A multidisciplinary meeting for generating a personalized pharmaceutical plan for older adults at hospital discharge: the IATROPREV study.

Abstract

Aims: The French government's IATROPREV program has been designed to assess the effectiveness and safety of medications prescribed to older adults discharged from acute geriatric units. IATROPREV includes the implementation of a personalized pharmaceutical plan validated at a multidisciplinary meeting attended by the patient's geriatrician, family physician, community pharmacist and hospital pharmacist. We hypothesized that a multidisciplinary meeting on discharge from hospital will enable the recommendations to be largely followed up.

Methods: A prospective, observational, multicentre study was conducted to analyse the personalized pharmaceutical plan and follow-up at 45 and 90 days for patients discharged from an acute geriatric unit between February 2021 and August 2023.

Results: Of 708 eligible patients, 380 (54%) were included. The main reason for non-inclusion was the family physician's refusal to participate. A total of 5977 recommendations (i.e., an average of 15 per patient) were issued during the multidisciplinary meeting. Seventy percent of these recommendations concerned medication adjustments. The remaining recommendations were related to clinical and laboratory follow-up, the management of home care, and vaccination updates. Follow-up data at 90 days were available for 295 (78%) of the 380 patients. At 90 days, the recommendation implementation rate was 83% (4178 out of 5977) overall, 86% for medication adjustments, 79% for patient monitoring, 87% for home care management and 56% for vaccinations.

Conclusions: IATROPREV is designed for patients with major therapeutic complexity. It enables a significant number of treatment optimization recommendations to be implemented within 90 days, thanks in particular to the multidisciplinary meeting.