Pharmacie clinique et thérapeutique (French Edition)

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Use of medication among patients living at home decreased notably with age. Our data confirm that the elderly in France consume large amounts of medication, whether they live at home or in nursing homes. This use increased steadily with age and only decreased in patients aged or more living at home. Use of medication was also very high in nursing homes and was less affected by age.

The mean number of drugs taken by elderly patients reached almost 10 different active ingredients. The most frequently used medications were analgesics, cardiovascular drugs, psychotropic drugs, and gastrointestinal drugs. Among the different drug classes there were clear differences between patients living at home and those in nursing homes.

This reflects different morbidity profiles and states of health, the clearest example of which was seen for mental health disorders. Although the methodologies are different, it is instructive to compare our findings with data in the French literature. One can therefore assume that more elderly subjects use medication today. In the s, mean daily intake of medicinal products was 3. Although the methodologies are different, our data suggest that the use of medication has practically doubled over the last 15 years.

This increase in the number of drugs taken every day is also apparent when comparing our data with those of population cohorts in France. Comparison of the types of drugs used in the late s and today shows that several have disappeared, withdrawn from sale because of inefficacy. Before, elderly subjects took on average 4 drugs, a good proportion of which were ineffective.

Essais cliniques de phase 1 : quelle sécurité pour les patients ? - Le Magazine de la santé

In contrast, all the drugs recorded in our study show genuine efficacy. Comparative data on elderly patients in nursing homes are scarce. A more recent french study 31 , performed on about 43 subjects aged 75 and over, being part of the EGB, shows a prescription of about 8. The most drug classes are comparable to the results of our study. A Swedish study 39 compared use of prescription drugs in patients aged 80 or over, living at home or in nursing homes, over the last quarter of In Sweden, patients living at home were taking half as many drugs median in each age range as their counterparts in France.

The same result is apparent for anxiolytics and antidepressants, use of which was more common in nursing homes for antidepressants among to year-olds, Percentage use nonetheless remained lower in Sweden, notably for anxiolytics. Use of mild analgesics in nursing homes was equivalent in Sweden and France. In contrast, patients living at home clearly used less medication in Sweden than in France.

Among cardiovascular treatments, renin-angiotensin system inhibitors were much less used in Sweden, whether patients were living at home or in nursing homes; beta-blockers, on the other hand, were used more in Sweden. In both cases, use of medication decreased with age.

Amélie MARSOT - Faculté de pharmacie - Université de Montréal

Gastroprotective agents and laxatives were less prescribed in Sweden than in France, both in patients living at home and in those in nursing homes. We have no data enabling analysis of the relevance of the prescriptions recorded. If we assume that morbidity among the advanced in age is similar in Sweden and France, a comparison of the levels of prescription between the two countries is suggestive of different medical practices. The weakness of the data concerning the morbidity of elderly subjects in France, especially those living at home, hampers a more qualitative analysis.

A survey among subjects 41 representative of the elderly population in nursing homes showed that morbidity could be overestimated using data extracted from a questionnaire completed by the attending physician, using a cost-appraisal tool. Whatever the limits of these data comparisons, the use of medication observed in our sample does not seem to be in contradiction with these epidemiological data. On the other hand, lack of epidemiological data on patients living at home jeopardizes qualitative interpretation of their use of medication.

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The data are incomplete and relate to causes of death or hospitalization, cohorts unrepresentative of the general population, or health policy objectives. Various ways of reviewing treatments in elderly patients have been proposed and in France are covered by good practice guidelines issued by the National Authority for Health 20,23— Optimization of drug prescribing.

Br J Clin Pharmacol. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med. Inappropriate prescribing for elderly Americans in a large outpatient population. Suboptimal prescribing in older inpatients and outpatients. J Am Geriatr Soc. Potentially inappropriate medication use and healthcare expenditures in the US community-dwelling elderly.

Med Care.

Dictionnaires, encyclopédies et lexiques en langue française

Frequency and risk factors of potentially inappropriate medication use in a community-dwelling elderly population: results from the 3C Study. Eur J Clin Pharmacol. Prevalence of potentially inappropriate medication use in older adults using the Beers criteria. Potentially inappropriate medication use among older adults in the USA in Age Ageing. Inappropriate medication in a national sample of US elderly patients receiving home health care.

Pharmacie clinique et thérapeutique

J Gen Intern Med. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 patients. Adverse events associated with prescription drug cost-sharing among poor and elderly persons. Hospitalization and death associated with potentially inappropriate medication prescriptions among elderly nursing home residents.

Hospitalisations caused by adverse drug reactions ADR : a meta-analysis of observational studies. Incident use and outcomes associated with potentially inappropriate medication use in older adults. Am J Geriatr Pharmacother. Adverse drug events after hospital discharge in older adults: types, severity, and involvement of Beers Criteria Medications.

Long-term cognitive and functional effects of potentially inappropriate medications in older women. Potentially harmful drug-drug interactions in the elderly: a review. Pasquier F. Rev Neurol Paris. Auvray L, Sermet C. Drugs — Real World Outcomes. Le Cossec C. French health insurance databases: What interest for medical research?

French national health insurance information system and the permanent beneficiaries sample. Prat Organ Soins. Med Arh.

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