[验证检测老年病科因药物不良反应导致跌倒住院的方法]。

IF 0.4 4区 医学 Q4 PSYCHIATRY Geriatrie et Psychologie Neuropsychiatrie De Vieillissement Pub Date : 2023-12-01 DOI:10.1684/pnv.2023.1132
Céline Vaesken, Véronique Lelong Boulouard, Sophie Fedrizzi, Hiba Abidi, Hazel Richard, Alexandra Muzard, Pablo Descatoire, Cédric Villain, Alexandre Meurant
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引用次数: 0

摘要

在法国,跌倒是导致药物相关入院(DRA)的五大原因之一。Thevelin 等人最近开发了一种标准化病历审查方法,用于识别老年患者的 DRA。我们的第二个目的是评估该方法的可行性,并评价其在评估因果关系、DRA 对住院的影响以及因药物相关跌倒而住院的老年患者中 DRA 的可避免性方面的可靠性。法国一所大学医院的老年病科于 2022 年 5 月对 16 例因跌倒入院的患者进行了回顾性观察研究。六名医护专业人员(药剂师、药理学家和老年病学家)分别对一种检测 DRA 的方法进行了评估,然后由多学科评定员对该方法进行了评定。在 DRA 检测、因果关系、可避免性以及 DRA 对住院治疗的影响等方面,对评分者之间的一致性(个人和两人)进行了评估。κ>0.4被认为是令人满意的一致性阈值。平均年龄为 86 岁。在单独进行评估时,与 DRA 相关的住院治疗的检出率(κ = 0.46; p
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[Validation of a method for detecting hospitalizations for falls related to adverse drug reactions in geriatric departments].

Fall is one of the five main causes of drug-related hospital admissions (DRA) in France. A standardized chart review method, to identify DRA adapted to elderly patients, has recently been developed by Thevelin et al. Our first aim was to assess the reliability of this method for detecting DRA for falls in elderly subjects. Our second aim was to assess the feasibility of this method and to evaluate its reliability for assessing causality, the contribution of DRA to hospitalization, and the avoidability of DRAs in elderly patients hospitalized for a medication-related fall. A retrospective observational study was conducted on 16 patient cases admitted to the hospital for falls in May 2022, in the geriatric department of a French university hospital. Six healthcare professionals (pharmacists, pharmacologists, and geriatricians) assessed a method for detecting DRA individually and then in multidisciplinary pairs of raters. Inter-rater agreement (individually and in pairs) was assessed for DRA detection, causality, avoidability, and contribution of the DRA to hospitalization. A κ > 0,4 was considered a satisfactory threshold for agreement. The mean age was 86 years. When the assessment was done individually, detection of DRA-related hospitalizations (κ = 0,46; p < ,001), and DRA contribution to hospitalization (κ = 0,50; p < ,001) were moderately concordant. The causality assessment (κ = 0,09; p = 0,24) did not agree, and the avoidability assessment (κ = 0,63; p < ,001) agreed substantially. When the evaluation was done in pairs, detection of DRA-related hospitalizations (κ = 0,47; p < ,001) was moderately concordant between pairs. Avoidability assessment (κ = 0,79; p < ,001) concurred substantially. The assessment of causality (κ = 0,29; p = 0,01) and DRA contribution to hospitalization (κ = 0,38; p < .001) agreed fairly well. This study validated, individually and in pairs, the reliability of the method to identify DRA in the context of falls. This method will be of great use in research and epidemiological studies.

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来源期刊
CiteScore
0.70
自引率
16.70%
发文量
0
审稿时长
6-12 weeks
期刊介绍: D''une qualité scientifique reconnue cette revue est, la première revue francophone gériatrique et psychologique indexée dans les principales bases de données internationales. Elle couvre tous les aspects médicaux, psychologiques, sanitaires et sociaux liés au suivi et à la prise en charge de la personne âgée. Que vous soyez psychologues, neurologues, psychiatres, gériatres, gérontologues,... vous trouverez à travers cette approche originale et unique, un veritable outil de formation, de réflexion et d''échanges indispensable à votre pratique professionnelle.
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