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DEPRESCRIBING IN OLDER ADULTS: LET’S TALK!

European Statement

Clinical Pharmacy Services

Author(s)

Steffy LEFAKOUONG, Mohamed MOSTEFA, Sarah BARBIEUX, Sophie VERNARDET, Isabelle LEFORT

Why was it done?

Institutional and multidisciplinary work has been carried out in the hospital since 2022 on reducing prescriptions of potentially inappropriate medications (PMIs) in older population (OP), in accordance with french recommandations.

What was done?

Our aim is to raise awareness among medical staff on the prescription of PMIs in OP through continuing education (CE) courses.

How was it done?

A PMI-specialized team composed of 2 geriatricians, 1 pharmacist and 1 pharmacy intern was formed.
CE is planned in the form of a structured medication review describing clinical cases based on discharge prescriptions of hospitalized patients, selected according to several criterias: >75 years old, ≥1 PMI on the prescription.
These prescriptions are analyzed by the specialized team using various reference documents, with a relevance audit grid provided by the regional drug authority as a basis.
The first MR was presented to the doctors and residents of the establishment’s various departments during a joint session.
A satisfaction survey was created to assess the interest and relevance of the course.

What has been achieved?

For our first session, we selected 3 prescriptions : two containing 4 PMIs each and one containing 2 PMIs.
A detail of each PMI was carried out with a focus on two main themes : deprescribing long-acting benzodiazepines and proton pump inhibitors.
Besides PMIs, a comprehensive prescription analysis was done by mentioning inadequate prescriptions from a geriatric medical view.
In total, we have a participation of 100% of the pharmacists, 89% of the geriatricians and 100% of pharmacy residents. Among the other departments, only 3 other physicians participated in the course.
According to the survey, 100% of participants said they were satisfied with the session and 44% wanted more interactive training.

What next?

The high participation of pharmacists and geriatricians, 2 teams of interest in the process of deprescribing MPIs, highlights the usefulness of this CE among healthcare professionals.
The structure of the session encourages constructive and collaborative exchanges while comparing visions of different professionals.
Nonetheless, a reflection on our approach’s appeal is necessary in order to increase the participation rate of physicians and medical residents absent during the session.
The satisfaction rate remains encouraging, and pushes us to renew this training periodically.

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