Influence of hospitalisation on the elderly people polypharmacy

Introduction. - The objective of this study was to analyse the influence of hospitalisation on the polypharmacy of elderly people in internal medicine. Methods. - Prescriptions before hospitalisation and after discharge were prospectively collected and analysed. The percentages of pharmaceutical medication classes used before and after hospitalisation were compared using marginal homogeneity's test for paired series. Results. - One hundred and sixteen patients (mean age: 79 years) were included in this study. The number of drugs prescribed amounted to 6.4 before hospitalisation and 6.7 at discharge. Hospitalisation did not lead to reduction in the amount of prescribed drugs but some medications were modified. We observed a significant reduction in beta-blockers (25 to 19.8%, P = 0.035) and lipid-lowering drugs (21.6 to 15.5%, P = 0.058). On the other hand, the laxative medication was increased at discharge (19.8 to 34.5%, P = 0.001). Similarly, there was an increase in psycholeptic drugs after hospitalisation (34.5 to 44%, P = 0.007). Conclusion. - These results pointed out firstly the polypharmacy observed in elderly patients and secondly the difficulty to reassess prescriptions. Our results should heighten clinicians' awareness of polypharmacy of elderly patients and of the usefulness of performing an individual assessment of the various drugs prescribed to a patient. The hierarchical organisation of disorders and drugs should allow to optimise the safety of the medications and decrease iatrogenic events. (c) 2008 Publie par Elsevier Masson SAS.