FORTA(Fit-fOR-The-Aged)-based medication optimization: retrospective analysis of experiences from an unconventional outpatient service.
Drug therapy
Fit fOR the aged (FORTA)
Inappropriate prescribing
Medication optimization
Older people
Outpatient service
Journal
European geriatric medicine
ISSN: 1878-7649
Titre abrégé: Eur Geriatr Med
Pays: Switzerland
ID NLM: 101533694
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
26
03
2020
accepted:
31
07
2020
pubmed:
11
8
2020
medline:
19
8
2021
entrez:
11
8
2020
Statut:
ppublish
Résumé
To address potentially harmful polypharmacy in multimorbid older patients. Secondary to assess FORTA (Fit-fOR-The-Aged) utility in ambulatory patients. Consecutive patients attending a novel ambulatory service for gerontopharmacology were included in this retrospective analysis. Baseline data, diagnoses, previous drug treatment and recommended changes in medication were analysed and the change of the FORTA score (sum of over- and undertreatment errors) calculated. The analysis of 182 cases revealed a high number of recommended medication alterations per case (9.81; 95% CI 9.13-10.50). The FORTA score was significantly reduced from 4.24 ± 2.30 to 0.80 ± 1.08 (P < 0.00001), as were under- and overtreatment errors if analysed separately. The large number of recommendations given in this special outpatient service points to a profound unmet medical need for improving medications in older patients. The FORTA approach was found to be useful to reduce both over- and undertreatment in multimorbid older patients.
Identifiants
pubmed: 32772258
doi: 10.1007/s41999-020-00378-z
pii: 10.1007/s41999-020-00378-z
pmc: PMC8219568
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1035-1041Commentaires et corrections
Type : ErratumIn
Références
United Nations, Department of Economic and Social Affairs, Population Division. World Population Ageing 2019: Highlights.
Maher RL, Hanlon J, Hajjar ER (2014) Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf 13:57–65. https://doi.org/10.1517/14740338.2013.827660
doi: 10.1517/14740338.2013.827660
pubmed: 24073682
Mangoni AA, Jackson SHD (2004) Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. Br J Clin Pharmacol 57:6–14. https://doi.org/10.1046/j.1365-2125.2003.02007.x
doi: 10.1046/j.1365-2125.2003.02007.x
pubmed: 14678335
pmcid: 1884408
Pazan F, Weiss C, Wehling M (2016) The FORTA (Fit fOR The Aged) List 2015: update of a validated clinical tool for improved pharmacotherapy in the elderly. Drugs Aging 33:447–449. https://doi.org/10.1007/s40266-016-0371-4
doi: 10.1007/s40266-016-0371-4
Kuhn-Thiel AM, Weiß C, Wehling M (2014) Consensus validation of the FORTA (Fit fOR The Aged) list: a clinical tool for increasing the appropriateness of pharmacotherapy in the elderly. Drugs Aging 31:131–140. https://doi.org/10.1007/s40266-013-0146-0
doi: 10.1007/s40266-013-0146-0
Pazan F, Weiss C, Wehling M (2019) The FORTA (Fit fOR The Aged) List 2018: third version of a validated clinical tool for improved drug treatment in older people. Drugs Aging 36:481–484. https://doi.org/10.1007/s40266-019-00669-6
doi: 10.1007/s40266-019-00669-6
pubmed: 30941728
Wehling M, Burkhardt H, Kuhn-Thiel A, Pazan F, Throm C, Weiss C, Frohnhofen H (2016) VALFORTA: a randomised trial to validate the FORTA (Fit fOR The Aged) classification. Age Ageing 45:262–267. https://doi.org/10.1093/ageing/afv200
doi: 10.1093/ageing/afv200
pubmed: 26786346
Wehling M (2013) Drug therapy for the elderly. Springer, Vienna
Pazan F, Kather J, Wehling M (2019) A systematic review and novel classification of listing tools to improve medication in older people. Eur J Clin Pharmacol 75:619–625. https://doi.org/10.1007/s00228-019-02634-z
doi: 10.1007/s00228-019-02634-z
pubmed: 30683971
O'Mahony D, O'Sullivan D, Byrne S, O'Connor MN, Ryan C, Gallagher P (2015) STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing 44:213–218. https://doi.org/10.1093/ageing/afu145
doi: 10.1093/ageing/afu145
pubmed: 25324330
Arai S, Ishikawa T, Kato H et al (2019) Multidrug use positively correlates with high-risk prescriptions in the Japanese elderly: a longitudinal study. J Pharm Health Care Sci 5:20
doi: 10.1186/s40780-019-0150-6
Tecklenborg S, Byrne C, Cahir C, Brown L, Bennett K (2020) Interventions to reduce adverse drug event-related outcomes in older adults: a systematic review and meta-analysis. Drugs Aging 37(2):91–98
doi: 10.1007/s40266-019-00738-w
Rouch L, Farbos F, Cool C et al (2018) Hospitalization drug regimen changes in geriatric patients and adherence to modifications by general practitioners in primary care. J Nutr Health Aging 22(3):328–334
doi: 10.1007/s12603-017-0940-1