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Measure n°14Version française

Monitoring drug-related iatrogenic accidents

To improve knowledge of iatrogenesis in Alzheimer’s patients and develop surveillance.

Measure

Developing partnerships with geriatrics centres or correspondents:
The Regional Drug safety Centres (Centres régionaux de Drug safety, CRPV, of which France has 31), due to their integration within university hospitals and their regionalisation, have already developed partnerships with geriatrics departments and correspondents in health centres or in independent practice with a high degree of contact with elderly patients. Certain CRPVs (such as Limoges and Caen) have also developed more specific gerontological approaches for collecting details of undesirable side-effects and researching medication in elderly people.

Training and informing geriatricians:
The CRPVs have an important role in the correct use of medication through three strongly developed activities:
1- collecting details of undesirable side-effects, accompanied by dialogue between the person making the report and the centre to evaluate the issue and return conclusions about the case.
2- requesting information about medication in order to respond to over 20,000 increasingly complex questions a year.
3- drug safety training as part of the curriculum for health professions and in continuing training. Currently the CRPV network provides over 2,700 hours of training.

These activities that are already in place could be targeted more at the specific aspect of training and information for geriatricians and health professionals providing care for elderly people and especially Alzheimer’s patients.

Undesirable side-effects from the National Drug safety Database - 2006

Serious Not Serious Total
Age (years)Number%Number%Number%
Under 60 5135 49,1% 6345 62,5% 11480 55,7%
60-69 1463 14,0% 1438 14,2% 2901 14,1%
70-79 1909 18,3% 1331 13,1% 3240 15,7%
80-89 1582 15,1% 843 8,3% 2425 11,8%
90 and over 371 3,5% 189 1,9% 560 2,7%
Total 10460 10146 20606

Source: AFSSAPS

Surveying the prevalence of undesirable side-effects in Alzheimer’s patients
Carrying out a survey of prevalence with the method used in the 1998 hospital survey "Iatrogénie médicamenteuse : estimation de sa prévalence dans les hôpitaux publics français" (Drug-related iatrogenesis: estimation of its prevalence in French public hospitals). However, in order to obtain a representative sample of the population of Alzheimer’s patients, the survey should be carried out in both public and private institutions and should include residential centres for elderly dependent people (établissements d’hébergement pour personnes âgées dépendantes, EHPADs).


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