Médicaments potentiellement inappropriés chez les personnes âgées hospitalisées pour chute: étude de prévalence en orthopédie

Thirty percent of people over 65 years of age fall in industrialized countries. A risk of falling has been described in ederly people because poly-medications. The current study aimed to investigate potentially inappropriate medication (PIM) in patients over 65 years of age admitted for fall in a department of orthopedic surgery. We carried out an observational, prospective, no-interventional study for six months. Admission medication reconciliation was performed with a geriatrician who identified the PIMs among patient's usual treatment. Subsequently, a clinical pharmacist identified also PIMs according to the three validated lists (lists of Laroche, Beers and STOPP). One hundred and seven patients aged 85.5±1.5 years were included in this study. The average number of prescription lines was 7.1±0.6 per patient. The geriatrician's PIMs identification and the PIM identification by lists concerned respectively 83% and 82% of patients and 27.6% and 25.6% of medication lines. 63.8% of PIMs identified from at least one list were common geriatrician PIMs. Five pharmacological classes had significantly different prevalence between geriatrician's PIMs and PIMs by lists: they were psychiatric, neurological, analgesic, diuretic and gastrointestinal drugs. The medication analyzed are a reflect of patients' drug use prior their falls. In view of high prevalence of PIM found, the integration of a standardized annual reassessment of treatments seems necessary in the management of patients at risk of falling. The anticipated identification of PIM by a clinical pharmacist could reduce the medical time required for this reassessment.