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Master Thesis

Introduction ou réintroduction de médicaments potentiellement inappropriés après une prise en charge en gériatrie : fréquence et conséquence, à propos de 100 patients

Abstract : Introduction: prescription of potentially inappropriate medication (PIM) is very frequent in the elderly; it increases morbimortality and avoidables hospitalisations . Objective: to determine if stopping most PIM during hospitalization in an acute geriatric ward (AGW) is sustainable, or if these MPI are reintroduced after being stopped. Methods: monocentric observational prospective survey, including 100 patients, 80+ years old hospitalized in a AGW, for the second time in the year. The STOPP/START criteria have been used to define PIM. The primary end point is the PIM reintroduction/ introduction rate between the two hospitalizations. Secondary end points were - the identification of factors supporting the introduction/ reintroduction of PIM - the identification of the drugs mostly introduced/reintroduced, - the number of patients rehospitalized for iatrogenicity, and the factors associated with rehospitalization for iatrogenicity. Results: there is an introduction/ reintroduction of PIM between the two hospitalizations in AGW (p=0.001) concerning only benzodiazepines (p=0.003) and neuroleptics (p=0.009). The PMI are more often introduced/reintroduced in patients with anxio-depressive symptoms (p<0.005, IC95% [1.523-24.881]). The total number (p=0.008) and the introduction/reintroduction of PIM between the two hospitalizations (p< 0.001) are the only factors significantly increasing the probability of rehospitalization for iatrogenicity.. Discussion: this study confirms the previous published data showing that polypharmacy is frequent in old people, with too many PMI, and that a great number of hospitalizations are motivated by potentially adverse drug effects. Furthemore, this study shows that despite stopping PMI during hospitalization, they are reintroduced during the following year (benzodiazepines and neuroleptics) constituting a major risk factor for hospitalization for iatrogenicity.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01580349
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Friday, September 1, 2017 - 12:59:40 PM
Last modification on : Saturday, November 11, 2017 - 1:14:36 AM
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Laetitia Legros-Lapebie. Introduction ou réintroduction de médicaments potentiellement inappropriés après une prise en charge en gériatrie : fréquence et conséquence, à propos de 100 patients. Médecine humaine et pathologie. 2017. ⟨dumas-01580349⟩

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