P-499: Communication between hospital and ambulatory care: is it enough for special administration drugs? Example of zoledronic acid and intravenous iron therapy in geriatric ward

摘要

Introduction: To ensure the continuity of treatment, the communication between hospital and ambulatory care is crucial. Most of the drugs appear on the prescription after the discharge but others, with special administration rate doesn't. The hospitalization report is transmitted to the patient's physician, therefore it is an important tool of communication. This is the case for zoledronic acid (ZA) and intravenous iron therapy (IIT), two treatments often used in elderly patients. ZA is an intravenous bisphosphonate administered once a year. IIT (carboxy-maltose iron) is a supplementation therapy administered once, possibly divided in two administrations separated by a week; the dose needed is calculated based on hemoglobin level and patient's weight. The aim of this study was to assess the traceability of ZA and IIT in the hospitalization report of patients hospitalized in geriatric unit. Methods: This is a monocentric retrospective study conducted in the acute geriatric unit of a French University hospital. All patients who received ZA or IIT in 2018 were included. Patients who died during their stay were excluded. Data were extracted from our computerized physician order entry; hospitalization reports and medical records were screened to assess the traceability of the administration and the posology (for IIT only). Results: Among the 12 ZA treatments prescribed, all of them were traced in the hospitalization report. The nurse traced the administration in the software for all of them. During the study period, 127 patients received an IIT. Most of them were traced in the hospitalization report (91.3%) and posology was specified in 95 of them (82%). The nurse traced the administration in the software for 117 patients (92%). Conclusion: ZA and IIT administrations are well traced in the hospitalization report of patients hospitalized in the acute geriatric unit. This is a key element in order to ensure the safety and efficacy of these drugs. ZA is often initiated during hospitalization, the ulterior administrations are ambulatory each year. IIT can only be done in a hospital but it's efficiency must be assessed by the patient's physician after a month. Therefore, he has to be informed of the treatment (date, dosage). An education of the medical staff was realized to sensitize them to the importance of the communication between hospital and ambulatory care via the traceability of special administration drugs in the hospitalization report.