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1

Hilout, Saïd. "Stabilité en optimisation convexe non différentiable." Comptes Rendus de l'Académie des Sciences - Series I - Mathematics 329, no. 11 (December 1999): 1027–32. http://dx.doi.org/10.1016/s0764-4442(00)88631-0.

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2

Kouada, I. "Sur la dualité en optimisation vectorielle convexe." RAIRO - Operations Research 28, no. 3 (1994): 255–81. http://dx.doi.org/10.1051/ro/1994280302551.

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3

Boyer, R. "Algorithmes de type F.A.C. en optimisation convexe." ESAIM: Mathematical Modelling and Numerical Analysis 28, no. 1 (1994): 95–119. http://dx.doi.org/10.1051/m2an/1994280100951.

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4

Rodriguez, Pedro, and Didier Dumur. "Robustification d'une commande GPC par optimisation convexe du paramètre de Youla." Journal Européen des Systèmes Automatisés 37, no. 1 (January 30, 2003): 109–34. http://dx.doi.org/10.3166/jesa.37.109-134.

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5

Abbas-Turki, Mohamed, Gilles Duc, and Benoît Clément. "Retouche de correcteurs par optimisation convexe. Application au pilotage d'un lanceur spatial." Journal Européen des Systèmes Automatisés 40, no. 9-10 (December 30, 2006): 997–1017. http://dx.doi.org/10.3166/jesa.40.997-1017.

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6

Belkeziz, K., and A. Metrane. "Optimisation d’une fonction linéaire sur l’ensemble des solutions efficaces d’un problème multicritère quadratique convexe." Annales mathématiques Blaise Pascal 11, no. 1 (2004): 19–33. http://dx.doi.org/10.5802/ambp.182.

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7

Kouada, A. Issoufou. "Sur la propriété de domination et l'existence de points Pareto-efficaces en optimisation vectorielle convexe." RAIRO - Operations Research 28, no. 1 (1994): 77–84. http://dx.doi.org/10.1051/ro/1994280100771.

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8

Barbet, C., H. Longuet, P. Gatault, N. Rabot, and J. M. Halimi. "Ligne directe ville–hôpital en néphrologie : optimisation du parcours de soins." Néphrologie & Thérapeutique 12, no. 5 (September 2016): 402–3. http://dx.doi.org/10.1016/j.nephro.2016.07.120.

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9

Clément, Benoît. "Analyse par intervalles et optimisation convexe pour résoudre un problème général de faisabilité d’une contrainte robuste." Journal Européen des Systèmes Automatisés 46, no. 4-5 (July 30, 2012): 381–95. http://dx.doi.org/10.3166/jesa.46.381-395.

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10

F. Aziz, Rahma, and Maha S. Younis. "A New Hybrid Conjugate Gradient Method with Global Convergence Properties." Wasit Journal for Pure sciences 3, no. 3 (September 30, 2024): 58–68. http://dx.doi.org/10.31185/wjps.453.

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Анотація:
This work introduces a novel hybrid conjugate gradient (CG) technique for tackling unconstrained optimisation problems with improved efficiency and effectiveness. The parameter is computed as a convex combination of the standard conjugate gradient techniques using and . Our proposed method has shown that when using the strong Wolfe-line-search (SWC) under specific conditions, it achieves global theoretical convergence. In addition, the new hybrid CG approach has the ability to generate a search direction that moves downward with each iteration. The quantitative findings obtained by applying the recommended technique about 30 functions with varying dimensions clearly illustrate its effectiveness and potential. This work introduces a novel hybrid conjugate gradient (CG) technique for tackling unconstrained optimisation problems with improved efficiency and effectiveness. The parameter is computed as a convex combination of the standard conjugate gradient techniques using and . Our proposed method has shown that when using the strong Wolfe-line-search (SWC) under specific conditions, it achieves global theoretical convergence. In addition, the new hybrid CG approach has the ability to generate a search direction that moves downward with each iteration. The quantitative findings obtained by applying the recommended technique about 30 functions with varying dimensions clearly illustrate its effectiveness and potential.
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11

Miramond, Benoît. "Technique de réduction d'ordonnancements hors-ligne pour applications embarquées à contraintes temps-réel. Optimisation hors-ligne d'ordonnancements temps-réel." Techniques et sciences informatiques 25, no. 7 (August 1, 2006): 867–92. http://dx.doi.org/10.3166/tsi.25.867-892.

