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Role of the community pharmacist in detecting frailty and spatio-temporal disorientation among community-dwelling older people in France

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Abstract

Background

Many older community-dwelling subjects may be frail and/or disoriented, putting them at risk of adverse outcomes. We investigated the prevalence of frailty and spatiotemporal disorientation among patients aged > 65 years collecting regular medication at a community pharmacy.

Methods

Prospective, cross-sectional study of geriatric evaluation in 218 community pharmacies in France. Regular customers aged > 65 years attending the pharmacy to receive ≥ 1 prescription drug were eligible. Spatio-temporal disorientation was assessed using a 4-item screening test; subjects were considered disoriented if they had ≥ 1 incorrect answers. Frailty was evaluated using the Short Emergency Geriatric Assessment (SEGA) grid. Subjects were considered as not frail (score < 8), or frail/very frail (score of 8 or more).

Results

4090 subjects were included, average age 77.5 ± 7.6 years, 60.1% females. Overall, 1025 (25%) were frail/very frail, and 384 (9.4%) were disoriented in space or time. On average, subjects were taking 5.4 ± 3.5 medications per day. Among non-frail patients, 116/3065 (3.8%) were disoriented, of whom 87 (87/116, 75%) managed their medication alone. Among frail/very frail patients, 268/1025 (26.1%) were disoriented, of whom 46 (46/268, 16.8%) managed their medication alone. The majority of patients (77.9%) collected their medication alone at the pharmacy, but significantly fewer frail patients came to collect their drugs alone (p < 0.001).

Conclusion

It is feasible for community pharmacists to detect disorientation and frailty among older patients. A quarter of subjects were frail/very frail, and 3.2% were disoriented yet managing their drugs alone. Additional social support should be envisaged for these subjects.

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Acknowledgements

The authors thank all the participants, investigators, students, and internship supervisors from the six French regions involved in this study, as well as the members of the Scientific Committee. The authors also thank the funding organizations and their representatives (CARSAT Hauts-de-France, Agence National d’Appui à la Performance, Centre Hospitalier Bertinot Juel–Chaumont-en-Vexin) and Mr Joseph Debray for his constant support.

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Authors and Affiliations

  1. General Hospital of Chaumont-en-Vexin, Bertinot Juel Hospital, 34 Bis Rue Pierre Budin, 60240, Chaumont-en-Vexin, France

    Mounir Rhalimi

  2. Pharmacy Faculty of Amiens, University of Picardy Jules Verne, Amiens, France

    E. Housieaux, A. Mary & M. Brazier

  3. Pharmacy Faculty of Rouen, University of Rouen-Normandy, Mont-Saint-Aignan, France

    C. Detuncq

  4. Pharmacy Faculty of Montpellier, University Paul-Valéry-Montpellier, Montpellier, France

    A. Muller & F. Georgin

  5. Pharmacy Faculty of Limoges, University of Limoges, Limoges, France

    F. Comby

  6. Pharmacy Faculty of Strasbourg, University of Strasbourg, Strasbourg, France

    C. Wehrlé

  7. Pharmacy Faculty of Rennes, University of Rennes, Rennes, France

    N. Davoust

  8. University Hospital of Amiens-Picardy, Amiens, France

    A. Mary & M. Brazier

Authors
  1. Mounir Rhalimi
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  2. E. Housieaux
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  3. A. Mary
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  8. C. Wehrlé
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  9. N. Davoust
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  10. M. Brazier
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Corresponding author

Correspondence to Mounir Rhalimi.

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Conflict of interest

The authors have no conflicts of interest to declare.

Statement of human rights, ethics approval

Authorization was obtained from the Ethics Committee (Comité de Protection des Personnes Nord-Ouest II) on January 13, 2017 (N° ID-RCB 2016-A017751-46, Ref. CPP 2016/107).

Informed consent

In accordance with the recommendations of the Ethics Committee, an information leaflet was given to each patient.

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The opinions expressed are those of the authors. The funders had no role in the design, methods, data collection, analysis, or preparation of this paper.

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Rhalimi, M., Housieaux, E., Mary, A. et al. Role of the community pharmacist in detecting frailty and spatio-temporal disorientation among community-dwelling older people in France. Aging Clin Exp Res 33, 1645–1650 (2021). https://doi.org/10.1007/s40520-020-01673-2

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  • DOI: https://doi.org/10.1007/s40520-020-01673-2

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