Welcome to the IM-AGE project website
Background
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Main outcome
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With the population aging, iatrogenic diseases related to medication use in the elderly is becoming a major public health issue. In 2001, the over 65 years old in France make up almost 16% of the overall population and consume 39% of the prescribed medication. The elderly are often poly-pathological patients, this can lead to a poly-medication therapeutic strategies and poly-medication is often related to an increase of the risk of adverse drug effects. This risk is of 13% with the use of two medications and increase to 58% with the use of 5 medications. The elderly are often the subject of unnecessary medication prescriptions, contraindicated medication prescriptions or wrong dosage medication prescriptions. The elderly are also subject to under prescription errors, more an elderly patient has a medication prescribed more the risk of under prescription of one or several medications is increased. Inappropriate medication prescription is one of the main causes of adverse drug reactions in the elderly people. The “good practice” of medication prescription can be assessed using clinical practice guidelines. Considerable efforts have been made to setup and promote the use of these documents in daily practice clinicians. Unfortunately, these efforts have rarely been adapted for the sustainability of their action for improving practices among clinicians. Several studies have shown that between 30% and 45% of patients do not receive care in relation to “good” and validated clinical practices and between 20% and 25% of care are not needed or potentially harmful. This happens because “good” clinical practices resulting from clinical research studies take too long time to be adopted into daily practice of clinicians. One of the best interventions which can help to improve patient safety and promote the use of “good” and validated clinical knowledge resulted from clinical practice guidelines is clinical decision support systems.
Main purpose
The main purpose of this study is to assess the degree of computerization of the most known clinical practice guidelines for medication prescription in the elderly: Beer’s, ACOVE, STOPP&START using a web tool called: eGLIA and to derive electronic clinical rules from these guidelines and finally to test these rules using a huge amount of clinical data from Two French databases: HEGP CDW a French hospital database and EGB, the French health insurance database.
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Secondary outcome
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