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12

Donnay, B., H. Mathy, V. Leroy, G. Axmann, R. Creutz, M. Mertens, and R. Michels. "Optimisation des propriétés d’emploi de poutrelles élaborées par une ligne de production courte." Revue de Métallurgie 96, no. 1 (January 1999): 99–108. http://dx.doi.org/10.1051/metal/199996010099.

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13

Rahma F. Aziz, Maha S. Younis, and Marwan S. Jameel. "An Investigation Of A New Hybrid Conjugates Gradient Approach For Unconstrained Optimization Problems." Bilangan : Jurnal Ilmiah Matematika, Kebumian dan Angkasa 2, no. 4 (June 26, 2024): 11–23. http://dx.doi.org/10.62383/bilangan.v2i4.136.

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Анотація:
This work introduces a novel hybrid conjugate gradient (CG) technique for tackling unconstrained optimisation problems with improved efficiency and effectiveness. The parameter is computed as a convex combination of the standard conjugate gradient techniques using and . Our proposed method has shown that when using the strong Wolfe-line-search(SWC) under specific conditions, it achieves global theoretical convergence. In addition, the new hybrid CG approach has the ability to generate a search direction that moves downward with each iteration. The quantitative findings obtained by applying the recommended technique about 30 functions with varying dimensions clearly illustrate its effectiveness and potential.
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14

Raberin, Monique. "Critères de réussite esthétique des génioplasties." L'Orthodontie Française 87, no. 2 (June 2016): 191–203. http://dx.doi.org/10.1051/orthodfr/2016024.

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Анотація:
Les dysmorphies maxillo-mandibulaires peuvent s’accompagner d’anomalies structurales mentonnières. Les déplacements chirurgicaux tridimensionnels des bases osseuses ont des limites. Une génioplastie appropriée complète la normalisation du profil cutané. Le trait d’ostéotomie par une inclinaison réfléchie et une possible extension latérale, telle la technique du chin wing, permet d’améliorer l’ovale du visage. La simulation céphalométrique avec la ligne R permet l’analyse des déplacements mentonniers et la gestion de l’impact de l’inclinaison des incisives inférieures sur le sillon labio-mentonnier lors de la géniolastie de propulsion. L’ancrage osseux constitue une aide précieuse pour une optimisation de la position des incisives inférieures et de la bascule du plan d’occlusion. Les critères orthodontiques sont des facteurs essentiels à la réussite esthétique de la génioplastie.
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15

Qi, Mingfeng, Lihua Dou, and Bin Xin. "3D Smooth Trajectory Planning for UAVs under Navigation Relayed by Multiple Stations Using Bézier Curves." Electronics 12, no. 11 (May 23, 2023): 2358. http://dx.doi.org/10.3390/electronics12112358.

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Navigation relayed by multiple stations (NRMS) is a promising technique that can significantly extend the operational range of unmanned aerial vehicles (UAVs) and hence facilitate the execution of long-range tasks. However, NRMS employs multiple external stations in sequence to guide a UAV to its destination, introducing additional variables and constraints for UAV trajectory planning. This paper investigates the trajectory planning problem for a UAV under NRMS from its initial location to a pre-determined destination while maintaining a connection with one of the stations for safety reasons. Instead of line segments used in prior studies, a piecewise Bézier curve is applied to represent a smooth trajectory in three-dimensional (3D) continuous space, which brings both benefits and complexity. This problem is a bi-level optimisation problem consisting of upper-level station routing and lower-level UAV trajectory planning. A station sequence must be obtained first to construct a flight corridor for UAV trajectory planning while the planned trajectory evaluates it. To tackle this challenging bi-level optimisation problem, a novel efficient decoupling framework is proposed. First, the upper-level sub-problem is solved by leveraging techniques from graph theory to obtain an approximate station sequence. Then, an alternative minimisation-based algorithm is presented to address the non-linear and non-convex UAV trajectory planning sub-problem by optimising the spatial and temporal parameters of the piecewise Bézier curve iteratively. Computational experiments demonstrate the efficiency of the proposed decoupling framework and the quality of the obtained approximate station sequence. Additionally, the alternative minimisation-based algorithm is shown to outperform other non-linear optimisation methods in finding a better trajectory for the UAV within the given computational time.
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16

