Évaluation des situations motivant le maintien des médicaments potentiellement inappropriés suite à une réévaluation pluridisciplinaire en hospitalisation en médecine aiguë gériatrique PDF Download
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Author: Cindy Riffard
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
Les médicaments potentiellement inappropriés (MPI) sont une source d'iatrogénie chez la personne âgée. Afin de sécuriser la prise en charge médicamenteuse du sujet âgé, des réévaluations des prescriptions sont effectuées mais ne permettent pas d'arrêter tous les MPI. L'objectif de cette étude est d'évaluer le caractère approprié ou non des MPI détectés par la liste STOPP/START V2 et maintenus après réévaluation pluridisciplinaire (RP), et de décrire l'évolution du nombre de MPI du sujet âgé au cours de son parcours de soins. Une étude prospective a été réalisée dans une unité de gériatrie aiguë au CHU Grenoble-Alpes, incluant les patients hospitalisés de janvier à avril 2018. Le nombre de MPI par patient a été recueilli à l'admission, après réévaluation pluridisciplinaire de la prescription et trois mois après la sortie. La justification de la poursuite du MPI suite à la RP a également été recherchée. Durant la période, 101 patients ont été inclus et 153 MPI ont été identifiés. Après la RP, 70% des MPI identifiés par la liste STOPP/START v2 étaient arrêtés (n=107 sur 153), 87% des MPI non arrêtés avaient une indication qui justifiait leur maintien. Le nombre de MPI par patient diminuait significativement entre l'entrée et la sortie d'hospitalisation (1.46 contre 0.46, p
Author: Cindy Riffard
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
Les médicaments potentiellement inappropriés (MPI) sont une source d'iatrogénie chez la personne âgée. Afin de sécuriser la prise en charge médicamenteuse du sujet âgé, des réévaluations des prescriptions sont effectuées mais ne permettent pas d'arrêter tous les MPI. L'objectif de cette étude est d'évaluer le caractère approprié ou non des MPI détectés par la liste STOPP/START V2 et maintenus après réévaluation pluridisciplinaire (RP), et de décrire l'évolution du nombre de MPI du sujet âgé au cours de son parcours de soins. Une étude prospective a été réalisée dans une unité de gériatrie aiguë au CHU Grenoble-Alpes, incluant les patients hospitalisés de janvier à avril 2018. Le nombre de MPI par patient a été recueilli à l'admission, après réévaluation pluridisciplinaire de la prescription et trois mois après la sortie. La justification de la poursuite du MPI suite à la RP a également été recherchée. Durant la période, 101 patients ont été inclus et 153 MPI ont été identifiés. Après la RP, 70% des MPI identifiés par la liste STOPP/START v2 étaient arrêtés (n=107 sur 153), 87% des MPI non arrêtés avaient une indication qui justifiait leur maintien. Le nombre de MPI par patient diminuait significativement entre l'entrée et la sortie d'hospitalisation (1.46 contre 0.46, p
Author: Mélody Daret
Publisher:
ISBN:
Category :
Languages : fr
Pages : 62
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Book Description
Dans la prise en charge des personnes âgées, le Bon Usage du Médicament est un objectif primordial à cause des modifications physiologiques liées à l'âge, de la polypathologie, et de la polymédication. De nombreux outils ont été développés afin d'améliorer la qualité des prescriptions, de limiter les médicaments potentiellement inappropriés (MPI). Les praticiens du service de gériatrie de Lannemezan réévaluent leurs ordonnances de sortie via la grille DICTIAS. Cette étude quantifie les modifications des ordonnances de 80 patients jusqu'à 6 mois après le retour à domicile. Il en ressort que le nombre de traitements recensé est stable vers 5,2 ±2,7 médicaments par patient. Quarante pourcent ±1% en consomment 4 ou moins, et 6-7% en prennent 10 ou plus. Les modifications apportées concernent à 49% les médicaments du système nerveux. Le taux de MPI est stable à 17%. Seules les ordonnances à charge atropinique de 1 ou 2 subissent une augmentation statistiquement significative de 55 à 70% entre le retour à domicile et le 3e mois. Ces données sont cohérentes avec la littérature et tendent à prouver que l'amélioration de la communication ville-hôpital porte des fruits. Les médicaments phares de la iatrogénie, les benzodiazépines, subissent un traitement satisfaisant. Les inhibiteurs de la pompe à protons sont insuffisamment déprescrits à l'hôpital et leur consommation n'augmente pas en ambulatoire. Connaître les raisons de la prescription des médicaments atropiniques nous permettrait de comprendre la cause de leur augmentation en médecine générale et d'oeuvrer conjointement pour les faire diminuer.
