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Article Dans Une Revue British Journal of Clinical Pharmacology Année : 2022

The impact of including a medication review in an integrated care pathway: a pilot study.

Résumé

Aim The objective of the present study was to measure the impact of the intervention of combining a medication review with an integrated care approach on potentially inappropriate medications (PIMs) and hospital readmissions in frail older adults. Methods A cohort of hospitalized older adults enrolled in the French PAERPA integrated care pathway (the exposed cohort) was matched retrospectively with hospitalized older adults not enrolled in the pathway (unexposed cohort) between January 1st, 2015, and December 31st, 2018. The study was an analysis of French health administrative database. The inclusion criteria for exposed patients were admission to an acute care department in a general hospital, age 75 years or over, at least three comorbidities or the prescription of diuretics or oral anticoagulants, discharge alive and performance of a medication review. Results For the study population (n = 582), the mean ± standard deviation age was 82.9 ± 4.9 years, and 380 (65.3%) were women. Depending on the definition used, the overall median number of PIMs ranged from 2 [0;3] on admission to 3 [0;3] at discharge. The intervention was not associated with a significant difference in the mean number of PIMs. Patients in the exposed cohort were half as likely to be readmitted to hospital within 30 days of discharge relative to patients in the unexposed cohort. Conclusion Our results show that a medication review was not associated with a decrease in the mean number of PIMs. However, an integrated care intervention including the medication review was associated with a reduction in the number of hospital readmissions at 30 days.
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hal-04536548 , version 1 (23-04-2024)

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Anaïs Payen, Claire Godard-Sebillotte, Nadia Sourial, Julien Soula, David Verloop, et al.. The impact of including a medication review in an integrated care pathway: a pilot study.. British Journal of Clinical Pharmacology, 2022, British Journal of Clinical Pharmacology, 89, pp.1036-1045. ⟨10.1111/bcp.15543⟩. ⟨hal-04536548⟩

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