Améliorer la prescription et la surveillance médicamenteuse chez les résidents des EHPAD : rôles du comité thérapeutique ville-hôpital

Iatrogenic risk is high in elderly patients with multiple pathologies due to multiple medications. Epidemiological studies showed this to be an important phenomenon leading to hospital admission and death. The most dangerous categories of drugs are those that are the most often prescribed: oral anticoagulant, antihypertensive, oral antidiabetic and psychotropic drugs. A local nursing home network in the south Seine-Saint-Denis area of France launched a drug-management project, setting up a drug and therapeutics committee bringing together nursing-home and hospital staff and drawing up therapeutic guidelines. The present study assessed the impact of the coordination achieved by the committee, and the main factors leading to hospital admission related to drug iatrogenesis. Reducing admission rates requires improved monitoring of high-risk drug categories and effective implementation of guidelines by prescribers.