[Hospital medication adherence scale development in cardiovascular disorders]. / Validation d'une échelle de mesure de l'adhésion médicamenteuse cardiovasculaire utilisable en contexte hospitalier.

OBJECTIVES: The consequences of non-adherence to prescribed cardiovascular drugs can be serious, with cardiovascular complications having been reported in both secondary and primary prevention. The objective of this study was to develop a new scale to assess medication adherence in patients with cardiovascular diseases during their hospitalization. METHODS: A cohort of 219 high risk cardiovascular patients was evaluated for this study. Data on reasons for non-adherence were collected using the newly developed Medication Adherence Scale in Cardiovascular disorders (Mascard) and compared with physician assessment during medical consultations and the control of their cardiovascular risk factors. RESULTS: The Mascard consists of 5 items has good psychometric properties and validity and correlated with physician assessment and control of cardiovascular risk factors. CONCLUSIONS: This rapid and easy to use scale may be useful for health care practitioners in their assessment of medication adherence in inpatients with cardiovascular disorders.

[Benefit of the geriatric mobile unit's intercession on the quality of medical prescriptions for the elderly: Past year assessment]. / Intérêt de l'intervention de l'unité d'évaluation gériatrique dans la cité sur la qualité des prescriptions médicamenteuses de la personne âgée : bilan à 1 an.

Our multidisciplinary geriatric mobile unit works in behalf of the frail elderly people, aged at least 75, who are in loss of self-reliance. One of its main aims is so optimize medical prescriptions. The purpose of this study was to show the benefit of geriatrician and pharmacist interventions over the quality of medical prescriptions for the elderly. Medication reconciliation of treatment and reassessment of the appropriateness of the prescriptions was systematically carried out. The problems related to drug therapy have been listed and classified according to the criteria of pharmaceutical interventions defined by the French Society of Clinical Pharmacy (SFPC). Out of 181 patients, 86,2% had potentially an inappropriate or sub-optimal prescription. Finally, 462 optimizations were proposed (2.9±1.9 by patients): 204 withdrawals, 166 additions, 58 dosage adaptations, 21 therapeutic follow-ups and 13 modalities of administration. This reassessment of the prescriptions allowed to develop between our geriatric mobile unit and the liberal professionals a communication focused on the therapeutic optimization and to spread recommendations on the proper use of drugs in the elderly population.

A one-day survey of characteristics of off-label hospital prescription of psychotropic drugs.

INTRODUCTION: The aim of this study was to explore the characteristics of off-label prescriptions of psychotropic drugs among patients hospitalised in psychiatry. METHODS: A one-day cross-sectional study was used to explore off-label prescribing in patients hospitalised in four wards of a state psychiatric hospital. Information regarding patients and treatment characteristics was collected from medical records. Off-label prescribing was defined according to the Summary of Product Characteristics. RESULTS: Seventy-five patients were included. Of the 261 prescriptions, more than one out of three (n=104, 39.8%) were off-label. Off-label prescribing was particularly high for anticonvulsants (97%), and to a lesser extent for mood stabilisers (33%) and anxiolytics (31%). The rate of off-label prescription was higher for 2nd compared to 1st generation antipsychotics. Most patients (84%) were prescribed at least one psychotropic drug outside of the licensed indication or recommended dosage. Patients with and without off-label prescription did not differ regarding history of prior admission, type of current admission (voluntary vs. compulsory) and diagnosis. CONCLUSION: In spite of its frequency in routine practice, off-label prescribing should not be trivialised. Prescribers should be better informed about the potential legal consequences of off-label prescribing.