monitoring of sales, monitoring of reports
Identification and treatment
Identification	Networks of Regional Pharmacovigilance Centres (CRPV) and Centres for the evaluation and information on pharmacodependency and addiction vigilance (CEIP-A)	Stimulate declarations to CRPV or CEIP-A of cases of misuse, including without an adverse effect in order to detect them better	Notifications/information requests received by networks of CRPV and CEIP. Sentinel networks of CEIP (OPPIDUM device via addiction structures; OSIAP device for falsified prescriptions, etc.) Mésange Project: identification of cases of misuse at the time of pharmaceutical dispensing
	Companies	Escalation of signals to National Agency for the Safety of Medicines and Health Products	Indicators for monitoring of sales, indicators for medical information questions
	Doctors and (dispensing) chemists	Structuring of shared medical record (universal access), and harmonisation with the pharmaceutical file
	Hospitals	Monitoring of consumption, monitoring of supply tensions
	National Agency for the Safety of Medicines and Health Products	Comparison of the number of average packs with respect to the expected number, for abuse and for non-MA prescriptions/dispenses. Highlighting of misuse via health insurance databases [21]	Detection of doctor-shopping behaviour [22]
	Patients	On an individual basis: Medicine conciliation; use by the doctor of tools for highlighting misuse (e.g. opioids)
Treatment	National Agency for the Safety of Medicines and Health Products	Change of prescription methods (health authorities), risk reduction measures (Agencies, commercial documents e.g. isotretinoide). Monitoring of change of prescription methods	Example with monitoring of zolpidem reports -> zopiclone for Z drugs [23]
	Dispensing chemists	Dispensation adaptée (01/07/2020) https://uspo.fr/dad-dispensation-adaptee-liste-des-specialites/