[Audits of good practice: implantable medical devices are also concerned]

Within the framework of a good practices agreement, French hospitals must perform clinical audits of costly molecules and implantable medical devices (IMD) to justify their medical costs. We present two examples of clinical audits of IMD: hip arthroplasties and cardiac stimulators.

The clinical audits were managed by the pharmacy with the support of the medical teams. Retrospective evaluation of patient files was performed by a pharmaceutical team using evaluation grids developed from official references from the French National Authority for Health and French National Health Insurance.

The audit of hip arthroplasty procedures, including a retrospective and prospective study, showed that 95.4% and 96.9% of the surgical procedures followed guidelines. The audit of cardiac stimulators showed 100% agreement with guidelines. The audit of traceability showed that 97% of the files were complete.

These audits show that the cost increases of the IMD are linked to following guidelines. It is important for these audits of pertinent use to be performed by both physicians and pharmacists.

There is very little information in the literature or from authorities to help implement these audits. It would be interesting to propose common prospective and retrospective methods to evaluate the pertinent use of IMD.