{"id":1975,"date":"2013-10-01T01:00:00","date_gmt":"2013-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/evaluation-des-pratiques-professionnelles-sur-la-pertinence-des-prescriptions-des-ipp-dans-un-centre-hospitalier-general\/"},"modified":"2018-10-20T18:40:08","modified_gmt":"2018-10-20T16:40:08","slug":"evaluation-des-pratiques-professionnelles-sur-la-pertinence-des-prescriptions-des-ipp-dans-un-centre-hospitalier-general","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/evaluation-des-pratiques-professionnelles-sur-la-pertinence-des-prescriptions-des-ipp-dans-un-centre-hospitalier-general\/","title":{"rendered":"Evaluation des pratiques professionnelles sur la pertinence des prescriptions des IPP dans un centre hospitalier g\u00e9n\u00e9ral."},"content":{"rendered":"

2013<\/strong><\/p>\n

Gilles Macaigne (1), C\u00e9line Saint-Laurent (2), Catherine Cuvelier (2), Florence Harnois (1), Brigitte Loison (2). service d\u2019h\u00e9pato-Gastro-Ent\u00e9rologie (1) \u2013 Pharmacie (2). Centre Hospitalier de Marne la Vall\u00e9e.<\/em><\/p>\n

Gastroent\u00e9rologie <\/strong>– \u00a02013-05-08 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

INTRODUCTION
\nLes inhibiteurs de la pompe \u00e0 protons (IPP) sont largement prescrits en ville et \u00e0 l\u2019h\u00f4pital. Ils repr\u00e9sentent un budget important de remboursement pour l\u2019assurance maladie, et bien qu\u2019ils poss\u00e8dent une bonne tol\u00e9rance \u00e0 court terme, leur utilisation au long cours peut exposer \u00e0 des risques d\u2019effets ind\u00e9sirables graves.
\nL\u2019objectif de ce travail est d\u2019\u00e9valuer la conformit\u00e9 des prescriptions aux recommandations valid\u00e9es pour tous les patients hospitalis\u00e9s dans un centre hospitalier g\u00e9n\u00e9ral. <\/p>\n

PATIENTS ET METHODES
\nIl s\u2019agit d\u2019une \u00e9tude prospective men\u00e9e sur une journ\u00e9e au cours de laquelle toutes les prescriptions d\u2019IPP des services d\u2019hospitalisation du Centre Hospitalier de Lagny Marne la Vall\u00e9e ont \u00e9t\u00e9 collig\u00e9es. Le recueil des donn\u00e9es a \u00e9t\u00e9 r\u00e9alis\u00e9 \u00e0 partir d\u2019un questionnaire comportant des informations relatives au patient (\u00e2ge, ant\u00e9c\u00e9dents,..), aux traitements associ\u00e9s, \u00e0 la posologie et \u00e0 l\u2019indication de l\u2019IPP prescrit. La validit\u00e9 des prescriptions a \u00e9valu\u00e9 au regard de l\u2019AMM et des recommandations \u00e9mises par HAS, AFSSaPS et l\u2019ACCF\/ACG\/AHA.<\/p>\n

