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Monitoring of Potentially Inappropriate Prescriptions in Older Inpatients: A French Multicenter Study.
- Source :
- Journal of the American Geriatrics Society; Dec2017, Vol. 65 Issue 12, p2713-2719, 7p, 1 Diagram, 2 Charts
- Publication Year :
- 2017
-
Abstract
- Objectives To determine whether potentially inappropriate medications ( PIMs) or potentially inappropriate associations ( PIAs) prescribed knowingly are associated with patient monitoring. Design Prospective observational study. Setting Geriatric units (n = 56) in 28 hospitals. Participants Inpatients aged 75 and older (N = 1,327). Measurements Potentially inappropriate prescriptions ( PIP) were defined as a PIM or a PIA selected by an expert board from lists of explicit criteria (Beers, Priscus, Laroche, French Health Agency) using a Delphi process. They were considered to be prescribed knowingly if they were maintained after reassessment by the geriatrician and the clinical pharmacist. Primary outcome was the rate of PIPs maintained (prescribed knowingly) and for which a geriatrician declared that specific monitoring was performed. Secondary outcomes were the parameters monitored and the rate of participants receiving knowingly a PIP. Results One thousand sixty-three PIPs were detected in 607 participants (46%). After reassessment, 826 (78%) PIPs were maintained in 490 participants (37%), the main reasons being participant's regular treatment and lack of alternative. Psychotropic (36%), cardiovascular (including antithrombotics) (29%), and laxative or antiemetic drugs (16%) were the most-frequent classes prescribed knowingly. The geriatricians declared to perform clinical or biological monitoring for 69% (n = 570) of PIMs or PIAs prescribed knowingly. Three types of specific monitoring were identified: clinical, biological, and follow-up with a specialist. Conclusion Approximately three-quarters of PIMs or PIAs were prescribed knowingly, of which 69% were monitored, with wide variations in occurrence and in quality according to drug classes. This underlines the need for accurate guidelines on PIP monitoring. [ABSTRACT FROM AUTHOR]
- Subjects :
- INAPPROPRIATE prescribing (Medicine)
DRUG monitoring
INPATIENT care
OLDER patients
PATIENT monitoring research
PSYCHIATRIC drugs
PHARMACIST-patient relationships
THERAPEUTIC use of fibrinolytic agents
THERAPEUTICS
MEDICAL care
GERIATRICIANS
ELDER care
ANTIEMETICS
CARDIOVASCULAR agents
DELPHI method
LAXATIVES
LONGITUDINAL method
MEDICAL cooperation
SCIENTIFIC observation
RESEARCH
DESCRIPTIVE statistics
OLD age
Subjects
Details
- Language :
- English
- ISSN :
- 00028614
- Volume :
- 65
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- Journal of the American Geriatrics Society
- Publication Type :
- Academic Journal
- Accession number :
- 126749228
- Full Text :
- https://doi.org/10.1111/jgs.15081