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Association anticholinergique/anticholinestérasique : étude transversale sur le mésusage médicamenteux concernant 1 367 prescriptions de résidents en EHPAD

Anticholinergic/anticholinesterase association: transversal study on drug misuse concerning 1367 prescriptions in nursing homes

  • Article Original / Original Article
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Les cahiers de l'année gérontologique

Résumé

Introduction

Chez les patients atteints de maladie d’Alzheimer, le traitement par anticholinestérasique est actuellement une des seules options médicamenteuses disponibles. De nombreux médicaments possèdent une activité anticholinergique, souvent méconnue, qui peut avoir une action antagoniste avec les anticholinestérasiques ainsi que des effets iatrogènes. L’objet de ce travail était de déterminer la prévalence de cette association antagoniste dans une population de résidents en établissement d’hébergement pour personnes âgées dépendantes (EHPAD).

Méthode

Nous avons réalisé une étude transversale multicentrique de type « un jour donné ».

Résultats

Mille trois cent soixante-sept prescriptions de patients institutionnalisés au sein de 22 EHPAD du sudest de la France ont été analysées. L’âge moyen était de 86,4 ans (+/-7,8 ans). 23 % des patients sous anticholinestérasique avaient un anticholinergique associé, soit 4 % de l’ensemble des prescriptions. Le premier traitement anticholinergique était l’hydroxyzine (Atarax), qui représentait 18 % des associations anticholinergique/anticholinestérasique.

Conclusion

Ce travail confirme que l’association anticholinestérasique/anticholinergique, bien que connue pour être antagoniste et à risque iatrogène, reste une association fréquemment réalisée chez les patients institutionnalisés.

Abstract

Introduction

Cholinesterase inhibitor is currently one of the few drug options available in Alzheimer disease. Many drugs have an anticholinergic activity, often overlooked, which may have an antagonistic action with cholinesterase inhibitors and iatrogenic effects. The purpose of this study was to determine the prevalence of this antagonist combination in a population of nursing home residents.

Method

We conducted a multicenter cross-sectional study of type “a given day”.

Results

1367 prescriptions of institutionalized patients in 22 nursing homes in the south-east of France were analyzed. The average age was 86.4 years (+/-7.8 years). 23 % of patients had an anticholinergic/anticholinesterase association, which represents 4 % of all prescriptions. The first anticholinergic drug was hydroxyzine (Atarax), which accounted for 18 % of anticholinergic/anticholinesterase associations.

Conclusion

This study confirms that the combination anticholinergic/anticholinesterase remains a frequently prescribed for institutionalized residents although it is known to be antagonistic and has iatrogenic risk.

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Authors and Affiliations

  1. Groupe MEDICA, F-06690, Tourette Levens, France

    G. Dosa-Toader & G. Marro

  2. Groupe ORPEA, F-06800, Cagnes sur Mer, France

    P. Balard

  3. Pôle de gérontologie, hôpital de Cimiez, CHU de Nice, F-06000, Nice, France

    S. Gonfrier, O. Guerin & G. Sacco

  4. EA CoBTeK Cognition Behaviour Technology, Université de Nice Sophia-Antipolis, Nice, France

    O. Guerin

  5. Centre Edmond et Lily Safra, Institut Claude Pompidou, 10 rue Molière, F-06100, Nice, France

    G. Sacco

Authors
  1. G. Dosa-Toader
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  2. P. Balard
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  3. S. Gonfrier
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  4. G. Marro
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  5. O. Guerin
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  6. G. Sacco
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Corresponding author

Correspondence to G. Sacco.

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Dosa-Toader, G., Balard, P., Gonfrier, S. et al. Association anticholinergique/anticholinestérasique : étude transversale sur le mésusage médicamenteux concernant 1 367 prescriptions de résidents en EHPAD. cah. année gerontol. 6, 83–86 (2014). https://doi.org/10.1007/s12612-014-0380-z

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  • DOI: https://doi.org/10.1007/s12612-014-0380-z

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