Year: 2025
Type: conference-paper
Study design: Observational Study
Abstract: Background and Importance Frail and complex older inpatients might receive an intervention from the Geriatric Mobile Team (GMT) of our hospital after request. The GMT provides specialised medico-social advice and optimises the patients’ care. Since 2020, a clinical pharmacist works with the GMT on the patients’ drug management by carrying out medication reconciliation and pharmaceutical analysis of their prescription within a national care pathway for the elderly. Aim and Objectives The aim of this study is to assess the pharmacist activity within the GMT and its potential impact on drug management and hospital readmission at 3 months after discharge. Material and Methods All inpatients assessed by the GMT and hospitalised in acute medicine unit, arrived via the emergency department, between 1 January 2020 and 31 December 2023 were included in this retrospective cohort study. The variables collected were: age, sex, length of stay, readmission in the hospital in the 3 months after discharge, drug class managed by the PI, drug related problems (DRP) identified, nature of the advice given, and acceptance rate by doctors. A PI is notified in the prescription software and can be discussed orally with the medical team. They are considered as accepted if they lead to a change in the prescription. Results Overall, 203 patients were included (mean age 87.4 ± 5.7 years, 51.7% female). Among them, 138 had a PI in their prescription: 246 PIs in total with an acceptance rate of 76.4%. Patients with a PI had longest length of stay (18.7 ± 12.5 vs 14.6 ± 6.2 days, p=0.01) and more prescribed drugs (9.2 ± 3.6 vs 7.8 ± 3.3, p = 0.01). No significant difference was observed in readmission rate (28.1% vs 33.9%, p=0.49). The drugs with most PIs were ‘supplements’ (14.6%), ‘proton pump inhibitors’ (10.6%) and ‘anticoagulants’ (8.5%). The most frequent DRPs highlighted were ‘Non conformity to guidelines or contraindication’ (28.1%), ‘Supratherapeutic dosage’ (24.4%) and ‘Drug without indication’ (23.2%). The advice proposed by the pharmacist were ‘Dose adjustment’ (32.5%), ‘Drug switch’ (26.4%) and ‘Drug discontinuation’ (22.4%). Conclusion and Relevance This multidisciplinary team encourages optimal prescriptions in these complex inpatients. Further research is necessary to explore and improve our impact on the patients’ readmission rate. References and/or Acknowledgements Conflict of Interest No conflict of interest
Authors: M Chappe, S Barre, A Simon, M Boisseau
Language: English
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4408376128