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Changes in Treatment of Very Elderly Patients Six Weeks after Discharge from Geriatrics Department

We assessed the prescriptions of patients hospitalized in a geriatric unit and subsequently discharged. This prospective and observational study was conducted over a two-month period in the geriatrics department (acute and rehabilitation units) of a university hospital. Patients discharged from this...

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Autores principales: Dipanda, Mélanie, Barben, Jérémy, Nuémi, Gilles, Vadot, Lucie, Nuss, Valentine, Vovelle, Jérémie, Putot, Alain, Manckoundia, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7555628/
https://www.ncbi.nlm.nih.gov/pubmed/32751095
http://dx.doi.org/10.3390/geriatrics5030044
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author Dipanda, Mélanie
Barben, Jérémy
Nuémi, Gilles
Vadot, Lucie
Nuss, Valentine
Vovelle, Jérémie
Putot, Alain
Manckoundia, Patrick
author_facet Dipanda, Mélanie
Barben, Jérémy
Nuémi, Gilles
Vadot, Lucie
Nuss, Valentine
Vovelle, Jérémie
Putot, Alain
Manckoundia, Patrick
author_sort Dipanda, Mélanie
collection PubMed
description We assessed the prescriptions of patients hospitalized in a geriatric unit and subsequently discharged. This prospective and observational study was conducted over a two-month period in the geriatrics department (acute and rehabilitation units) of a university hospital. Patients discharged from this department were included over a two-month period. Prescriptions were analyzed at admission and discharge from the geriatrics department (DGD), and six weeks after DGD. We included 209 patients, 63% female, aged 86.8 years. The mean number of medications prescribed was significantly higher at DGD than at admission (7.8 vs. 7.1, p = 0.003). During hospitalization, 1217 prescriptions were changed (average 5.8 medications/patient): 52.8% were initiations, 39.3% were discontinuations, and 7.9% were dose adjustments. A total of 156 of the 209 patients initially enrolled completed the study. Among these patients, 81 (51.9%) had the same prescriptions six weeks after DGD. In univariate analysis, medications were changed more frequently in patients with cognitive impairment (p = 0.04) and in patients for whom the hospital report did not indicate in-hospital modifications (p = 0.007). Multivariate analysis found that six weeks after DGD, there were significantly more drug changes for patients for whom there were changes in prescription during hospitalization (p < 0.001). A total of 169 medications were changed (mean number of medications changed per patient: 1.1): 52.7% discontinuations, 34.3% initiations, and 13% dosage modifications. The drug regimens were often changed during hospitalization in the geriatrics department, and a majority of these changes were maintained six weeks after DGD. Improvements in patient adherence and hospital-general practitioner communication are necessary to promote continuity of care and to optimize patient supervision after hospital discharge.
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spelling pubmed-75556282020-10-19 Changes in Treatment of Very Elderly Patients Six Weeks after Discharge from Geriatrics Department Dipanda, Mélanie Barben, Jérémy Nuémi, Gilles Vadot, Lucie Nuss, Valentine Vovelle, Jérémie Putot, Alain Manckoundia, Patrick Geriatrics (Basel) Article We assessed the prescriptions of patients hospitalized in a geriatric unit and subsequently discharged. This prospective and observational study was conducted over a two-month period in the geriatrics department (acute and rehabilitation units) of a university hospital. Patients discharged from this department were included over a two-month period. Prescriptions were analyzed at admission and discharge from the geriatrics department (DGD), and six weeks after DGD. We included 209 patients, 63% female, aged 86.8 years. The mean number of medications prescribed was significantly higher at DGD than at admission (7.8 vs. 7.1, p = 0.003). During hospitalization, 1217 prescriptions were changed (average 5.8 medications/patient): 52.8% were initiations, 39.3% were discontinuations, and 7.9% were dose adjustments. A total of 156 of the 209 patients initially enrolled completed the study. Among these patients, 81 (51.9%) had the same prescriptions six weeks after DGD. In univariate analysis, medications were changed more frequently in patients with cognitive impairment (p = 0.04) and in patients for whom the hospital report did not indicate in-hospital modifications (p = 0.007). Multivariate analysis found that six weeks after DGD, there were significantly more drug changes for patients for whom there were changes in prescription during hospitalization (p < 0.001). A total of 169 medications were changed (mean number of medications changed per patient: 1.1): 52.7% discontinuations, 34.3% initiations, and 13% dosage modifications. The drug regimens were often changed during hospitalization in the geriatrics department, and a majority of these changes were maintained six weeks after DGD. Improvements in patient adherence and hospital-general practitioner communication are necessary to promote continuity of care and to optimize patient supervision after hospital discharge. MDPI 2020-07-29 /pmc/articles/PMC7555628/ /pubmed/32751095 http://dx.doi.org/10.3390/geriatrics5030044 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Dipanda, Mélanie
Barben, Jérémy
Nuémi, Gilles
Vadot, Lucie
Nuss, Valentine
Vovelle, Jérémie
Putot, Alain
Manckoundia, Patrick
Changes in Treatment of Very Elderly Patients Six Weeks after Discharge from Geriatrics Department
title Changes in Treatment of Very Elderly Patients Six Weeks after Discharge from Geriatrics Department
title_full Changes in Treatment of Very Elderly Patients Six Weeks after Discharge from Geriatrics Department
title_fullStr Changes in Treatment of Very Elderly Patients Six Weeks after Discharge from Geriatrics Department
title_full_unstemmed Changes in Treatment of Very Elderly Patients Six Weeks after Discharge from Geriatrics Department
title_short Changes in Treatment of Very Elderly Patients Six Weeks after Discharge from Geriatrics Department
title_sort changes in treatment of very elderly patients six weeks after discharge from geriatrics department
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7555628/
https://www.ncbi.nlm.nih.gov/pubmed/32751095
http://dx.doi.org/10.3390/geriatrics5030044
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