[What happens to therapeutic changes decided during hospitalization in an internal medicine ward? A two-month single-centre prospective study in France].
OBJECTIVE
During a hospitalization in an internal medicine department, drug prescriptions are frequently modified. We studied the course of these therapeutic changes after patients' discharge.


METHODS
Eighty-four patients with a long-term drug prescription and a registered general practitioner were included on the day of their discharge from an internal medicine department in Paris. Their medications before and after the hospitalization were established according to the discharge letter, and patients were contacted two months after discharge in order to assess the modifications that could have occurred during these two months after discharge.


RESULTS
Medications prescribed before the admission were often preserved, 17.7% were withdrawn, and 7% were switched to another medication. Two months after discharge, 85% of the modifications were maintained, the discharge drug prescription was renewed without a change for 77% of the patients. The drug classes that were the more frequently modified during the hospital stay were the antihypertensive therapies, with 65% of sustained modifications at two months, and analgesics, with 75% of sustained modifications. Therapeutic changes that were explained in the discharge letter were more frequently preserved at two months than those that were not explained (100% versus 79%, 95%CI of the difference [0.09-0.27]; P<0.0001).


CONCLUSIONS
Therapeutic changes decided during a hospitalization in an internal medicine unit and prescribed at discharge are mostly preserved in outpatients two months after discharge, especially when the modifications are explained in the discharge letter.
Service de médecine interne A, université Sorbonne Paris-Cité-Diderot, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France. Electronic address: martin.coutellier@free.fr.
M
M
Coutellier
Service de médecine interne A, université Sorbonne Paris-Cité-Diderot, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
S
S
Mouly
Service de médecine interne A, université Sorbonne Paris-Cité-Diderot, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
V
V
Delcey
Service de médecine interne A, université Sorbonne Paris-Cité-Diderot, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
A
A
Lopes
Service de médecine interne A, université Sorbonne Paris-Cité-Diderot, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
C
C
Lloret-Linares
Service de médecine interne A, université Sorbonne Paris-Cité-Diderot, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
J-F
JF
Bergmann
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D019587:Dietary Supplements / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006785:Hospitals, University; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007297:Inpatients / Q000706:statistics & numerical data*; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D010297:Paris; D055553:Prescription Drugs; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D013997:Time Factors; D016903:Drug Monitoring
D000700:Analgesics; D000925:Anticoagulants; D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents; D055553:Prescription Drugs; D054328:Proton Pump Inhibitors; D001569:Benzodiazepines
Continuity of care; Continuité des soins; General practice; Hospitalisation; Hospitalization; Médecine générale; Prescriptions