How a Patient Personalised Clinical Pharmacy Programme Can Secure Therapeutic Care in an Orthogeriatric Care Pathway (5P Project)? - Archive ouverte HAL
Article Dans Une Revue Clinical Interventions in Aging Année : 2021

How a Patient Personalised Clinical Pharmacy Programme Can Secure Therapeutic Care in an Orthogeriatric Care Pathway (5P Project)?

Marine Barral
  • Fonction : Auteur
Julie Martin
  • Fonction : Auteur
Emmanuelle Carre
  • Fonction : Auteur
Florence Ranchon
  • Fonction : Auteur
Stéphanie Parat
  • Fonction : Auteur
Catherine Rioufol
  • Fonction : Auteur
Sylvain Goutelle
  • Fonction : Auteur
Laurent Bourguignon
  • Fonction : Auteur
Teddy Novais
  • Fonction : Auteur
Sebastien Doh
  • Fonction : Auteur
Matthieu Malatray
  • Fonction : Auteur
Philippe Chaudier
  • Fonction : Auteur
Jerome Gauthier
  • Fonction : Auteur
Christine Pivot
  • Fonction : Auteur
Christelle Mouchoux
  • Fonction : Auteur

Résumé

Background: A new model was developed for integrating a personalised clinical pharmacy programme (5P project) into the orthogeriatric care pathway. Objective: To secure the therapeutic care of orthogeriatric patients. Design and setting: Prospective descriptive study in a multisite teaching hospital from June 2019 to January 2020. Subjects: Patients aged ≥75 years admitted for hip fracture. Methods: A prescription review was performed for all patients at inclusion. Other clinical pharmacy activities (additional prescription review, pharmaceutical interviews, medication reconciliation) were dedicated to "high-risk" patients. Potential medication errors (ME), either pharmaceutical interventions (PI) or unintentional discrepancies (UID), were recorded. The potential clinical impact of PI was evaluated by a pluriprofessional expert panel using a validated tool. Results: In the 455 patients included, 955 potential ME were detected, that is ≥1 potential ME for 324/455 (71%) patients. In acute care, 561 PI were formulated during prescription review for 440/455 (97%) patients and 348/561 (62%) were accepted by physicians. Medication reconciliation was performed for 213 patients, 316 UID were identified. In rehabilitation units, a second prescription review was performed for 112/122 (92%) "high-risk" patients, leading to 61 PI. The clinical impact was evaluated for 519/622 (83%) PI. A consensus was obtained for 310/519 (60%) PI: 147/310 (47%) were rated as having minor clinical impact, 138/310 (45%) moderate, 22/310 (7%) major, 2/310 (0.6%) vital, and 1/310 (0.3%) null. Conclusion: The 5P project secured the orthogeriatric care pathway by detecting a great number of potential ME, including PI mostly considered as having a significant clinical impact.
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Dates et versions

hal-04664839 , version 1 (30-07-2024)

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Marine Barral, Julie Martin, Emmanuelle Carre, Audrey Janoly-Dumenil, Florence Ranchon, et al.. How a Patient Personalised Clinical Pharmacy Programme Can Secure Therapeutic Care in an Orthogeriatric Care Pathway (5P Project)?. Clinical Interventions in Aging, 2021, Volume 16, pp.1857-1867. ⟨10.2147/cia.s325035⟩. ⟨hal-04664839⟩
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