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International Journal of Clinical Pharmacy

, Volume 39, Issue 1, pp 113–119 | Cite as

Potentially inappropriate prescribing in a population of frail elderly people

  • Isabelle RécochéEmail author
  • Cécile LebaudyEmail author
  • Charlène Cool
  • Sandrine Sourdet
  • Antoine Piau
  • Maryse Lapeyre-Mestre
  • Bruno Vellas
  • Philippe Cestac
Research Article
First Online:

Abstract

Background Frailty is a clinical syndrome highly predictive of functional decline after a stress or a medical event, such as adverse drug events. Objective To describe the prevalence of potentially inappropriate prescribing in a population of frail elderly patients. Setting Geriatric day hospital for assessment of frailty and prevention of disability, Toulouse, France. Method A cross-sectional study performed from January to April 2014. Two pharmacists retrospectively analyzed the prescriptions of elderly patients who were sent to the day hospital to assess their frailty and to be given a personalized plan of care and prevention. Potentially inappropriate prescribing was defined by combining explicit criteria: Laroche list, screening tool of older people’s prescriptions, and screening tool to alert to right treatment with an implicit method (drug utilization review for each medication). Prescriptions’ optimizations were then suggested to the geriatricians of the day hospital and classified according to criteria defined by the French Society of Clinical Pharmacy. Main outcome measure Prevalence of potentially inappropriate prescribing. Results Among the 229 patients included, 71.2% had potentially inappropriate prescribing. 76 patients (33.2%) had at least one drug without any valid indication. 51 (22.3%) had at least one drug with an unfavorable benefit-to-risk ratio according to their clinical and biological data, 42 (18.3%) according to the Laroche list and 38 (16.6%) had at least one drug with questionable efficacy. Conclusion Our work shows that the incidence of PIP is high in the frail elderly and that, in most cases, it could be avoided with an adequate and regular reassessment of the prescriptions. In future, prescription optimization will be integrated into the personalized medical care plan to further prevent drug-related disability.

Keywords

Adverse drug event Drug therapy Frail elderly France Inappropriate prescribing 
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Notes

Acknowledgements

We would like to thank members of the team of the “geriatric frailty clinic for assessment of frailty and prevention of disability”.

Funding

None

Conflicts of interest

Bruno Vellas is a Scientific Board Member of Biogen, GSK, Lilly, Lundbeck, Medivation, MSD, Nestlé, Nutricia, Pfizer, Roche, Sanofi, Servier, TauRx Therapeutics, Alzhéon, Transition Therapeutics, Takeda and received Gerontopôle Research Grants from Abbvie, Affiris, Avid, BMS, Eisai, Elan, Envivo, Exhonit, Genentech, GSK, Ipsen, Lilly, Lundbeck, Médivation, MSD, Nutricia, Otsuka, Pharnext, Pfizer, Pierre-Fabre, Régénéron, Roche, Sanofi, Servier, TauRx Therapeutics, Wyeth, Astra-Zénéca, LPG Systems. All the others authors have no conflict of interest to declare.

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Copyright information

© Springer International Publishing 2016

Authors and Affiliations

  • Isabelle Récoché
    • 1
    Email author
  • Cécile Lebaudy
    • 1
    Email author
  • Charlène Cool
    • 1
    • 2
  • Sandrine Sourdet
    • 2
    • 3
  • Antoine Piau
    • 3
  • Maryse Lapeyre-Mestre
    • 2
    • 4
  • Bruno Vellas
    • 2
    • 3
  • Philippe Cestac
    • 1
    • 2
  1. 1.Department of PharmacyCentre Hospitalier Universitaire de ToulouseToulouse Cedex 9France
  2. 2.UMR INSERM 1027University of Toulouse IIIToulouseFrance
  3. 3.Department of Geriatric Medicine University HospitalToulouse Cedex 9France
  4. 4.Department of PharmacologyUniversity HospitalToulouseFrance

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