Frély Anne, Chazard Emmanuel, Pansu Aymeric, Beuscart Jean-Baptiste, Puisieux François
Gerontology Clinic, Lens General Hospital, Lens, France.
Department of Medical Information and Archives, CHRU Lille, Lille, France.
Geriatr Gerontol Int. 2016 Feb;16(2):272-8. doi: 10.1111/ggi.12474. Epub 2015 Mar 21.
In France, over 20% of hospitalizations of elderly people are a result of adverse drug events, of which 50% are considered preventable. Tools have been developed to detect inappropriate prescriptions. The Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) criteria are innovative and adapted to French prescriptions. This is one of the first French prospective studies to evaluate the impact of acute geriatric care on prescriptions at discharge in elderly patients using the STOPP/START criteria.
The evaluation of prescriptions according to STOPP/START was carried out on admission and at discharge of patients in acute geriatric units at three hospitals in the Nord-Pas de Calais region, France. A total of 202 elderly hospitalized patients were included during the 4.5 months of the study (1.5 months per center).
The mean number of drugs was seven on admission and at discharge. Over half of the prescriptions at admission contained at least one potentially inappropriate medication or one potential prescription omission. The prescriptions at discharge contained significantly fewer potentially inappropriate medications than prescriptions on admission (P < 0.001). In contrast, there was no difference between prescriptions at discharge in terms of potential prescription omissions.
Acute geriatric hospitalization in France improves prescriptions in terms of potentially inappropriate medication, but has no impact on potential prescription omissions. Further studies must be carried out to see if STOPP/START could be used as a tool in French prescription.
在法国,超过20%的老年人住院是由药物不良事件导致的,其中50%被认为是可预防的。已开发出检测不适当处方的工具。老年人处方筛查工具/提醒医生正确治疗的筛查工具(STOPP/START)标准具有创新性且适用于法国的处方。这是首批使用STOPP/START标准评估急性老年护理对老年患者出院处方影响的法国前瞻性研究之一。
根据STOPP/START对法国北部加来海峡地区三家医院急性老年病房患者入院时和出院时的处方进行评估。在为期4.5个月的研究期间(每个中心1.5个月)共纳入了202名老年住院患者。
入院时和出院时的平均用药数量均为7种。超过一半的入院处方包含至少一种潜在不适当药物或一项潜在处方遗漏。出院处方中潜在不适当药物的数量明显少于入院处方(P < 0.001)。相比之下,出院处方在潜在处方遗漏方面没有差异。
法国的急性老年住院治疗在潜在不适当药物方面改善了处方,但对潜在处方遗漏没有影响。必须开展进一步研究以确定STOPP/START是否可作为法国处方中的一种工具。