Améliorer la prescription des psychotropes - version anglaise

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Submitted to the 19th IAGG World Congress of Gerontology and Geriatrics 5 – 9 july 2009, Paris IMPROVING THE PRIMARY CARE PRESCRIPTION OF HYPNOTIC AND ANXIOLYTIC DRUGS IN THE FRENCH ELDERLY Improving the prescription of hypnotic and

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Submitted to the 19th IAGG World Congress of Gerontology and Geriatrics 5 9 july 2009, Paris IMPROVING THE PRIMARY CARE PRESCRIPTION OF HYPNOTIC AND ANXIOLYTIC DRUGS

IN THE FRENCH ELDERLY Improving the prescription of hypnotic and anxiolytic drugs in the elderly in France Armelle Desplanques-Leperre 1 MD, PhD, Jean Doucet 2 Nathalie Riolacci 1 MD, Sandrine Buscail 1 MD, Sylvie Royant-Parola 3 MD, MD Sylvie Legrain 4 MD and the French task force to improve the prescription of psychotropic drugs in the elderly (1) Haute Autorité de Santé, Saint-Denis, F; (2) Rouen Hospital, F; (3) Garches private Hospital, F (4) Bretonneau Hospital, Paris, F The remit of the French National Authority for Health (HAS) is to contribute toward the quality and safety of care. The prescribing of hypnotic and/or anxiolytic drugs (H/A) is often inappropriate and higher in France than in other European countries, specifically in the elderly who are more prone to side-effects. To monitor prescribing practices and to identify appropriated actions, data in the elderly are required. In close collaboration with geriatrics, psychiatrics and general practitioners, public health bodies, insurers, and patients, the circumstances of prescriptions in insomnia and anxiety were analysed in order to identify (i) the reasons of prescriptions and (ii) the drugs used. The H/A consumption overall the elderly French population was measured using the National Health Insurance database. The data were analysed with health professionals to elaborate implementation tools for good practices. All results have been published online into webpages dedicated to practices. In 2007, 3,498,826 people over the age of 65 (34,8%) had long term H/A prescription, respectively 27,6% in the 65-74 y.o., 39% in the 75-84 y.o., 46,8% after 85 years. New prescriptions of benzodiazepines concerned 358,738 people after 65 years (3.5%) between the 1stof September and the 31th of December 2007.Tthe elderly in ambulatory setting are proposed : (i)o improve practices in implementation tools for good practices (reminders, clinical cases, diagnosis tools, guidelines for the discontinuation of BZD in the elderly), (ii) professional sessions to discuss about clinical experiences; (iii) press conference to promote key messages. The H/A overuse is confirmed: key actions to reduce first and renewal prescriptions have been undertaken and the H/A consumption will be followed each year. However, a media campaign on the H/A targeted at the general public in order to sustain the changes in practice is probably necessary.

HAS/DAQSS/UPP/2009

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