Grande fréquence des prescriptions médicamenteuses à visée cardiovasculaire potentiellement inappropriées dans la population âgée [Potentially inappropriate prescribing cardiovascular medications in the aged population: prospective study in a district hospital centre (France)].

Details

Serval ID
serval:BIB_1CFB4C3532AA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Grande fréquence des prescriptions médicamenteuses à visée cardiovasculaire potentiellement inappropriées dans la population âgée [Potentially inappropriate prescribing cardiovascular medications in the aged population: prospective study in a district hospital centre (France)].
Journal
Presse Médicale
Author(s)
Gentes É., Hertzog M., Vogel T., Lang P.O.
ISSN
0755-4982 (Print)
ISSN-L
0755-4982
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
44
Number
2
Pages
e41-e50
Language
french
Notes
Publication types: English Abstract ; Journal ArticlePublication Status: ppublish
Abstract
OBJECTIVES: Cardiovascular disease is a leading cause of morbidity and mortality in the elderly population. We evaluated the adequacy of prescribing (miss and under used) with respect to STOPP-START criteria.
METHODS: A sample of 100 patients hospitalized in cardiovascular specialty divisions (medicine or surgery) or in the different sectors making up the geriatric network (day-care hospital, short or rehabilitation ward, nursing home) has been considered. Drug prescriptions at the admission time were analysed.
RESULTS: Eight hundred and seventy-four prescriptions were analysed. In 65% of patients, from 5 to 10 medications were prescribed and in 28% over 10. Fifty-four percent of patients had, at least, one potentially inappropriate prescription (PIP) by STOPP. Among them, 48% of PIP prescriptions contained 1, 41% 2 and 11% 3 or more. The omission of one medication according to START criteria concerned 57% of the sample. Among them, 46% had one omission, 44% 2 to 3 and 10% 4 omissions or over. The cardiovascular system is the one most concerned by the PIP. Whether 28.1% of the PIP by STOPP criteria concerned cardiovascular drugs, the omission of prescription, according to START criteria, was 41.8%. There was no significant difference between the different settings studied. There was no effect of age or sex on the impact of PIP (P>0.20) or being polymédiqué (P=0.44). According to the criteria STOPP-A, the prescription of antiplatelet (indication and dose) was highlighted. Prescribing omission also concerned antiplatelet agents but also statins in patients with atherosclerosis as well as antiplatelet and anticoagulant in patients with permanent atrial fibrillation and inhibitor of angiotensin converting enzyme (ACE) after myocardial infarction or with chronic heart failure.
CONCLUSION: Potentially inappropriate prescribing medications were very common in elderly patients with cardiovascular conditions. They concerned as much as underusing of important drugs with potential benefits and prescribing commission of treatment that did not fit with patients' comorbidities and/or characteristics.
Keywords
Aged, Aged, 80 and over, Cardiovascular Agents/administration & dosage, Cardiovascular Agents/adverse effects, Cardiovascular Diseases/drug therapy, Cardiovascular Diseases/epidemiology, Comorbidity, Female, France/epidemiology, Hospitalization/statistics & numerical data, Hospitals, District, Humans, Inappropriate Prescribing/statistics & numerical data, Male, Polypharmacy, Prevalence
Pubmed
Create date
15/04/2015 7:58
Last modification date
20/08/2019 12:53
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