[Prescription drug in the elderly. Study of changes in treatment during a stay in 221 geriatric patients in the Lyon region].

Prescribe in the elderly has specifcities, with age-related pharmacologica modifications, polypharmacy, and risk of drug toxicity. At time of the prescription renewal, each drug must be re-evaluated. The objective of this study was to identify the nature and reasons of drugs modifications during a hospitalization in a geriatric ward, in order to optimize drug prescriptions in elderly and to limit iatrogenic diseases. A descriptive study was carried out with 221 patients hospitalized in 4 geriatrics wards of Lyon region, over a period of 2 months. Prescriptions modifications between admission and exit were studied. Among drugs the most often stopped, we found proton pump inhibitors and serotonin uptake inhibitors. All non steroidal anti inflammatory agents and anti-arthritis drugs, as neary al cerebra vasodilators which were prescribed, were stopped. The reasons for stop were no indication (37 % of cases), adverse effects (13.2 %), inappropriate medication (7.7 %), non demonstrated effectiveness (5.9 %). Drugs overuse concerned above all proton pump inhibitors and antihypertensive agents. Among drugs the most often started, we found paracetamol, morphine, benzodiazepines with short half-life, cholinesterase inhibitors, the most often for an acute pathology (61.7 % of cases). Drugs overuse is therefore predominant, more than inappropriate medication and drugs underuse. To stop needless drugs and drugs which didn't prove their effectiveness would already allow to improve drugs prescription in elderly.