Frailty: a key indicator to minimize inappropriate medication in older people

Poudel, A., Hubbard, R. E., Nissen, L. and Mitchell, C. (2013) Frailty: a key indicator to minimize inappropriate medication in older people. QJM: An International Journal of Medicine, 106 10: 969-975. doi:10.1093/qjmed/hct146


Author Poudel, A.
Hubbard, R. E.
Nissen, L.
Mitchell, C.
Title Frailty: a key indicator to minimize inappropriate medication in older people
Journal name QJM: An International Journal of Medicine   Check publisher's open access policy
ISSN 1460-2725
Publication date 2013-10-01
Year available 2013
Sub-type Article (original research)
DOI 10.1093/qjmed/hct146
Open Access Status Not yet assessed
Volume 106
Issue 10
Start page 969
End page 975
Total pages 7
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Subject 2700 Medicine
Abstract Older populations are more likely to have multiple co-morbid diseases that require multiple treatments, which make them a large consumer of medications. As a person grows older, their ability to tolerate medications becomes less due to age-related changes in pharmacokinetics and pharmacodynamics often heading along a paththat leads to frailty. Frail older persons often have multiple co-morbidities with signs of impairment in activities of daily living. Prescribing drugs for these vulnerable individuals is difficult and is a potentially unsafe activity. Inappropriate prescribing in older population can be detected using explicit (criterion-based) or implicit (judgment-based) criteria. Unfortunately, most current therapeuticguidelines are applicable only to healthy older adults and cannot be generalized tofrail patients. These discrepancies should be addressed either by developing new criteria or by refining the existing tools for frail older people. The first andforemost step is to identify the frail patient in clinical practice by applying clinically validated tools. Once the frail patient has been identified, there is a needfor specific measures or criteria to assess appropriateness of therapy that consider such factors as quality of life, functional status and remaining life expectancy and thus modified goals of care.
Formatted abstract
Older populations are more likely to have multiple co-morbid diseases that require multiple treatments, which make them a large consumer of medications. As a person grows older, their ability to tolerate medications becomes less due to age-related changes in pharmacokinetics and pharmacodynamics often heading along a paththat leads to frailty. Frail older persons often have multiple co-morbidities with signs of impairment in activities of daily living. Prescribing drugs for these vulnerable individuals is difficult and is a potentially unsafe activity. Inappropriate prescribing in older population can be detected using explicit (criterion-based) or implicit (judgment-based) criteria. Unfortunately, most current therapeuticguidelines are applicable only to healthy older adults and cannot be generalized tofrail patients. These discrepancies should be addressed either by developing new criteria or by refining the existing tools for frail older people. The first andforemost step is to identify the frail patient in clinical practice by applying clinically validated tools. Once the frail patient has been identified, there is a needfor specific measures or criteria to assess appropriateness of therapy that consider such factors as quality of life, functional status and remaining life expectancy and thus modified goals of care.
Keyword Comprehensive Geriatric Assessment
Randomized Controlled Trials
Elderly People
Health Care
Life
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

 
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