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Validation d’une méthode de détection des hospitalisations pour chute liées à un effet indésirable médicamenteux en service de gériatrie aiguë.

Auteurs : Vaesken C1, Boulouard VL2, Fedrizzi S3, Abidi H4, Richard H3, Muzard A1, Descatoire P4, Villain C5, Meurant A6
Affiliations : 1Service de Pharmacie, CHU de Caen Normandie, Caen, France.2Normandie Univ, Unicaen, Inserm UMR 1075, COMETE, France, Service de Pharmacologie, CHU de Caen Normandie, Caen, France.3Centre régionale de Pharmacovigilance, CHU de Caen Normandie, Caen, France.
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Date 2023 Décembre 01, Vol 21, Num 4, pp 437-446Revue : Gériatrie et psychologie neuropsychiatrie du vieillissementType de publication : résumé en anglais; article de périodique; étude d'observation; DOI : 10.1684/pnv.2023.1132
Résumé

Fall is one of the five main causes of drug-related hospital admissions (DRA) in France. A standardized chart review method, to identify DRA adapted to elderly patients, has recently been developed by Thevelin et al. Our first aim was to assess the reliability of this method for detecting DRA for falls in elderly subjects. Our second aim was to assess the feasibility of this method and to evaluate its reliability for assessing causality, the contribution of DRA to hospitalization, and the avoidability of DRAs in elderly patients hospitalized for a medication-related fall. A retrospective observational study was conducted on 16 patient cases admitted to the hospital for falls in May 2022, in the geriatric department of a French university hospital. Six healthcare professionals (pharmacists, pharmacologists, and geriatricians) assessed a method for detecting DRA individually and then in multidisciplinary pairs of raters. Inter-rater agreement (individually and in pairs) was assessed for DRA detection, causality, avoidability, and contribution of the DRA to hospitalization. A κ > 0,4 was considered a satisfactory threshold for agreement. The mean age was 86 years. When the assessment was done individually, detection of DRA-related hospitalizations (κ = 0,46; p < ,001), and DRA contribution to hospitalization (κ = 0,50; p < ,001) were moderately concordant. The causality assessment (κ = 0,09; p = 0,24) did not agree, and the avoidability assessment (κ = 0,63; p < ,001) agreed substantially. When the evaluation was done in pairs, detection of DRA-related hospitalizations (κ = 0,47; p < ,001) was moderately concordant between pairs. Avoidability assessment (κ = 0,79; p < ,001) concurred substantially. The assessment of causality (κ = 0,29; p = 0,01) and DRA contribution to hospitalization (κ = 0,38; p < .001) agreed fairly well. This study validated, individually and in pairs, the reliability of the method to identify DRA in the context of falls. This method will be of great use in research and epidemiological studies.

Mot-clés auteurs
adverse drug event; elderly; fall; hospitalization; iatrogeny;
 Source : MEDLINE©/Pubmed© U.S National Library of Medicine
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Vaesken C, Boulouard V, Fedrizzi S, Abidi H, Richard H, Muzard A, Descatoire P, Villain C, Meurant A. Validation d’une méthode de détection des hospitalisations pour chute liées à un effet indésirable médicamenteux en service de gériatrie aiguë. Geriatr Psychol Neuropsychiatr Vieil. 2023 Déc 01;21(4):437-446.
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Dernière date de mise à jour : 31/01/2024.


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