Usage des médicaments potentiellement inappropriés chez les aînés admis aux urgences du Centre hospitalier universitaire de Limoges (France) : une comparaison entre les femmes et les hommes

Objectifs : Decrire et comparer les medicaments potentiellement inappropries utilises par les femmes et les hommes âges lors de leur visite aux urgences du Centre hospitalier universitaire de Limoges (France). Methode : Nous avons realise une etude transversale retrospective chez les aines multimorbides de 75 ans et plus vus a l’urgence entre le 1er fevrier et le 20 avril 2017. Les medicaments et les associations potentiellement inappropries ont ete definis selon les criteres de Laroche. Des analyses descriptives ont ete realisees en comparant les femmes et les hommes. Resultats : Les 330 patients inclus dans l’etude (âge moyen : 87,9 ± 5,5 ans; 63 % femmes) consommaient en moyenne 7,7 ± 3,5 medicaments. Le tiers (n = 110) avait au moins un medicament potentiellement inapproprie. Les medicaments potentiellement inappropries (n = 140) representaient 5,5 % de la medication totale recensee (n = 2563). Parmi ceux-ci, les benzodiazepines etaient les plus frequents (37 %). Les classes de medicaments potentiellement inappropries ne differaient pas entre les sexes, mais davantage de femmes en consommaient deux ou plus (29 % vs 17 %, p = 0,16). Les associations potentiellement inappropriees etaient presentes chez 179 patients (54 %). Les plus frequentes comprenaient l’association de deux medicaments anticholinergiques (n = 92). Les femmes etaient plus susceptibles que les hommes de recevoir des associations de medicaments anticholinergiques (p = 0,05). Conclusion : La detection des medicaments potentiellement inappropries pourrait enclencher un processus de revision pharmacologique et favoriser une vigilance supplementaire au regard des effets indesirables potentiels et des associations inappropriees. Autant les femmes que les hommes âges pourraient en beneficier. Abstract Objectives: To describe and compare potentially inappropriate medications used by elderly women and men during their visit to the emergency department of the Centre hospitalier universitaire de Limoges (France). Method: We conducted a retrospective cross-sectional study in multimorbid elderly patients 75 years of age and older seen in the Emergency Department between February 1 and April 20, 2017. Potentially inappropriate medications and combinations were defined according to the Laroche criteria. Descriptive analyses were performed in which women and men were compared. Results: The 330 patients included in the study (mean age: 87.9 ± 5.5 years; 63% women) were using a mean of 7.7 ± 3.5 medications. One-third (n =110) had at least one potentially inappropriate medication. Potentially inappropriate medications (n = 140) accounted for 5.5% of the total medication count (n = 2563). Of these, benzodiazepines were the most common (37%). There were no gender differences in terms of the classes of potentially inappropriate drugs, but more women used two or more of them (29% vs. 17%; p = 0.16). Potentially inappropriate combinations were present in 179 patients (54%). The most common ones included the combination of two anticholinergic drugs (n = 92). Women were more likely than men to receive combinations of anticholinergics (p = 0.05). Conclusion: The identification of potentially inappropriate medications could trigger a drug review process and promote additional vigilance for potential adverse effects and inappropriate combinations. Both elderly women and men could benefit from this.