[Causes of medication administration errors in elderly people: a systematic review]. / Causes des erreurs médicamenteuses à l'administration chez la personne âgée : une revue de la littérature.

The elderly are particularly vulnerable to medication administration errors (MAE). To prevent these errors, it is crucial to identify and understand their causes. A review of the literature using the PRISMA method was conducted. Of 2,798 articles, 15 were included in the literature review. The causes identified were divided into 4 categories: patient-related, direct drug-related, healthcare professional-related, and organizational, teamwork, and environmental causes. It was found that the causes were many and varied (n = 56). These were mostly related to physical and cognitive disorders of the patient. Few studies of causes based on empirical data were conducted on this specific subject. The majority of studies were conducted in a health care facility and institution. Therefore, this study cannot provide a comprehensive review of all the risk factors for MAE, especially in the elderly who are capable of administering their medication on their own. To study this topic, a complementary literature review on the causes of non-adherence in the elderly would be necessary.

REview of potentially inappropriate MEDIcation pr[e]scribing in Seniors (REMEDI[e]S): French implicit and explicit criteria.

PURPOSE: To establish a consensus on both explicit and implicit criteria in order to identify potentially inappropriate prescribing (PIP) in French older people aged 75 years and over or 65 years and over with multimorbidity. METHODS: Fifteen experts in geriatrics, general practice, pharmacy, and clinical pharmacology were involved in a two-round Delphi survey to assess preliminary explicit and implicit criteria based on an extensive literature review and up-to-date evidence data. Experts were asked to rate their level of agreement using a 5-level Likert scale for inclusion of criteria and also for rationale and therapeutic alternatives. A consensus was considered as reached if at least 75% of the experts rated criteria as "strongly agreed" or "agreed." RESULTS: The new tool included a seven-step algorithm (implicit criteria) encompassing the three main domains that define PIP (i.e. overprescribing, underprescribing, and misprescribing) and 104 explicit criteria. Explicit criteria were divided into 6 tables related to inappropriate drug duplications (n = 7 criteria), omissions of medications and/or medication associations (n = 16), medications with an unfavourable benefit/risk ratio and/or a questionable efficacy (n = 39), medications with an unsuitable dose (n = 4) or duration (n = 6), drug-disease (n = 13), and drug-drug interactions (n = 19). CONCLUSION: The REMEDI[e]S tool (REview of potentially inappropriate MEDIcation pr[e]scribing in Seniors) is an original mixed tool, adapted to French medical practices, aimed at preventing PIP both at the individual level in clinical practice and the population level in large-scale studies. Therefore, its use could contribute to an improvement in healthcare professionals' prescribing practices and safer care in older adults.