Assessment of drug treatment in geriatrics with the new FORTA criteria - Preliminary clinical experience
Assessment of drug treatment in geriatrics with the new FORTA criteria - Preliminary clinical experience
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DOI：
10.1055/s-0031-1281530
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发表时间：
2011-07-01
影响因子：
0.6
通讯作者：
Wehling, M.
中科院分区：
文献类型：
--
作者：
Frohnhofen, H.;Michalek, C.;Wehling, M.
背景：老年人的多发病往往导致不适当和有害的多药联用。各种方法被用来确定药物治疗的优先顺序，特别是在像啤酒清单这样的负面清单上。一种新的方法是FORTA评估系统(适合老年人)，其中药物分为阳性(A，应给予)、中等(B或C)和阴性(D不应给予)。方法：在这项对46名老年病房患者的初步研究中，根据FORTA标准，在入院和出院时对药物进行评估。结果：用FORTA后，用药前药物总数从7.3+/-2，9减少到6.7+/-2，3(p=0.06)，阳性评价药物(A/B)从59+/-20增加到77+/-38%(p<；以及负面评价药物(D)从7+/-12%下降到5+/-9%(p=0.06)。被评估为中间体(C)的药物数量没有显著变化。不足治疗从65%下降到39%(p<；0.01)，过度治疗从65%下降到20%(p<；0.01)。药物相互作用的数量从79个减少到54个(p<；0.01)。结论：这项非对照的初步研究表明，FORTA标准可以用于日常临床护理：它以一种可信的方式描述了老年病房药物治疗的变化质量。这项研究提供了基本的非对照数据，应该在对照研究中验证这些数据，比较使用和不使用FORTA标准的治疗质量。(DKRS-ID：DRKS00000531)
Background: Multimorbidity in the elderly often leads to inappropriate and harmful polypharmacy. Various approaches have been used to prioritize components of drug treatment, especially as on negative lists like the Beers list. A new approach is the FORTA assessments system (Fit fOR The Aged) in which drugs are graded as positive (A, should be given), intermediate (B or C), and negative (D should not be given).Methods: In this pilot study of 46 patients in a geriatric ward medication was assessed on admission and at discharge, using the FORTA criteria. All changes in the number of prescribed drugs, the distribution of FORTA criteria, and the number of drug interactions were recorded.Results: The use of FORTA resulted in a decrease in the total number of prescirbed drugs from 7.3 +/- 2,9 to 6.7 +/- 2,3 (p = 0.06), and an increase in positively assessed drugs (A / B) from 59 +/- 20 to 77 +/- 38% (p < 0.01), as well as a decrease in negatively assessed drugs (D) from 7 +/- 12 to 5 +/- 9% (p = 0.06). The number of drugs assessed as intermediate (C) did not change significantly. Under-treatment decreased from 65 to 39% (p < 0.01), over-treatment from 65% to 20% (p < 0.01). The number of drug interactions decreased from 79 to 54 (p < 0.01).Conclusion: This uncontrolled pilot study indicates that the FORTA criteria can be used in day-to-day clinical care: it describes the quality of changes in drug treatment in a geriatric ward in a plausible way. This study has provided basic uncontrolled data which should be validated in controlled studies comparing the quality of treatment with or without the use of the FORTA criteria. (DKRS-ID: DRKS00000531)