Drug safety profiles in geriatric patients with Parkinson’s disease using the FORTA (Fit fOR The Aged) classification: results from a mono-centric retrospective analysis

Abstract

To reduce potentially inappropriate medications, the FORTA (Fit fOR The Aged) concept classifies drugs in terms of their suitability for geriatric patients with different labels, namely A (indispensable), B (beneficial), C (questionable), and D (avoid). The aims of our study were to assess the medication appropriateness in PD inpatients applying the FORTA list and drug-drug interaction software, further to assess the adequacy of FORTA list for patients with PD. We retrospectively collected demographic data, comorbidities, laboratory values, and the medication from the discharge letters of 123 geriatric inpatients with PD at the university hospital of Hannover Medical School. Patients suffered on average from 8.2 comorbidities. The majority of the medication was labeled A (60.6% of PD-specific and 40.9% of other medication) or B (22.3% of PD-specific and 26.9% of other medication). Administered drugs labeled with D were amantadine, clozapine, oxazepam, lorazepam, amitriptyline, and clonidine. Overall, 545 interactions were identified, thereof 11.9% severe interactions, and 1.7% contraindicated combinations. 81.3% of patients had at least one moderate or severe interaction. The FORTA list gives rational recommendations for PD-specific and other medication, especially for general practitioners. Considering the demographic characteristics and the common multimorbidity of geriatric PD patients, this study underlines the importance of awareness, education, and preventive interventions to increase drug safety.

Patient Safety in a Box: Implementation and Evaluation of the Emergency Box in Geriatric and Parkinson Patients

“…Geriatric and PD patients in our study had a mean number of 10.1 ± 4.3 comorbidities. Similar data were obtained in comparable studies before [ 13 , 21 , 22 ]. These results underline the high risk of these patients for recurrent and acute visits to hospitals [ 5 ].…”

“…Adding to this, general practitioners regularly change medication schemes shortly after discharge from the hospital [ 11 ]. Drug safety issues due to polypharmacy and the resulting hazard of drug interactions were reported frequently, especially for geriatric multimorbid patients [ 4 , 12 , 13 ]. A data management system like the emergency box has the potential to discover and solve drug interaction problems in acute and inpatient care.…”

Cerebral Microstructural Alterations in Patients With Early Parkinson’s Disease Detected With Quantitative Magnetic Resonance Measurements

“…Patients with clinical conditions interfering with MRI diagnostics, like severe head tremor, dystonia or dyskinesia, had to be excluded as well. PD patients with severe comorbidities were also excluded from our study ( Klietz et al, 2019b ; Greten et al, 2020 ).…”

One Year Trajectory of Caregiver Burden in Parkinson’s Disease and Analysis of Gender-Specific Aspects

“…Hence, longitudinal prospective interventional studies are needed to determine the effect of specific potentially multidimensional interventions on the caregiver burden of female and male caregivers in the future. This study also did not evaluate patients' comorbidities and medications [48,49].…”