title: [Adaptations of psychotropic drugs in patients aged 75 years and older in a departement of geriatric internal medecine: report of 100 cases].
abstract: The elderly often with multiple diseases are particularly at risk from adverse drug reactions. Nearly half of iatrogenic drug in the elderly are preventable. Some medications such as psychotropic drugs are particularly involved in iatrogenic accidents. We wanted to know if the tools of the comprehensive geriatric assessment or other factors could influence the changes of psychotropic drugs in a geriatric departement. Our prospective study of four months in 100 patients aged 75 years and older hospitalized in the Geriatric Internal Medecine Departement of University Hospital of Nice investigated what were the clinical or biological reasons and tools used during changes of psychotropic drugs. We compared these changes according to the comprehensive geriatric assessment tools and we analyzed the changes based on lists of potentially inappropriate medications by Laroche et al. and from the instrument STOPP/START. The Mini Mental State Examination (MMSE) was the tool that has most influenced the changes in psychotropic including a tendency to increase and the introduction of anxiolytics when MMSE < 20 (p = 0.007) while neuroleptics instead arrested and decreased (p = 0.012). The comprehensive geriatric assessment has its place in decision support during the potentially iatrogenic prescriptions of drugs such as psychotropic and new tools such as STOPP/START can also be a help to the prescriber informed.
authors.affiliation: Pôle de gérontologie, CHU de Nice, Hôpital de Cimiez, NicePôle de gérontologie, CHU de Nice, Hôpital de Cimiez, Nice. couderc.a@chu-nice.fr
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Couderc
authors.forename: Cindy
authors.initials: C
authors.lastname: Bailly-Agaledes
authors.forename: Joëlle
authors.initials: J
authors.lastname: Camalet
authors.forename: Françoise
authors.initials: F
authors.lastname: Capriz-Ribière
authors.forename: André
authors.initials: A
authors.lastname: Gary
authors.forename: Philippe
authors.initials: P
authors.lastname: Robert
authors.forename: Patrice
authors.initials: P
authors.lastname: Brocker
authors.forename: Olivier
authors.initials: O
authors.lastname: Guérin
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000009:adverse effects / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015897:Comorbidity; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004347:Drug Interactions; D057915:Drug Substitution; D005602:France; D015577:Geriatric Assessment / Q000379:methods; D005853:Geriatrics; D006748:Hospital Departments; D006785:Hospitals, University; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use; D007388:Internal Medicine; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000009:adverse effects* / Q000627:therapeutic use*
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D011619:Psychotropic Drugs