Mellon, G., A. C. Crémieux, J. Molina, O. Pajot, C. Geffrier, K. Lacombe, H. Cordel, S. Diamantis, and R. Hellmann. "Optimisation de l’antibiothérapie dans les services d’urgence : l’expérience d’une ligne téléphonique dédiée aux maladies infectieuses en Île-de-France." Médecine et Maladies Infectieuses 48, no. 4 (June 2018): S60—S61. http://dx.doi.org/10.1016/j.medmal.2018.04.156.

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17

Berthoz, Nicolas, Emmanuel Bourgeois, Denis Branque, Agathe Michalski, Wassim Mohamad, Alain Le Kouby, Fabien Szymkiewicz, and Charles Kreziak. "Impact du creusement au tunnelier sur un pieu : synthèse de l’exercice de prévision TULIP." Revue Française de Géotechnique, no. 173 (2022): 2. http://dx.doi.org/10.1051/geotech/2022015.

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Анотація:
Un exercice de prévision a été organisé dans le cadre du projet de recherche TULIP (TUnneliers et Limitation des Impacts sur des Pieux) sur la base d’une expérimentation en vraie grandeur originale réalisée sur la ligne 16 du Grand Paris Express. Cet exercice de modélisation a vu une large mobilisation des acteurs des travaux souterrains (bureaux d’études, entreprises, concepteurs de logiciels géotechniques, universitaires) qui ont confronté leurs approches d’estimation des déplacements induits en surface du terrain, du tassement d’un pieu, et des efforts induits dans le pieu par le passage du tunnelier. La synthèse des hypothèses effectuées entre les différents participants révèle tout d’abord une grande diversité d’approches, tant en termes de choix des caractéristiques géotechniques des terrains à données d’entrée constantes, qu’en termes de procédés de modélisation du tunnelier. La synthèse des résultats des différents modèles et leur comparaison aux résultats expérimentaux révèle ensuite une dispersion significative, preuve que l’estimation de l’impact d’un tunnelier sur des fondations profondes reste un sujet ouvert à l’heure actuelle, avec une optimisation possible des projets.
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18

Chrétien, A. S., A. Harlé, M. Meyer-Lefebvre, M. Rouyer, M. Husson, C. Ramacci, P. Genin, A. Leroux, and J. L. Merlin. "Analyse des mutations KRAS dans les cancers colorectaux métastatiques : optimisation des techniques et des délais pour la sélection rationnelle d’une première ligne thérapeutique." Annales de Pathologie 31, no. 5 (November 2011): S143. http://dx.doi.org/10.1016/j.annpat.2011.09.039.

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19

Liu, Si Ying, Wipa Charles, Ralf Cord-Ruwisch, Ka Yu Cheng, and Goen Ho. "Bioelectrochemical upgrading of anaerobic digester biogas under thermophilic conditions." Renewable Energy and Environmental Sustainability 8 (2023): 8. http://dx.doi.org/10.1051/rees/2023009.

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Bioelectrochemical systems (BESs) can be integrated in situ into anaerobic digesters for increasing methane (CH4) content of biogas. Using BES ex situ for improving biogas quality has recently been gaining attention. However, information on the process under thermophilic conditions is very limited. In this study, we placed a BES cathode in-line at the exit gas from a thermophilic anaerobic digester to convert carbon dioxide (CO2) in the biogas into CH4. The performance of the ex situ BES reactor under thermophilic conditions was evaluated. When poising the cathode at −1.1 V versus Ag/AgCl in the ex situ BES reactor, CH4 content increased from 50% to 85%. Of the incoming CO2 73% was biologically converted to CH4 and 23% absorbed by alkalinity generated in the cathode. The energy output as additional CH4 as a percentage of the energy input to operate the BES was calculated at 56%. The biocathode of the BES reactor was dominated by Methanothermobacter spp., which are thermophilic hydrogen consuming methanogens. This study confirms that thermophilic BES can be used as an ex situ treatment process for enriching the CH4 content of biogas. However, energy efficiency of the process was found to be limited by the lack of an energetically efficient anodic reaction. For industrial applications, optimisation of energy efficiency is an area for further research.
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20

