Assessment of Prescriptions in Elderly Patients Hospitalized in Medicine Departments
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. First Audit Phase
3.1.1. Patient Characteristics
3.1.2. Compliant Criteria (Non-Compliance Rate < 10%)
3.1.3. Criteria Considered Non-Compliant (Non-Compliance Rate > 10%)
3.2. Improvement Approaches
3.3. Second Audit Phase and Comparison
3.3.1. Patient Characteristics
3.3.2. Evolution of Criteria between the Two Phases
3.3.3. Criterion 9: PIMs Prescription
3.3.4. Criterion 8: Renal Clearance Adaptation
3.3.5. Criterion 6: Illogical Associations
3.3.6. Criterion 10: Overall Anti-Cholinergic Score
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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References | Items |
---|---|
CPGF/HAS | 1. No more than two psychotropic drugs |
2. No more than one non-steroidal anti-inflammatory drug | |
3. No more than one benzodiazepine or related drugs | |
4. No cerebral vasodilator | |
5. No contraindicated association between two drugs | |
6. No illogical association | |
7. Adaptation of the galenic formulation to the patient | |
8. Adaptation of drugs to renal clearance | |
PIMs list | 9. No Potentially Inappropriate Medications for the Elderly (PIMs) |
AIC | 10. Weak overall anti-cholinergic score (≤3) |
Criteria | Non-Compliance Rates % (n) |
---|---|
1. No more than two psychotropic drugs | 5.5 (9) |
2. No more than one non-steroidal anti-inflammatory drug | 0.6 (1) |
3. No more than one benzodiazepine or related drugs | 3.6 (6) |
4. No cerebral vasodilator | 0 (0) |
5. No contraindicated association between two drugs | 0 (0) |
6. No illogical association | 9.7 (16) |
7. Adaptation of the galenic formulation to the patient | 1.8 (3) |
8. Adaptation of drugs to renal clearance | 24.9 (41) |
9. No Potentially Inappropriate Medications for the Elderly (PIMs) | 57.6 (95) |
10. The total Anti-cholinergic score is week (≤3) | 12.1 (20) |
Phase 1 | Phase 2 | p Value | |
---|---|---|---|
Number of patients | 165 | 165 | - |
Sex ratio | 1.04 | 0.67 | p = 0.060 |
Men %(n) | 50.9 (84) | 40.0 (66) | - |
Women %(n) | 49.1(81) | 60.0 (99) | - |
Age (years) | 84.2 | 83.9 | p = 0.53 |
Length of stay (days) | 9.9 | 9.8 | p = 0.27 |
BMI (kg/m2) | 26.4 | 25.4 | p = 0.51 |
Renal function (ml/min/1.73 m2) | 52.2 | 54.9 | p = 0.41 |
Serum albumin level (g/L) | 29.1 | 29.3 | p = 0.59 |
Average number of drugs prescribed per patient | 9.5 | 10.3 | p = 0.05 |
Patients coming from home (n) | 145 | 140 | p = 0.52 |
Dependent elderly patients (n) | 63 | 78 | p = 0.12 |
Criteria | First Phases Non-Compliance Rates % (n) | Second Phases Non-Compliance Rates % (n) | p Value |
---|---|---|---|
1. No more than two psychotropic drugs | 5.5 (9) | 3.0 (5) | p = 0.41 |
2. No more than one non-steroidal anti-inflammatory drug | 0.6 (1) | 0 (0) | p = 1.00 |
3. No more than one benzodiazepine or related drugs | 3.6 (6) | 3.0 (5) | p = 1.00 |
4. No cerebral vasodilator | 0 (0) | 0 (0) | p = 1.00 |
5. No contraindicated association between two drugs | 0 (0) | 0 (0) | p = 1.00 |
6. No illogical association | 9.7 (16) | 2.4 (4) | p < 10−3 |
7. Adaptation of the galenic formulation to the patient | 1.8 (3) | 0 (0) | p = 0.25 |
8. Adaptation of drugs to renal clearance | 24.9 (41) | 10.3 (17) | p < 10−3 |
9. No Potentially Inappropriate Medications for the Elderly (PIMs) | 57.6 (95) | 32.1 (53) | p < 10−3 |
10. Weak overall anti-cholinergic score (≤3) | 12.1 (20) | 7.3 (12) | p = 0.19 |
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Giroux, A.; Prudent, C.; Jouanny, P.; Muller, G.; Devilliers, H.; Vadot, L. Assessment of Prescriptions in Elderly Patients Hospitalized in Medicine Departments. J. Clin. Med. 2021, 10, 5343. https://doi.org/10.3390/jcm10225343
Giroux A, Prudent C, Jouanny P, Muller G, Devilliers H, Vadot L. Assessment of Prescriptions in Elderly Patients Hospitalized in Medicine Departments. Journal of Clinical Medicine. 2021; 10(22):5343. https://doi.org/10.3390/jcm10225343
Chicago/Turabian StyleGiroux, Audrey, Christelle Prudent, Pierre Jouanny, Géraldine Muller, Hervé Devilliers, and Lucie Vadot. 2021. "Assessment of Prescriptions in Elderly Patients Hospitalized in Medicine Departments" Journal of Clinical Medicine 10, no. 22: 5343. https://doi.org/10.3390/jcm10225343