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Master Thesis

Intérêt de l’utilisation d’un outil de révision des ordonnances dans la prescription des psychotropes par les médecins généralistes en EHPAD

Abstract : Introduction: For the over 65 year old senior patient, drug related iatrogeny, and particularly prescription of psychotropics is frequent. Medicated adverse effects are twice more frequent with these frail elderly population with multiple pathologies. In 2013 the “ARS Aquitaine” developed a project aiming to restrict elderly neuroleptic prescription. We have studied the impact of using a revision tool of psychotropic drugs prescription by general practicioners within an EHPAD (retirement home for dependant seniors) in 2013 in link with falls and hospitalizations. Method: This retrospective study within an EHPAD compared the evolution of psychotropic prescription at 3 different times, January, June and December 2013. A semi directed discussion with the coordinating nurse completed the research. Results: The total number of drugs prescribed and polydrug use have decreased. The prescription of neuroleptics and anti-Alzeimer drugs has been reduced, as well as long half-life hypnotic Benzodiazepine. On the other hand, the prescription of anti-depressants remains steady on the whole. We have noticed an important polydrug use and an important consumption of psychotropic drugs among patients who suffer falls. The use by the coordinating nurse of this medical prescription revision tool in collaboration with referring physicians has helped to reduce the preparation of pill boxes by half an hour a week. Practically, its use is simple and it has been favourably welcome by physicians, particularly for the renewal of treatments, and it has reinforced the dialogue with the health care team. Conclusion: The use of a revision tool for prescriptions issued from HAS recommendations within an EHPAD has led to a reduction of psychotropic drug prescription, and has had an impact on iatrogeny as well as it has been a help for medical prescription.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01421733
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Submitted on : Thursday, December 22, 2016 - 5:28:15 PM
Last modification on : Wednesday, August 23, 2017 - 4:32:21 PM
Long-term archiving on: : Monday, March 20, 2017 - 4:57:14 PM

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Sophie Perez. Intérêt de l’utilisation d’un outil de révision des ordonnances dans la prescription des psychotropes par les médecins généralistes en EHPAD. Médecine humaine et pathologie. 2016. ⟨dumas-01421733⟩

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