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Persistence of Effect of Medication Review on Potentially Inappropriate Prescriptions in Older Patients Following Hospital Discharge

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Abstract

Background

Potentially inappropriate prescriptions (PIPs) can lead to adverse drug reactions and should be avoided whenever possible.

Objective

Our objective was to assess the PIP resumption rate 6 months after discharge from our geriatric unit and to compare it with data in the literature.

Methods

This single-center observational study included patients aged ≥ 70 years with at least one PIP that had been stopped during hospitalization (according to Screening Tool for Older Persons Prescriptions [STOPP] and Screening Tool to Alert doctors to Right Treatment [START] criteria, version 2) between May 2018 and October 2018. We collected sociodemographic data, medication reconciliation data, and descriptive data during a comprehensive geriatric assessment. Each patient’s medication history after discharge was determined in collaboration with their usual community pharmacist.

Results

A total of 125 patients (females 70%, mean age 87.1 years) were included. Data for the admission and discharge medication reconciliations were available for 44 patients (35%). On admission, 121 of the 125 patients (97%) were taking cardiovascular medication. Of the 336 treatments withdrawn, 61 (18.2%) had been re-prescribed at 6 months post-discharge—including half within the first month. The most frequent STOPP criterion was lack of indication (32%), and the overall PIP resumption rate was 22%. According to the anatomical therapeutic chemical (ATC) classification, the main organ system affected by PIPs was the cardiovascular system (47%, with a resumption rate of 17%).

Conclusion

Our results highlighted a low PIP resumption rate at 6 months and showed that a collaborative medication review is associated with persistent medium-term medication changes.

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Authors and Affiliations

  1. Gériatrie, CHU de Tours, 2 Boulevard Tonnellé, 37000, Tours, France

    Camille Debacq, Amal Aidoud, Joëlle Bleuet, Marc Mennecart, Veronique Dardaine-Giraud & Bertrand Fougère

  2. Pharmacie, CHU Tours, 2 Boulevard Tonnellé, 37000, Tours, France

    Julie Bourgueil

Authors
  1. Camille Debacq
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  2. Julie Bourgueil
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  3. Amal Aidoud
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  4. Joëlle Bleuet
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  6. Veronique Dardaine-Giraud
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  7. Bertrand Fougère
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Corresponding author

Correspondence to Camille Debacq.

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No funding was used for this work.

Conflicts of Interest

Camille Debacq, Julie Bourgueil, Amal Aidoud, Joëlle Bleuet, Marc Mennecart, Veronique Dardaine-Giraud, Bertrand Fougère have no conflicts of interest that are directly relevant to the content of this article.

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Not applicable.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University of medicine of Tours.

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Informed consent of each patient was collected by sending an information letter accompanied by an objection form.

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Debacq, C., Bourgueil, J., Aidoud, A. et al. Persistence of Effect of Medication Review on Potentially Inappropriate Prescriptions in Older Patients Following Hospital Discharge. Drugs Aging 38, 243–252 (2021). https://doi.org/10.1007/s40266-020-00830-6

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  • DOI: https://doi.org/10.1007/s40266-020-00830-6

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