The FORTA (Fit fOR The Aged) List 2021: Fourth Version of a Validated Clinical Aid for Improved Pharmacotherapy in Older Adults

Pazan, Farhad; Weiß, Christel; Wehling, Martin; Bauer, Jürgen; Berthold, Heiner K.; Denkinger, Michael; Arnim, Christine von; Dovjak, Peter; Frohnhofen, Helmut; Gosch, Markus; Gutzmann, Hans; Heuser-Collier, Isabella; Honecker, Friedemann; Hüll, Michael; Iglseder, Bernhard; Jaehde, Ulrich; Kressig, Reto W.; Kwetkat, Anja; Schindler, Christoph; Schulz, Ralf-Joachim; Zeyfang, Andrej; Pautex, Sophie; Wedding, Ulrich

doi:10.1007/s40266-022-00922-5

Cited by 44 publications

(59 citation statements)

References 20 publications

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“…Various management strategies are available to optimize pharmacotherapy and prevent medication-related problems in geriatric patients. Physician-led interventions are based on standardized tools, such as Beers' criteria [23], STOPP criteria (Screening Tool of Older persons' Potentially Inappropriate Prescriptions) and START (Screening Tool to Alert doctors to the Right Treatment) [24], the FORTA (Fit For the Aged) List [25], the PRISCUS list [26],…”

Section: Discussionmentioning

confidence: 99%

Prevalence, predisposing factors and strategies to reduce polypharmacy among older patients in Poland

Błeszyńska-Marunowska¹,

Jagiełło²,

Grodzicki³

et al. 2022

Polish Archives of Internal Medicine

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The study adheres to STROBE guidelines. What's new?Our study reveals that Polish home-dwelling seniors consume a high number of prescription and non-prescription drugs. The factors predisposing to polypharmacy and excessive polypharmacy include multimorbidity, male sex, age 85-89 years, low level of education, and living in small or medium-sized cities. Moreover, our study provides unique data on the consumption of single pill combinations (SPCs) in Polish older patients.Since polypharmacotherapy can have negative health consequences, action must be taken in the field of complex medical and pharmaceutical care for geriatric patients. Various management strategies are available to optimize pharmacotherapy and prevent medicationrelated problems. Unfortunately, there is still limited clinical evidence for long term benefits of these interventions in elderly people. Our data can provide supportive information for the introduction of coordinated pharmaceutical care in Poland.

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Section: Discussionmentioning

confidence: 99%

Prevalence, predisposing factors and strategies to reduce polypharmacy among older patients in Poland

Błeszyńska-Marunowska¹,

Jagiełło²,

Grodzicki³

et al. 2022

Polish Archives of Internal Medicine

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“…8 and tools available in the literature were selected to contribute to each step of the process. 8,[12][13][14][15][16][17][18] The first step of the protocol is essential because it encompasses an in-depth review of older patients' health and sociodemographic data. A list of all medications used by the patient is prepared, including prescription and non-prescription drugs.…”

Section: Discussionmentioning

confidence: 99%

“…15 The EURO-FORTA List was prepared by experts from several European countries and differs from other instruments in that it classifies medications as positive and negative, with medications being assessed according to their safety, efficacy, and age adjustment. 16 As a complement to these tools, we also used a national instrument. The Brazilian Consensus on PIMs for Older Persons provides a list of medications adapted to the reality of the country, since many drugs available in Brazil are not included in international criteria.…”

Section: Discussionmentioning

confidence: 99%

“…• Classify drugs according to the Anatomical Therapeutic Chemical (ATC) classification system; 14 • Identify polypharmacy (use of 5 or more regular medications); 2 • Identify PIMs using Beers criteria, 15 the EURO-FORTA (Fit fOR The Aged) List, 16 and the Brazilian Consensus on PIMs for Older Persons; 4. Adjust: discuss patients' expectations, beliefs, and preferences and adjust the prescription to their real possibilities.…”