Author: Yasser Khazaal
Publisher: Frontiers Media SA
ISBN: 2889454967
Category : Video games in education
Languages : en
Pages : 311
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Book Description
Recent years have seen important developments in the computer and game industry, including the emergence of the concept of serious games. It is hypothesized that tools such as games, virtual reality, or applications for smartphones may foster learning, enhance motivation, promote behavioral change, support psychotherapy, favor empowerment, and improve some cognitive functions. Computers and games may create supports for training or help people with cognitive, emotional, or behavioral change. Games take various formats, from board games to informatics to games with interactive rules of play. Similarly, computer tools may vary widely in format, from self-help or assisted computerized training to virtual reality or applications for smartphones. Some tools that may be helpful for mental health were specifically designed for that goal, whereas others were not. Gamification of computer-related products and games with a numeric format tend to reduce the gap between games and computers tools and increase the conceptual synergy in such fields. Games and computer design share an opportunity for creativity and innovation to help create, specifically design, and assess preventive or therapeutic tools. Computers and games share a design conception that allows innovative approaches to overcome barriers of the real world by creating their own rules. Yet, despite the potential interest in such tools to improve treatment of mental disorders and to help prevent them, the field remains understudied and information is under-disseminated in clinical practice. Some studies have shown, however, that there is potential interest and acceptability of tools that support various vehicles, rationales, objectives, and formats. These tools include traditional games (e.g., chess games), popular electronic games, board games, computer-based interventions specifically designed for psychotherapy or cognitive training, virtual reality, apps for smartphones, and so forth. Computers and games may offer a true opportunity to develop, assess, and disseminate new prevention and treatment tools for mental health and well-being. Currently, there is a strong need for state-of-the-art information to answer questions such as the following: Why develop such tools for mental health and well-being? What are the potential additions to traditional treatments? What are the best strategies or formats to improve the possible impact of these tools? Are such tools useful as a first treatment step? What is the potential of a hybrid model of care that combines traditional approaches with games and/or computers as tools? What games and applications have already been designed and studied? What is the evidence from previous studies? How can such tools be successfully designed for mental health and well-being? What is rewarding or attractive for patients in using such treatments? What are the worldwide developments in the field? Are some protocols under development? What are the barriers and challenges related to such developments? How can these tools be assessed, and how can the way that they work, and for whom, be measured? Are the potential benefits of such products specific, or can these additions be attributed to nonspecific factors? What are the users’ views on such tools? What are the possible links between such tools and social networks? Is there a gap between evidence-based results and market development? Are there any quality challenges? What future developments and studies are needed in the field?
