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Évaluation des pratiques d’une équipe pharmaceutique sur le respect des recommandations HAS de prise en charge de la BPCO chez les patients hospitalisés
Mémoire de Master / Thèse d'exercice   Open Access

Évaluation des pratiques d’une équipe pharmaceutique sur le respect des recommandations HAS de prise en charge de la BPCO chez les patients hospitalisés

Mélinda Rigoni
Masters , Université de Montpellier
14/04/2023

Résumé

COPD Non-conformities Clinical pharmacy Pharmacie clinique BPCO Non-conformité
COPD is currently the third leading cause of death worldwide with 3.23 million deaths in 2019. Despite recommendations, many care non-conformities are observed in COPD patients. Objectives: describe the intervention of a pharmaceutical team on the number of non-conformities detected in relation to the recommendations emitted by the HAS. Describe the distribution of the different non-conformities detected, to describe the proposals for improvement of the management and to identify the factors that may have an impact on the non-compliance to recommendation. Methods: this is a retrospective evaluation of professional practices conducted between January and July 2022. COPD patients were proposed a pharmaceutical interview about medical follow-up, smoking, treatments, medication adherence, vaccinations, good use ofinhalers and quality of life measured by the VQ11 survey. The use of inhalation devices was measured by using dummy devices or patient’s devices.Results: 85 patients were included. The mean age was 70.5 years. In total, 173 non-conformities were detected on 79 patients, i.e. 2 non-conformities per patient. The most frequent errors were the misuse of inhalation devices (77.2%) and the absence of vaccination against pneumococcus (67.1%). Smoking concerned 32.9% of patients. 31.2% of the prescriptions were considered to be non-compliant. Analysis of the different factors that may influence non-compliance to recommendations shows that regular follow-up by a pneumologist increases pneumococcal vaccination coverage and decreases the median number of errors made while using the devices. 12 patients were proposed a change of treatment at the end of the interview. Conclusion: the clinical pharmacist, by a presence in the care units, can contribute to the detection of care non-conformities and make recommendations to optimize the management of patients with chronic diseases as COPD during their hospitalization.

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