Évaluation de l'impact d'un outil d'optimisation des prescriptions médicamenteuses dans la prise en charge du sujet âgé hospitalisé en service de court séjour gériatrique

Abstract : Prescribing optimization is a major issue of geriatric care. This non-interventional study evaluated the influence of a prescribing optimization tool in the short-stay geriatric unit of the Caen University Hospital, including 250 patients spread in two groups, “routine care” and “prescribing optimization”. In this last group, a prescribing optimization form was designed at the time of hospital admission according to the STOPP/START.v2 criteria. The primary study endpoint was the differential number of inappropriate prescriptions between admission and discharge. The prescription of inappropriate drugs and the omission of appropriate drugs was lower at discharge, without any statistical difference between the two groups (-0.9±1.2 vs. 1.3±1.4 ; p=0.12 et -0.2±1 vs. -0.3±1.3 ; p=0.22). In the “optimization” group, there was a significant lower rate of unjustified omission of appropriate drugs (61.4% vs. 49.6% ; p=0.048) and a significant lower prescription of inappropriate drugs in patients whose admission prescription comprehended 7 drugs or more (-1.1±1.2 vs. -1.7±1.5 ; p=0.02). Our tool failed to reduce inappropriate prescribing; however, the “optimization” group was compared to a group taken care of by geriatric specialists trained in prescribing optimization.
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https://dumas.ccsd.cnrs.fr/dumas-02048627
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Claire Delmas. Évaluation de l'impact d'un outil d'optimisation des prescriptions médicamenteuses dans la prise en charge du sujet âgé hospitalisé en service de court séjour gériatrique. Médecine humaine et pathologie. 2018. ⟨dumas-02048627⟩

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