L'étude de l'Unité d'enseignement clinique Canadienne: prévenir les événements iatrogéniques associés

 

Todd Lee

Centre universitaire de santé McGill [CUSM]

 

Domaine :  services de santé

Programme chercheurs-boursiers-cliniciens  - Junior 1

Concours 2017-2018

Patients who develop several medical conditions will often require an increasing number of medications
which are usually individually given to improve health are reduce the chance of disease. However, as the
number of medications a patient takes increases, so too does the chance that patients will suffer side effects
and adverse drug events. Patients who frequently take more than 5 or 10 daily medications, such as the
elderly, are particularly at risk of such outcomes. In fact, nearly 27,000 Canadian seniors are admitted to
hospital each year as a result of an adverse drug event at a cost estimated to exceed 35 million dollars.

The key to preventing these events is to try to avoid the use of medications which have little benefit
but subject the patient to the risks of adverse event. One way to do this is to evaluate the patient as a
whole looking at their entire medical history, their goals of care and preferences, their ability to adhere to
medications, and their entire list of medications. Then, using defined criteria, one can identify specific drugs
which for that patient are now likely to be inappropriate. Together, the doctor and patient can then decide to stop medications which are unlikely to be of benefit or too likely to lead to harm. This process is called
deprescription.

Using hospitalization as the key opportunity to evaluate at the patient as a whole, my proposed research will
help to identify those at high risk of developing adverse drug events and then aid doctors in facilitating safe
and controlled deprescription of potentially inappropriate medications. This should lead to improvements in
patient quality of life, a reduction in adverse drug events, and overall reductions in healthcare costs.