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Master Thesis

Étude de la consommation chronique d'inhibiteurs de la pompe à protons en EHPAD : indications documentées et médications associées pour 134 résidents

Abstract : Long term use of proton pump inhibitors in nursing home: documented indications and associated prescriptions for 134 residents. Use of Proton pump inhibitors (PPIs) constantly increases. Few studies had explore the long term prescription patterns in nursing home (NH). OBJECTIVE: two additional studies have been realized. Their respective objectives were: 1/ quantitative and qualitative evaluation of the annually PPI use in 100 NH. 2/ among a sample of long term PPI users in four NH : (i) to confront indications with the official recommendations in order to bring out appropriate prescriptions ; (ii) to examine the associated drugs to long term use of PPI. METHOD: 1/descriptive, observational, retrospective and multi centric study, including residents that had benefited from at least one PPI prescription, in 2013, in 100 french NH. 2/ observational, retrospective and multi centric study, among a sample of long term PPI users, with analysis of indications and co-medications of antiplatelet agents (APA), anticoagulants (AC) and nonsteroidal anti inflammatory agents (NSAIDs). RESULTS: 1/ among 12 739 residents, 40% had use one PPI in 2013. Long term use were majority (92% of prescriptions). Then, 4 650 residents (37%) had benefited from at least one long term PPI prescription in 2013. PPIs were prescribed in one making unit (95% of cases), essentially in the evening (81% of prescriptions). Esomeprazole were the most prescribed PPI (43% of the long term prescriptions). 2/ 134 long term PPI users were included. Indications / patterns were documented in only 44% of cases. Among these indications, only one on two was appropriated. Associated prescriptions with APA, AC or NSAID or corticoid concerned 70% of residents. 65% of residents without explicit justification of PPI prescription used an APA or an AC. CONCLUSION: PPI use in NH is not enough justified by the clinicians, and a significant number of prescriptions are potentially inappropriate. Associated medication with APA or AC possibly contribute to PPI’s overuse and misuse.
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https://dumas.ccsd.cnrs.fr/dumas-01251217
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Submitted on : Tuesday, January 5, 2016 - 6:13:39 PM
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Romain van Overloop. Étude de la consommation chronique d'inhibiteurs de la pompe à protons en EHPAD : indications documentées et médications associées pour 134 résidents. Médecine humaine et pathologie. 2015. ⟨dumas-01251217⟩

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