Skip to Main content Skip to Navigation
Master Thesis

Evaluation of the reasons for not discontinuing potentially inappropriate medications after a medication multidisciplinary review in an acute geriatric care unit

Abstract : Potentially inappropriate medications (PIM) are an iatrogenic illness source in the elderly population. In order to ensure the safety of drug management for the elderly patient, prescriptions reassessments are carried out but do not allow all PIM to be stopped. The objective of this study is to evaluate the appropriateness of detected PIM with STOPP criteria v2 and continued after a multidisciplinary medication review (MMR), as well as to describe the evolution of PIM number during the care pathway of older patients. A prospective study was carried out in an acute geriatrics unit at the Grenoble-Alpes University Hospital, including patients hospitalised from January to April 2018. The PIM number per patient has been collected at admission, after a MMR and three months after the hospitalisation. The geriatrician's justification for continuing the PIM prescription after the MMR was also investigated. During the period, 101 patients were included and 153 PIM were identified. After the MMR, 70% of identified PIM with the STOPP/START v2 list were discontinued (n=107 out of 153), 87% of non-discontinued PIM had an indication that justified their continuation. The PIM number per patient statistically decreased between the hospital admission and discharge (1.46 versus 0.46, p<0.01). This decrease remained at three months (2.18 versus 0.93; p<0.01). PIM are complex drugs to discontinue, especially during a hospitalisation. The STOPP/START list is an effective tool for PIM detection, but its use must necessarily be accompanied by a reassessment of the drug benefit-risk balance on a case-by-case basis, and integrated in the care pathway of older patients.
Document type :
Master Thesis
Complete list of metadatas

Cited literature [124 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-02420858
Contributor : Jean-Hugues Morneau <>
Submitted on : Friday, December 20, 2019 - 10:35:26 AM
Last modification on : Wednesday, July 15, 2020 - 8:56:03 AM
Long-term archiving on: : Saturday, March 21, 2020 - 4:10:02 PM

File

2019GREA7012_riffard_cindy(1)(...
Files produced by the author(s)

Identifiers

  • HAL Id : dumas-02420858, version 1

Citation

Cindy Riffard. Evaluation of the reasons for not discontinuing potentially inappropriate medications after a medication multidisciplinary review in an acute geriatric care unit. Pharmaceutical sciences. 2019. ⟨dumas-02420858⟩

Share

Metrics

Record views

45

Files downloads

46