La perfusion sous-cutanée chez l'adulte au CHU d'Angers : audit des pratiques au Département de Soins de Suite et Soins de Longue Durée (DSSSLD)

The subcutaneous route has been used for the administration of treatments for more than a century and has been enjoying a renewed interest over the past decades, mainly for elderly patients and in palliative care programs. It is a simple, effective and fairly painless solution that offers an alternative when oral and venous administration are not recommended or are impossible. However, the limited number of medication which are granted with a Marketing Authorization Application (MAA) for this route of administration doesn’t cover all the needs and leads doctors to use off-label prescription. In the framework of the initiative aiming at securing the medication circuit developed at the University Hospital Centre of Angers, a validated document listing the medication that can be administrated subcutaneously with or without MAA depending on their grade of recommendation was created. An audit of practices was carried out for 3 months at the Department of rehabilitation and long-term care : 154 prescriptions by subcutaneous route were listed for 86 patients. This survey highlighted non-compliances as well as the following improvement areas : harmonisation of the duration of catheter use, and traceability of administration modes and surveillance. It has been observed that medical prescriptions were conformed to the data available in the literature and that the rate of adverse effects is low, as the subcutaneous route is well tolerated.