Brand, Cornelius, Martin Koutecký, and Sebastian Ordyniak. "Parameterized Algorithms for MILPs with Small Treedepth." Proceedings of the AAAI Conference on Artificial Intelligence 35, no. 14 (May 18, 2021): 12249–57. http://dx.doi.org/10.1609/aaai.v35i14.17454.

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Solving (mixed) integer (linear) programs, (M)I(L)Ps for short, is a fundamental optimisation task with a wide range of applications in artificial intelligence and computer science in general. While hard in general, recent years have brought about vast progress for solving structurally restricted, (non-mixed) ILPs: n-fold, tree-fold, 2-stage stochastic and multi-stage stochastic programs admit efficient algorithms, and all of these special cases are subsumed by the class of ILPs of small treedepth. In this paper, we extend this line of work to the mixed case, by showing an algorithm solving MILP in time f(a,d)poly(n), where a is the largest coefficient of the constraint matrix, d is its treedepth, and n is the number of variables. This is enabled by proving bounds on the denominators (fractionality) of the vertices of bounded-treedepth (non-integer) linear programs. We do so by carefully analysing the inverses of invertible sub-matrices of the constraint matrix. This allows us to afford scaling up the mixed program to the integer grid, and applying the known methods for integer programs. We then trace the limiting boundary of our "bounded fractionality" approach both in terms of going beyond MILP (by allowing non-linear objectives) as well as its usefulness for generalising other important known tractable classes of ILP. On the positive side, we show that our result can be generalised from MILP to MIP with piece-wise linear separable convex objectives with integer breakpoints. On the negative side, we show that going even slightly beyond such objectives or considering other natural related tractable classes of ILP leads to unbounded fractionality. Finally, we show that restricting the structure of only the integral variables in the constraint matrix does not yield tractable special cases.
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21

Owsiński, Jan. "On the optimal division of an empirical distribution (and some related problems)." Przegląd Statystyczny. Statistical Review 2012, SI1 (June 30, 2012): 109–22. http://dx.doi.org/10.59139/ps.2012.si1.6.

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Анотація:
We consider division of an empirical distribution of xi, i being the index of a unit, for which we observe xi (e.g., province i, for which xi is the GDP per capita). Values xi are ordered non-decreasingly. We analyse the cumulative distribution, zi = ∑i'=1,...,ixi. The sequence zi is convex. We want to divide the distribution of zi into subsets of i, with the shape of the distribution {zi} possibly well approximated by the segments of the straight line, determined for the subsets, forming a piecewise linear contour, the number of segments being possibly small. This corresponds to the frequently used categorisations for similar distributions (e.g., “developed”, “developing”,... countries). For such categorisations, usually no formal methods are applied but “substantive” prerequisites, or the methods applied are limited to establishing quantiles of the distribution, without considering its shape and the objective premises for determination of a different number of segments, including optimisation of the criterion mentioned before. A general approach is proposed for optimising division of such distribution conform to the criterion mentioned. A general objective function is proposed and its concrete realisation, as well as algorithms. The methodology proposed allows for obtaining the optimum divisions into categories for arbitrary distributions. Yet, on the basis of concrete empirical distributions, problems are outlined, due to the fact that the distributions obtained often display the features, leading to questioning of the foundations of the methodology proposed, and of the very sense of such categorisations. Examples of distributions of this kind, and consequences for the potential categorisations, are discussed. In summary, the methodology proposed, including the criterion function, constitutes a basis for the categorisation with respect to the cumulative distribution, and a tool for evaluating the rationality of the way, in which the distributions are obtained.
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22

Gay, C. "Psychoéducation et bipolarité, vivre avec son trouble." European Psychiatry 29, S3 (November 2014): 660. http://dx.doi.org/10.1016/j.eurpsy.2014.09.042.

