Influence de l’hospitalisation sur la prescription médicamenteuse dans l’hypertension artérielle et les maladies chroniques

Abstract: Objectives: To evaluate the influence of hospitalization on drug prescription in chronic conditions. Methods: Admission and discharge prescriptions from 92 patients consecutively admitted in a specialized department of the Assistance Publique–Hôpitaux de Paris hospital were recorded in a prospective two-month study. A Qualitative Therapeutical Score (QTS) was calculated as an estimation of qualitative modifications in the prescription. Results: Patients admitted for an hospital stay of over 24h have more lines of prescription than patients admitted for an hospitalization shorter than 24h (5.7±4.2/d vs 2.9±2.5/d, P <0.01). For all the patients enrolled, the hospital stay is not associated with any change in the global number of treatments. However, in patients treated with antihyperstensive drug, the number of drug intakes decreases (2.6±1.5/d vs 1.9±1.4/d, P <0.05) as a consequence of an increase in the prescription of fixed-dose combinations. In patients with cardiovascular diseases, the QTS is higher and qualitative modifications are more often found in patients admitted for an hospital stay of over 24h than for those admitted for a an hospitalization shorter than 24h (0.57 vs 0.11; P <0.01 and 31% vs 11%; P <0.05 respectively). Antihypertensive drugs are the most represented drugs within these qualitative modifications. Conclusion: In patients with drug treatments for arterial hypertension or chronic conditions, hospitalization is not associated with quantitative but with qualitative modifications, especially for an over 24h hospital stay. [Copyright &y& Elsevier]