GRP-098 Inappropriate Prescribing For Elderly People: is the Hospital the Initiator?

Background Adverse drug reactions are frequently encountered in older people. They represent the cause of hospitalisation of 10 to 20% of hospitalised people aged 60 years or over. The quality of geriatric prescription is thus a healthcare priority. Potentially inappropriate drugs (PIDs) are medicines with an unfavourable benefit/risk ratio or questionable efficacy while other and safer therapeutic alternatives are available. Purpose To evaluate the quality of prescribing in our hospital for patients who are 75 years old or over. Are PIDs prescribed to our patients? Who first prescribed this treatment: our hospital doctors or family doctors? Materials and Methods A list of potentially inappropriate medicines, judged by 34 criteria, specially adapted to French medical practise, was used as reference. 28 of these drugs are used in our hospital. We analysed the prescriptions of patients who were 75 years old or over, hospitalised on one day chosen arbitrarily, in order to collect data about their treatments. Results 133 patients (29.6% of patients hospitalised in medical and surgical care units) were included. On average, 8 systemic drugs were prescribed per patient. 31 patients had at least 1 PID prescribed (23.3%): 24 (18%) had 1 PID, 5 (3.8%) had 2 PIDs and 2 (1.6%) had 3 or more PIDs. 70.9% were psychotropic drugs. 53.7% of them were initiated by doctors working in our hospital, 86.4% of which by a senior doctor versus 13.6% by a resident. Conclusions This study shows that a significant proportion of PIDs are initiated in our hospital. To improve practise, pharmacists have to make doctors aware of PIDs and suggest therapeutic alternatives before treatment is started. If PIDs are prescribed, pharmacists should formulate pharmaceutical interventions. We will add this criterion to our trigger tool which selects high-risk prescriptions. No conflict of interest.