Author: HIpE
Publisher:
ISBN: 9780646551241
Category :
Languages : en
Pages : 16
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Book Description
Author: Dr Malcolm Kendrick
Publisher: Kings Road Publishing
ISBN: 1843582368
Category : Health & Fitness
Languages : en
Pages : 337
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Book Description
Statins are widely prescribed to lower blood cholesterol levels and claim to offer unparalleled protection against heart disease. Believed to be completely safe and capable of preventing a whole series of other conditions, they are the most profitable drug in the history of medicine. In this groundbreaking book, GP Malcolm Kendrick exposes the truth behind the hype. He will change the way we think about cholesterol forever. Rubbishing the diet-heart hypothesis, in which clinical trials 'prove' that high cholesterol causes heart disease and a high-fat diet leads to heart disease, Kendrick lambastes a powerful pharmaceutical industry and unquestioning medical profession, who, he claims, perpetuate the madcap concepts of 'good' and 'bad' cholesterol and cholesterol levels to convince millions of people to unnecessarily spend billions of pounds on statins. Clearly and comprehensively debunking assumptions on what constitute a healthy lifestyle and diet, "The Great Cholesterol Con" is the accessible, indispensable and absorbing case against statins and for a more common-sense approach to heart disease and general wellbeing. No more over-hyped miracle drugs; no more garlic, red wine, anti-oxidants, fruit or vegetables; even a vegetarian diet is rejected in this controversial yet authoritative critique of how we have been mislead over how food and drugs affect our coronary health. Here, for the first time, is the invaluable guide for anyone who though there was a miracle cure for heart disease, "The Great Cholesterol Con" is a fascinating breakthrough that will set dynamite under the whole area.
Author: James B. Yoseph
Publisher: Hannah Yoseph
ISBN: 9780615618173
Category : Statins (Cardiovascular agents)
Languages : en
Pages : 335
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Book Description
"The Yosephs have written the most stunning expose. In plain language they reveal the science, the corruption and the enormous conspiracy it took to bring statins to market. As fast paced as a Mickey Spillane novel they report the research, the fraud and the facts like a detective in hot pursuit of a Nazi war criminal. It is riveting. They have accomplished the impossible: they have made both complex science and medical history fascinating to read. What could not be done in an expose they accomplished with almost unbelievablable ease. It will change your paradigms about medicine forever."--p.[4] of cover.
Author: American Society of Health System Pharmacists
Publisher:
ISBN: 9781585286119
Category :
Languages : en
Pages : 840
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Book Description
Author: Edward Robert Pinckney
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 180
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Book Description
Author: Marc G. Jeschke
Publisher: Springer Nature
ISBN: 3030391930
Category : Medical
Languages : en
Pages : 217
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Book Description
The second edition of this practical guide offers a comprehensive summary of the most important and most immediate therapeutic approaches in the assessment and treatment of burn injuries. Taking into account age-specific needs in pediatric, adult, and elderly burn patients, several chapters on key issues – such as pre-hospital treatment, wound care and infection control, burn nursing, critical care, burn reconstructive surgery and rehabilitation for burn victims – have now been updated. In addition, the book has been supplemented with the latest information on fluid resuscitation, organ support for burn patients, necrotizing soft tissue infections, and TEN/SJS. Written in a concise manner, the updated edition of this book provides essential guidelines for optimal care to improve patient outcomes, and thus will be a valuable reference resource for physicians, surgeons, residents, nurses, and other burn care providers.
Author: European Federation for Medical Informatics
Publisher: IOS Press
ISBN: 1614991014
Category : Medical
Languages : en
Pages : 1284
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Book Description
Medical informatics and electronic healthcare have many benefits to offer in terms of quality of life for patients, healthcare personnel, citizens and society in general. But evidence-based medicine needs quality information if it is to lead to quality of health and thus to quality of life. This book presents the full papers accepted for presentation at the MIE2012 conference, held in Pisa, Italy, in August 2012. The theme of the 2012 conference is ‘Quality of Life through Quality of Information’. As always, the conference provides a unique platform for the exchange of ideas and experiences among the actors and stakeholders of ICT supported healthcare. The book incorporates contributions related to the latest achievements in biomedical and health informatics in terms of major challenges such as interoperability, collaboration, coordination and patient-oriented healthcare at the most appropriate level of care. It also offers new perspectives for the future of biomedical and health Informatics, critical appraisal of strategies for user involvement, insights for design, deployment and the sustainable use of electronic health records, standards, social software, citizen centred e-health, and new challenges in rehabilitation and social care informatics. The topics presented are interdisciplinary in nature and will be of interest to a variety of professionals; physicians, nurses and other allied health providers, health informaticians, engineers, academics and representatives from industry and consultancy in the various fields.