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Анотація:
Les troubles bipolaires sont déterminés par un ensemble de facteurs, à la fois psychologiques, génétiques et environnementaux bien connus. Les perturbations des relations familiales et sociales constituent également des facteurs de fragilisation.Les thymorégulateurs ont considérablement amélioré le pronostic de ces troubles, en limitant le nombre de récidives. Néanmoins, un pourcentage important de patients continuent à présenter des fluctuations thymiques du fait d’une mauvaise observance thérapeutique, de la persistance de facteurs déclenchants, précipitants ou d’entretien du trouble ou encore du fait de l’insuffisance d’efficacité des thymorégulateurs.D’autres mesures thérapeutiques ont été proposées afin d’optimiser les traitements pharmacologiques et d’agir en amont sur les éléments déclenchants ou précipitants. Les mesures psychoéducatives, dont l’efficacité a longtemps été sous-évaluée, sont aujourd’hui les traitements psychologiques les mieux documentées et pour lesquels il existe un niveau de preuve élevé. Ils figurent en première ligne dans la plupart des guidelines anglo-saxons. Les bénéfices de cette approche complémentaires se situent à différents niveaux : reconnaissance précoce des symptômes qui annoncent une récidive, optimisation de l’observance, acceptation du trouble, amélioration de la qualité de vie, meilleure gestion de la vie sociale, professionnelle et affective, consolidation de l’alliance thérapeutique, contrôle des facteurs déclenchants et précipitants. Les études publiées rapportent une diminution du nombre de récidives et de rechutes, une réduction de la durée d’hospitalisation, un meilleur équilibre de la vie familiale, une amélioration de l’observance et une amélioration de la qualité de vie. L’expert de cette session, qui anime depuis 2000 des séances de psychoéducation, vient d’écrire un manuel conçu pour proposer aux patients un accompagnement personnalisé visant à renforcer le suivi thérapeutique et à stabiliser la maladie. Il présentera aussi l’expérience innovante de la création du Clubhouse France.
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23

Tett, Simon F. B., Kuniko Yamazaki, Michael J. Mineter, Coralia Cartis, and Nathan Eizenberg. "Calibrating climate models using inverse methods: case studies with HadAM3, HadAM3P and HadCM3." Geoscientific Model Development 10, no. 9 (September 28, 2017): 3567–89. http://dx.doi.org/10.5194/gmd-10-3567-2017.

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Abstract. Optimisation methods were successfully used to calibrate parameters in an atmospheric component of a climate model using two variants of the Gauss–Newton line-search algorithm: (1) a standard Gauss–Newton algorithm in which, in each iteration, all parameters were perturbed and (2) a randomised block-coordinate variant in which, in each iteration, a random sub-set of parameters was perturbed. The cost function to be minimised used multiple large-scale multi-annual average observations and was constrained to produce net radiative fluxes close to those observed. These algorithms were used to calibrate the HadAM3 (third Hadley Centre Atmospheric Model) model at N48 resolution and the HadAM3P model at N96 resolution.For the HadAM3 model, cases with 7 and 14 parameters were tried. All ten 7-parameter cases using HadAM3 converged to cost function values similar to that of the standard configuration. For the 14-parameter cases several failed to converge, with the random variant in which 6 parameters were perturbed being most successful. Multiple sets of parameter values were found that produced multiple models very similar to the standard configuration. HadAM3 cases that converged were coupled to an ocean model and run for 20 years starting from a pre-industrial HadCM3 (3rd Hadley Centre Coupled model) state resulting in several models whose global-average temperatures were consistent with pre-industrial estimates. For the 7-parameter cases the Gauss–Newton algorithm converged in about 70 evaluations. For the 14-parameter algorithm, with 6 parameters being randomly perturbed, about 80 evaluations were needed for convergence. However, when 8 parameters were randomly perturbed, algorithm performance was poor. Our results suggest the computational cost for the Gauss–Newton algorithm scales between P and P2, where P is the number of parameters being calibrated.For the HadAM3P model three algorithms were tested. Algorithms in which seven parameters were perturbed and three out of seven parameters randomly perturbed produced final configurations comparable to the standard hand-tuned configuration. An algorithm in which 6 out of 13 parameters were randomly perturbed failed to converge.These results suggest that automatic parameter calibration using atmospheric models is feasible and that the resulting coupled models are stable. Thus, automatic calibration could replace human-driven trial and error. However, convergence and costs are likely sensitive to details of the algorithm.
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24

