4CPS-162 Evaluation of antihypertensive prescriptions of patients of a geriatric day hospital

<h3>Background and Importance</h3> Elderly patients are particularly vulnerable to drug related complications. Regular medications are reassessed during geriatric day hospital consultations. Blood pressure medications carry a high-risk. However, they are usually prescribed by specialists and therefore often are not reassessed. <h3>Aim and Objectives</h3> The aim of this project is a professional practice evaluation of antihypertensive prescriptions of patients of our geriatric day hospital. <h3>Material and Methods</h3> We gathered data from Easily, electronic patient record, including medical history, usual medication and blood pressure readings of patients during June of 2024. We reported this information in an Excel spreadsheet to compare blood pressure treatments with the recommendations from French1 and European2 academic societies. These guidelines are composed of five therapeutic algorithms depending on comorbidities linked to high blood pressure. They additionally suggest age-appropriate blood pressure targets ranging from 130 to 149 mmHg. <h3>Results</h3> A total of 87 patients were seen at our geriatric day hospital and nearly 55% (48/87) of them were found to have nonconforming blood pressure therapies. Our study identified three main nonconforming therapeutic algorithms: 69% (31/45) of patients with isolated high blood pressure, 78% (7/9) of those with high blood pressure and atrial fibrillation and 100% (9/9) of patients with high blood pressure associated to coronary diseases. Most nonconformities of patients with isolated high blood pressure were linked to prescriptions of beta blockers and too high or too low blood pressure levels. Furthermore, the nonconforming algorithms for patients with atrial fibrillation or coronary diseases show an average of about 2.5 antihypertensives, while the recommendations suggest monotherapy, and these patients also had blood pressure readings below the recommended levels. <h3>Conclusion and Relevance</h3> A majority of antihypertensive prescriptions did not conform to guidelines. The benefice of treatment versus drug related complications varies for every patient, meaning that some nonconforming therapies may be necessary. However, a systematic reassessment of those medications, along with optimisation suggestions for general practitioners, could improve patient care. <h3>References and/or Acknowledgements</h3> HAS. SFHTA. Prise en charge de l’hypertension artérielle de l’adulte - Recommandation de bonne pratique – 2016 2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal (2018) <h3>Conflict of Interest</h3> No conflict of interest