Sécurisation du parcours de soins du sujet âgé : intérêt d’une offre variée d’activités pharmaceutiques ?

Abstract

In order to prevent medication errors during patient's care pathway, all transition steps must be secured. The main objective of this study was to assess the interest of medication review at hospital discharge on the sustainability of therapeutic optimizations made during hospitalisation in a geriatric population. This was a three months prospective, single-centre study performed in an acute geriatric unit of a university hospital. All patients hospitalized during the study were included. They were divided in two groups: the securing pathway (SP) group with admission reconciliation, step 3prescription analysis (according to the French Society of clinical pharmacy) and medication review at hospital discharge were compared to the not concerned group (NSP) with only a step 2 (according to the French Society of clinical pharmacy) prescriptions analysis. The Medication Regimen Complexity Index was used to quantify the complexity of medication regimens. In total, 53patients of the SP group and 44patients of the NSP group got the benefit of whole clinical pharmaceutical activities put in places. The average medications on discharge's drug prescription is lower in SP group (SP 8.4±3.4medications and NSP 9.6±3.2medications, P=0.06). The discharge's drug prescription complexity index is lower in SP group compared to NSP group (SP 27.9±9.8and NSP 32.7±11.5, P=0.02). The same trend is observed 30days post discharge. A medication review at hospital discharge reduces the subsequent drug prescription's complexity score. This multidisciplinary dynamic makes easier the communication between health care professionals and contributes to strengthen the city-hospital link.