Nizeyimana, Jean Baptiste, and Asnath Mukanteri. "L’impact du marketing numérique sur les Petites et Moyennes Entreprises." RUFSO Journal of Social Science and Engineering 35, no. 03 (April 13, 2023). http://dx.doi.org/10.55272/rufso.rjsse.35.3.2.

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Анотація:
L’objectif de ce papier est d’étudier et d’analyser le rôle que joue la numérisation dans la croissance des PME en adoptant des stratégies de marketing numérique.Le Digital Marketing vise à mettre en place une stratégie pour optimiser la visibilité du site web de son entreprise sur d’autres supports digitaux. Pour y parvenir, il utilise des techniques comme l’achat de mots-clés, le référencement naturel, le développement de partenariats ou de bandeaux publicitaires. Une fois que vous êtes sur la bonne voie, le marketing digital peut faire de votre PME un succès. En plus d’augmenter vos ventes, le marketing digital vous permet de mieux cibler vos clients et d’améliorer votre service clientèle. Il peut même vous aider à attirer les prospects vers votre site physique. La digitalisation des systèmes de communication en ligne permet d’accroître la productivité de PME et d’améliorer les performances des collaborateurs. Comme Avantages du marketing digital on a : Faiblesse des coûts d’exécution. Optimisation des campagnes de communication. Augmentation de la visibilité de l’entreprise. … Tandis que comme Avantages du marketing digital. Faiblesse des coûts d’exécution. Optimisation des campagnes de communication. Augmentation de la visibilité de l’entreprise. … Come inconvénients du marketing digital on a concurrence et insécurité, exigence d’une plus grande compétence.
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25

Baumann, Phillip, Idriss Mazari-Fouquer, and Kevin Sturm. "The Topological State Derivative: An Optimal Control Perspective on Topology Optimisation." Journal of Geometric Analysis 33, no. 8 (May 15, 2023). http://dx.doi.org/10.1007/s12220-023-01295-w.

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AbstractIn this paper, we introduce the topological state derivative for general topological dilatations and explore its relation to standard optimal control theory. We show that for a class of partial differential equations, the shape-dependent state variable can be differentiated with respect to the topology, thus leading to a linearised system resembling those occurring in standard optimal control problems. However, a lot of care has to be taken when handling the regularity of the solutions of this linearised system. In fact, we should expect different notions of (very) weak solutions, depending on whether the main part of the operator or its lower order terms are being perturbed. We also study the relationship with the topological state derivative, usually obtained through classical topological expansions involving boundary layer correctors. A feature of the topological state derivative is that it can either be derived via Stampacchia-type regularity estimates or alternately with classical asymptotic expansions. It should be noted that our approach is flexible enough to cover more than the usual case of point perturbations of the domain. In particular, and in the line of (Delfour in SIAM J Control Optim 60(1):22–47, 2022; J Convex Anal 25(3):957–982, 2018), we deal with more general dilatations of shapes, thereby yielding topological derivatives with respect to curves, surfaces or hypersurfaces. To draw the connection to usual topological derivatives, which are typically expressed with an adjoint equation, we show how usual first-order topological derivatives of shape functionals can be easily computed using the topological state derivative.
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26

Woods, Brendan, Michael Legal, Stephen Shalansky, Tamara Mihic, and Winnie Ma. "Designing a Pharmacist Opioid Safety and Intervention Tool." Canadian Journal of Hospital Pharmacy 73, no. 1 (February 20, 2020). http://dx.doi.org/10.4212/cjhp.v73i1.2952.

