Publication details

Title
Inappropriate prescribing in elderly patients admitted in the University Hospital of Amiens.
Authors
Decoudu,L.;Marquant,B.;Liabeuf,S.;Jouanny,P.;Andrejak,M.;Moragny,J.
Publication Year
2013
Abstract
Objectives: Drug associated adverse effects are frequently encountered in elderly patients. Efforts have been made to assist choose of the best treatment for the elderly. One approach is the avoidance of inappropriate medication. The objectives of the present study were to evaluate the characteristics and prevalence of inappropriate prescribing (before admission and at discharge) according to Laroche's list in elderly patients hospitalized in different hospital units. Patients and Methods: The prescription in primary care and at discharge were analysed in 268 randomized patients in four different geriatric units and seven medicine or surgery units of the university hospital in Amiens. Patients included in this study must have been hospitalized more than 3 days and be older than 75 years. In geriatric units, a geriatric assessment has been carried including Charlson score, malnutrition (mini MNA), cognitive disorders (MMS) and loss of autonomy (ADL). Results: Among 268 patients (84.8 (plus or minus) 5.7 years, 98 men and 170 women), 80 were included in geriatrics and 188 in the other wards. The mean number of prescribed drugs was respectively 7.1 at home and 8.2 at discharge. The majority of patients have a Charlson score more than 4 (mean 6.7 (plus or minus) 2.1), a mean MMS of 17.5 (plus or minus) 7.8, mean MNA 8.5 (plus or minus) 2.8, mean ADL 4.1 (plus or minus) 1.7. In primary care, 198 inappropriate prescriptions according Laroche's criteria were found among 111 patients. At discharge, 181 inappropriate medications were prescribed among 106 patients. The most frequently found inappropriate prescriptions concerned benzodiazepines. The polypathological patients with dementia and malnourished were found at greater risk to inappropriate prescriptions concerned benzodiazepines and related drugs. Polyprescription at discharge were associated with the prescription of inappropriate molecules. Differences in terms of inappropriate prescription between the units have been pointed and specific recommendations performed. Discussion: Inappropriate medications are too frequent in elderly patients including at discharge after a hospitalization. Prescribers need to have additional formation regarding this purpose. This project will be integrated in a larger study performed in the four regional hospitals.
Journals
Fundam Clin Pharmacol.
Volume
27
Issue
1
Startpage
103
Endpage
[Poster Abstract P2-123, 8th Congress of Physiology, Pharmacology and Therapeutics (PT2) (17th Annual Meeting of French Society of Pharmacology and Therapeutics, the 80th Annual Meeting of Society of Physiology, the 34th Pharmacovigilance Meeting, th
Booktitle
Editors
City
Publisher
Issnisbn
Reflist
0
Doi
doi:10.1111/fcp.12026
Pmid
Keywords
benzodiazepine derivative;society;human;aged;physiology;inappropriate prescribing;hospitalization;pharmacology;university hospital;therapy;drug surveillance program;drug therapy;patient;primary medical care;prescription;female;ward;hospital subdivisions a????
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