Premium
Impact of recommendations on crushing medications in geriatrics: from prescription to administration
Author(s) -
Bourdenet Gwladys,
Giraud Sophie,
Artur Marion,
Dutertre Sophie,
Dufour Marie,
LefèbvreCaussin Marie,
Proux Alice,
Philippe Sandrine,
Capet Corinne,
FontaineAdam Magali,
Kadri Karine,
Landrin Isabelle,
Gréboval Emmanuelle,
Touflet Myriam,
Nanfack Jules,
Tharasse Christine,
Varin Rémi,
Rémy Elise,
Daouphars Mikaël,
Doucet Jean
Publication year - 2015
Publication title -
fundamental and clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.655
H-Index - 73
eISSN - 1472-8206
pISSN - 0767-3981
DOI - 10.1111/fcp.12116
Subject(s) - medicine , medical prescription , geriatrics , prospective cohort study , geriatric care , swallowing , emergency medicine , surgery , pharmacology , nursing , psychiatry
The practice of crushing drugs is very common in geriatric units. In 2009 a first study, performed in all geriatric units of a university hospital, showed that numerous errors were made during prescription, preparation and administration. The aim of this second prospective study was to assess the impact of regional and national recommendations in the same geriatric units. A survey of 719 patients (85.3 ± 6.7 years) was performed in 2013. For each patient who received crushed drugs, we recorded the reason the drugs were crushed, pharmacological classes, galenic presentations and the technique used for preparation and administration. Results were compared to the previous study. The number of patients receiving drugs after crushing was significantly lower than in the previous study (22.9% vs. 32.3%, P < 0.001). The number of crushed drugs was lower too (594 per 165 patients vs. 966 per 224 patients ( P < 0.01). The main indication for crushing drugs remained swallowing disorders. The dosage form prevented crushing in 24.9% of drugs (vs. 42.0% in 2009, P < 0.001), but the drugs generally remained crushed all together. A mortar was used less often (38.6% vs. 92.6%, P < 0.001), with preference for individual‐specific cups (56.1%). Mortars were more often cleaned between each patient (56.0% vs. 11.6%). The vehicle was more often neutral (water 88.5% vs. 5.7%, P < 0.001). This second study shows that regional and national recommendations have led to an overall improvement of practices for crushing drugs. Technical improvements are still possible, in association with appropriate pharmacological studies.