Geriatric Clinical Trial
Official title:
Impact of Medication Reconciliation at Discharge on Potentially Inappropriate Medications in the Elderly : Community-hospital Coordination. ICM2SA
The geriatric population is exposed to poly-medication. Furthermore, old people have
important pharmacodynamic and pharmacokinetic changes that expose to much drug iatrogenic.
Adverse drug effects are a great cause for hospitalization that is why the knowledge of the
complete list of medications taken by the patient is necessary. The poly-medication in
elderly can lead to extremely serious clinical consequences and significant costs. Reference
documents specific to geriatrics guide the doctor in therapeutic choices. On the one hand,
the Laroche's criteria lists all PIM of the French pharmacopoeia in elderly. On the other
hand, STOPP/START criteria are a tool for detect PIM listing inappropriate drugs and criteria
of potentially drug omissions. This has been validated in French language. It is important
that any changes proposed by the geriatrician resulting in just prescription is sustainable
beyond the hospitalization to prevent the recurrence of adverse effects. Effective
community-hospital coordination is essential.
Medication reconciliation is defined as the formal process of checking the complete, accurate
list of a patient's previous medication — including drug name, dosage, frequency, and route —
and comparing it with the prescription after a transition of care (on admission, after
transfer to another medical unit, and/or at discharge).
Two groups of patients will be created, one for which medication reconciliation at discharge
will be practiced and the other a similar process but not standardized. Four to eight weeks
after the discharge, the member of the pharmacy team is calling the usual community pharmacy
to get the first non-hospital prescription by fax and compare the number of PIM with the
prescription before hospitalization.
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