Section: Protocol Descriptionmentioning

confidence: 99%

“…2 PIMs were reviewed based on Beers criteria, 15 the Brazilian Consensus on PIMs for Older Persons, 4 and the EURO-FORTA List. 16 Possible drug-drug and drug-food interactions were assessed using the Drugs.com Interactions Checker tool. 17 The pharmacists and medical team reviewed and discussed the individual aspects of the patient's health, including life expectancy, cognitive impairments, comorbidities, and palliative care.…”

Section: Implementation Of the Protocol In The Geriatric Psychiatry O...mentioning

confidence: 99%

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The process of deprescribing in older adults: a methodological protocol

Linkievicz

Engroff

Neto

et al. 2022

Geriatr Gerontol Aging

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Objective: To report, by means of a methodological protocol, the process of deprescribing implemented in a geriatric psychiatry outpatient clinic of a teaching hospital. Methods: The topic of interest was comprehensively reviewed in the scientific literature. Instruments and tools necessary to develop the protocol were selected, including the Treatment Adherence Measure, Beers criteria, the EURO-FORTA List, the Brazilian Consensus on Potentially Inappropriate Medications for Older Persons, Drugs.com, and deprescribing algorithms. Results: The protocol consists of the following steps: 1) Review: Assess older patients’ physical and behavioral status and family context and list all medications used; 2) Analyze: Review patients’ drug therapy; 3) Act: Initiate deprescribing (if indicated); 4) Adjust: Discuss patients’ expectations, beliefs, and preferences and adjust the prescription to their real possibilities; 5) Monitor: Identify responses to treatment, assess adherence to the deprescribing process, and detect return of symptoms or worsening of the underlying disease. Conclusions: Health care professionals need to work together to provide comprehensive care for older persons. The inclusion of deprescribing in more research groups focused on the geriatric population will increase attention to the safety of pharmacological treatment for older patients.

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The impact of hospitalization on inappropriate prescribing and polypharmacy in older patients: A descriptive cross‐sectional study

Weiss,

Eyre,

Ellenbogen

et al. 2024

Pharmacoepidemiology and Drug

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BackgroundPolypharmacy and the use of potentially inappropriate medications (PIMs) in older individuals are widespread phenomena that are associated with an increase in morbidity and mortality. The Beers Criteria is a tool that helps to identify patients that are prescribed with PIMs, thereby reducing the risk of associated harm. Amongst other populations, the criteria identify drugs that should not be used by the majority of older patients.AimDetermining the proportion of older inpatients who were discharged from hospitalization with polypharmacy (a prescription for more than seven drugs), or with a PIM as defined by the Beers Criteria.MethodsA descriptive cross‐sectional study based on patients aged 65 and over who were hospitalized in the years 2019–2021 in the internal medicine, orthopedic and surgical wards at a medium‐size hospital. Demographic information and details about drug treatment were collected from the electronic patient records system. Patients who died during hospitalization were excluded from the study group.Main Outcome MeasuresThe proportion of inpatients with polypharmacy or a PIM as part of their regular prescription, at the time of admission and at discharge.Results49 564 patients were included in the study cohort. At discharge, 19% of the patients were given a prescription for a PIM, with a small but significant decrease compared with the rate admission (22.1%). At discharge, 42.8% of patients had polypharmacy, representing a small but significant increase compared with the rate on admission (40.6%).ConclusionsThe study demonstrated high baseline rates of PIM prescription and polypharmacy. Hospitalization was associated with a decrease in PIM prescription and an increase in polypharmacy. This highlights the importance of medication review during admission to reduce the potential risk to older adults from polypharmacy and PIM prescription.

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The FORTA (Fit fOR The Aged) List 2021: Fourth Version of a Validated Clinical Aid for Improved Pharmacotherapy in Older Adults

Cited by 44 publications

References 20 publications

Prevalence, predisposing factors and strategies to reduce polypharmacy among older patients in Poland

Prevalence, predisposing factors and strategies to reduce polypharmacy among older patients in Poland

The process of deprescribing in older adults: a methodological protocol

The impact of hospitalization on inappropriate prescribing and polypharmacy in older patients: A descriptive cross‐sectional study

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