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ABSTRACTBackground: Despite the recent increase in opioid overdoses across Canada, few pharmacy-led initiatives have been implemented to address issues related to opioid prescribing in the hospital setting.Objectives: The primary objective of this study was to develop a clinical tool, intended for use by hospital pharmacists and informed by best practices from the literature, that would provide a structured approach to enhancingthe safety of opioid prescribing. The secondary objective was to collect pharmacists’ opinions about the feasibility and utility of this tool.Methods: A comprehensive literature search and pharmacist focus group analysis provided content for development of a candidate clinical tool. This tool was then piloted by clinical pharmacists working on generalmedical and surgical units in a single hospital. Pharmacists participating in the pilot were invited to complete an online survey concerning their perceptions of the tool. Descriptive statistics were used to analyze the survey results.Results:The literature search and focus group analysis led to development of a candidate clinical tool that focused on Medication review, Optimization, Reassessment, and Education (MORE). It included key risk factors relating to opioid safety, along with suggested mitigating strategies. The MORE tool was piloted for 3 weeks by 14 clinical pharmacists, 9 of whom responded to the subsequent survey. Five respondents indicated that the clinical tool increased their ability to identify risk factors. Five respondents also noted an increase in their ability to identify possible interventions. Most respondents felt that the tool was useful and that it would be feasible to integrate it into their practice; however, they noted that a more streamlined version could improve ease of use.Conclusions: The MORE tool was well received by clinical pharmacists. Implementation of the tool into routine practice requires additional changes to improve ease of use. Suggestions for modifying and streamlining the tool will be incorporated into future versions.RÉSUMÉContexte : Malgré l’augmentation récente des surdoses d’opioïdes au Canada, peu d’initiatives menées sous la houlette de pharmacies ont été mises en place sur les enjeux potentiels liés à la prescription d’opiacés en milieu hospitalier.Objectifs : L’objectif principal de cette étude visait à élaborer un outil destiné aux pharmaciens d’hôpitaux, s’inspirant des meilleures pratiques rapportées dans la documentation, qui fournirait une approche structuréepour améliorer la sécurité de la prescription d’opioïdes. L’objectif secondaire consistait à recueillir les opinions des pharmaciens sur la faisabilité et l’utilité d’un tel outil.Méthode : Des recherches bibliographiques étendues ainsi qu’une analyse de groupes de discussion de pharmaciens ont fourni le contenu necessaire à l’élaboration d’un outil clinique expérimental. Ensuite, cet outil a été testé par des pharmaciens cliniciens travaillant dans des unités médicales générales et chirurgicales au sein d’un seul hôpital. Les pharmaciens participant au projet pilote ont été invités à répondre à une enquête en ligne sur leur perception de l’outil. Des statistiques descriptives ont permis d’analyser les résultats de l’enquête.Résultats : Les recherches bibliographiques et l’analyse des groupes de discussion ont débouché sur le développement d’un outil clinique nommé MORE [pour Medication review, Optimization, Reassessment, and Education, ou Examen, optimisation, réévaluation et éducation aux médicaments]. Il comprenait des facteurs de risque liés à la sécurité des opioïdes ainsi que des suggestions de stratégies d’atténuation. Quatorzepharmaciens cliniciens, dont neuf ont répondu à l’enquête qui a suivi, ont testé le MORE pendant trois semaines. Cinq répondants ont indiqué que l’outil clinique augmentait leur capacité à déterminer les facteurs de risque. Cinq ont également noté une meilleure capacité à déterminer les interventions possibles. La plupart des répondants ont estimé que l’outil était utile et qu’il serait possible de l’intégrer dans leur pratique; cependant, ils ont aussi noté qu’une version simplifiée pourrait faciliter son utilisation.Conclusions : Les pharmaciens cliniciens ont bien accueilli l’outil MORE. Sa mise en oeuvre dans la pratique courante exige cependant des changements supplémentaires pour faciliter son utilisation. Les versions à venir tiendront compte des propositions visant à le modifier et à le simplifier.
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