RESULTATS
\nAu cours de cette journ\u00e9e, 142 patients ont re\u00e7u un traitement par IPP, soit 34% des patients pr\u00e9sents dans l\u2019\u00e9tablissement (hors h\u00f4pital de jour). Les services les plus prescripteurs \u00e9taient la cardiologie, la r\u00e9animation et la pneumologie avec respectivement 68%, 55% et 50% des patients hospitalis\u00e9s. Pour la moiti\u00e9 des prescriptions le traitement a \u00e9t\u00e9 initi\u00e9 avant l\u2019arriv\u00e9e du patient dans le service. Les IPP \u00e9taient essentiellement prescrits par voie orale (89%) avec une posologie moyenne de 26 \u00b1 15 mg, et de 65 \u00b1 32mg pour la voie intraveineuse. La voie injectable n\u2019\u00e9tait pas justifi\u00e9e pour 44% (7\/16) des cas. La prise d\u2019IPP \u00e9tait matinale dans 52% des cas. Pour 18% des patients, l\u2019indication n\u2019\u00e9tait pas connue du m\u00e9decin, essentiellement du fait d\u2019une initiation de traitement par le m\u00e9decin de ville (70% des cas). Seules 30% des indications recens\u00e9es correspondaient \u00e0 celles de l\u2019AMM. Parmi les prescriptions hors AMM, on notait la pr\u00e9vention du risque h\u00e9morragique en cas de traitement antiagr\u00e9gant plaquettaire par d\u2019aspirine \u00e0 faible dose chez les sujets \u00e0 risque (34%) et la pr\u00e9vention de l\u2019ulc\u00e8re de stress en r\u00e9animation (8%). Les principales indications hors AMM et hors recommandations \u00e9tait la pr\u00e9vention de la gastrite et des douleurs \u00e9pigastriques (32%), la carence martiale et anorexie (23%), la pr\u00e9vention des l\u00e9sions gastro-duod\u00e9nales en cas de traitement par cortico\u00efde ou anticoagulant ou antiagr\u00e9gant plaquettaire en l\u2019absence de facteurs de risque (16%). Ces indications non valides sont retrouv\u00e9es majoritairement dans les services de g\u00e9riatrie (23%), m\u00e9decine interne et diab\u00e9tologie (21%), cardiologie (10%). Seules 42% des prescriptions sont conformes pour l\u2019indication, la posologie et la voie d\u2019administration.<\/p>\n

CONCLUSION
\nLes r\u00e9sultats de notre travail confirment que la prescription d’IPP est tr\u00e8s fr\u00e9quente (34% des malades hospitalis\u00e9s), souvent inappropri\u00e9e pour les modalit\u00e9s d\u2019administration et le respect des indications de l\u2019AMM (30% de conformit\u00e9).
\nSuite \u00e0 cette \u00e9valuation des pratiques professionnelles concernant la prescription des IPP dans notre \u00e9tablissement, des axes d\u2019am\u00e9liorations ont \u00e9t\u00e9 d\u00e9gag\u00e9s, comme la sensibilisation des m\u00e9decins \u00e0 l\u2019\u00e9valuation de la pertinence des indications hors AMM et \u00e0 la r\u00e9\u00e9valuation des prescriptions \u00e0 l\u2019entr\u00e9e du patient dans le service. Ces donn\u00e9es sont reprises dans une fiche m\u00e9mo sur le bon usage des IPP et sera diffus\u00e9e \u00e0 l\u2019ensemble des prescripteurs de l\u2019h\u00f4pital.<\/p>\n","protected":false},"excerpt":{"rendered":"

2013 Gilles Macaigne (1), C\u00e9line Saint-Laurent (2), Catherine Cuvelier (2), Florence Harnois (1), Brigitte Loison (2). service d\u2019h\u00e9pato-Gastro-Ent\u00e9rologie (1) \u2013 Pharmacie (2). Centre Hospitalier de Marne la Vall\u00e9e. Gastroent\u00e9rologie – \u00a02013-05-08 –\u00a0CO – ________________________________ INTRODUCTION Les inhibiteurs de la pompe \u00e0 protons (IPP) sont largement prescrits en ville et \u00e0 l\u2019h\u00f4pital. Ils repr\u00e9sentent un budget […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[4],"tags":[24],"class_list":["post-1975","post","type-post","status-publish","format-standard","hentry","category-gastroenterologie","tag-24"],"yoast_head":"\nEvaluation des pratiques professionnelles sur la pertinence des prescriptions des IPP dans un centre hospitalier g\u00e9n\u00e9ral. - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/evaluation-des-pratiques-professionnelles-sur-la-pertinence-des-prescriptions-des-ipp-dans-un-centre-hospitalier-general\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Evaluation des pratiques professionnelles sur la pertinence des prescriptions des IPP dans un centre hospitalier g\u00e9n\u00e9ral. - 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