Off-label use of midazolam in older inpatients: analysis of prescribing practices in a French hospital (MIDnight study).

Midazolam is a short-acting benzodiazepine approved for sedation and anesthesia induction. Recent data suggested that midazolam may also be used in off-label indications such as treatment of behavioral and psychological disturbances in older people. Given the scarcity of published data and a lack of evidence in older people in such indications, midazolam raises concern because it may also cause serious-related adverse events. To provide a better understanding of its real-life use in geriatrics, we examined the prescribing practices of midazolam in French older inpatients. Of the 460 patients aged 65 years and over hospitalized at the time of the study, 21 had a prescription of midazolam (5%) which was mainly prescribed for anxiolysis (n = 12), premedication before painful procedures (n = 5), and agitation (n = 4). Midazolam was often prescribed "as required," and the median duration of prescription was 6 months. This work results in a better knowledge and information about the use of midazolam in older people. These prescribing practices, which are not anecdotal, also plead for age-specific guidelines for the treatment of behavioral and psychological disturbances.

[Screening and care of chronic renal insufficiency in the elderly population]. / Dépistage et prise en charge de l'insuffisance rénale chronique parmi la population âgée.

The prevalence of chronic renal insufficiency (CRI) increases with age. This growth shall result in it becoming a public health issue for the most elderly In this age group, chronic renal insufficiency primarily stems from diabetes and vascular and glomerular origins. The limiting point is the assessment of the glomerular filtration rate which remains imprecise. Care aims to limit the development of renal insufficiency and to prevent its complications, which are sources of fragility.