Specific features of rational geriatric pharmacotherapy: the role of clinical pharmacists in individualized drug treatment in older age


Authors: Daniela Fialová 1,2,3
Authors‘ workplace: Univerzitní vzdělávací centrum klinické farmacie, Farmaceutická fakulta UK v Hradci Králové 1;  Geriatrická klinika 1. LF UK a VFN v Praze 2;  Katedra sociální a klinické farmacie, Farmaceutická fakulta UK v Hradci Králové 3
Published in: Vnitř Lék 2018; 64(11): 1028-1034
Category:

Overview

Polypharmacy and polymorbidity are frequent phenomena in the older age and the complexity of prescribed drug regimens often lead to prescribing problems and indication of drugs, doses and drug schemes inappropriate in older adults. Also, physiological and pathological changes accompanied aging are not sufficiently respected. The articles summarized results of previous European projects conducted in the Czech Republic in the area of potentially inappropriate prescribing in older patients. It refers to the most often used explicit criteria, supporting safety and efficacy of pharmacotherapy in older age and refers to importance of clinical-pharmacy services in primary and secondary care during the individualization of drug regimens. At the end of the article is introduced newly starting EUROAGEISM H2020 project (FIP7 program) supported by the European Commission for the period 2017–2021. The main aims of this project are to describe problematic features of geriatric prescribing in Central and Eastern Europe (in the Czech Republic, Estonia, Latvia, Slovac Republic, Serbia, Croatia and Albania, comparatively to Western-European and Northern-European countries: Ireland, Portugal and Finland) and to support development of clinical-pharmacy services in different settings of care in Central and Eastern Europe.

Key words:

individualized drug therapy – clinical pharmacy in geriatrics – pharmacokinetic and pharmacodynamic changes in the older age – rational geriatric pharmacotherapy


Sources
  1. Mamolo M, Scherbov S. Population projections for fourty-four European countries: The ongoing population ageing. European Demographic Research Papers 2009/2. Vienna Institute of Demography of the Austrian Academy of Sciences: Vienna (Austria) 2009. Dostupné z WWW: <https://core.ac.uk/download/pdf/33900431.pdf>.
  2. Spinewine A, Fialová D, Byrne S. The role of the pharmacist in optimizing pharmacotherapy in older people. Drugs Aging 2012; 29(6): 495–510. Dostupné z DOI: <http://dx.doi.org/10.2165/11631720–000000000–00000>.
  3. EU H2020 “EUROAGEISM” project (2017–2021). Dostupné z WWW: <https://portal.faf.cuni.cz/Research-Overview/Euroageism-project/>.
  4. Fialová D. Specifické rysy geriatrické farmakoterapie I. Změna terapeutické hodnoty léků ve stáří. Karolinum: Praha 2007. ISBN 978–80–246–1353–6.
  5. Topinková E. Geriatrie pro praxi. Galén: Praha 2005. ISBN 8072623656.
  6. Kalvach Z, Zadák Z, Jirák R et al. Geriatrie a gerontologie. Grada: Praha 2004. ISBN 80–247–0548–6.
  7. Yu Z, Hu G. The prevalence of the Metabolic Syndrome. In: Batone TE. Metabolic Syndrome Research Trends. Nova Science Publishers: UK 2008. ISBN-10: 1604562242. ISBN-13: 978–1604562248.
  8. Kubínek R, Pidrman V. Deprese seniorů. Psychiatr Prax 2008; 9(1): 8–12.
  9. Holmerová I, Vaňková H, Jurašková B. Deprese ve stáří. In: Deprese z různých úhlů pohledu II. Galén: Praha 2007: 93–123. ISBN 9788072624744.
  10. Vaňková H, Hradcová D, Jedlinská M et al. Prevalence kognitivních poruch v pobytových zařízeních pro seniory v ČR – nárůst mezi lety 2007 a 2013. Geri Gero 2013; 2(3): 111–114.
  11. Simonson W. Introduction to the Aging Process. In: Delafuente MS, Steward RB. Therapeutics in the elderly. 3rd ed. WHITNEY, HARVEY BOOKS: Cincinnati (USA) 2000. ISBN 978–0929375229.
  12. Kubešová H, Holík J, Šipr K et al. Farmakoterapie starších klientů praktického lékaře – teorie a skutečnost. Geriatria 2000; 6(3): 27–33.
  13. Topinková E, Fialová D. Geriatrická farmakoterapie – léčiva nevhodná pro starší nemocné. Postgrad Med 2006; 8(Suppl): 28–35.
  14. Topinková E, Fialová D, Býma S et al. Část I. Racionální farmakoterapie geriatrických pacientů. Doporučený postup (novelizace 2014). In: Červený R, Topinková E. Doporučené terapeutické a diagnostické postupy pro všeobecné praktické lékaře – Geriatrie. CDP-PL Centrum doporučených postupů pro všeobecné praktické lékaře (CDP-PL): Praha 2014: 3–17. Dostupné z WWW:< http://www.svl.cz/files/files/Doporucene-postupy-od-2013/DP-Geriatrie-2014.pdf>.
  15. Fialová D, Topinková E, Gambassi G et al. Potentially Inappropriate Medication Use Among Elderly Home Care Patients in Europe. JAMA 2005; 293(11): 1348–1358. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.293.11.1348>.
  16. Onder G, Liperoti R, Fialova D et al. [SHELTER research group]. Polypharmacy in nursing home in Europe: results from the SHELTER study. J Gerontol A Biol Sci Med Sci 2012; 67(6): 698–704. Dostupné z DOI: http://doi: 10.1093/gerona/glr233>.
  17. Gallagher P, Lang PO, Cherubini A et al. Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals. Eur J Clin Pharmacol 2011; 67(11): 1175–1188. Dostupné z DOI: <http://dx.doi.org/10.1007/s00228–011–1061–0>.
  18. Topinková E, Mádlová P, Fialová D et al. Nová evidence-based kritéria pro posouzení vhodnosti lékového režimu u seniorů. Kritéria STOPP a START. Vnitř Lék 2008; 54(12): 1161–1169.
  19. Gallagher P, Ryan C, Byrne S et al. STOPP (Screening Tool of Older Person‘s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation. Int J Clin Pharm Ther 2008; 46(2): 72–83.
  20. O‘Mahony D, O‘Sullivan D, Byrne S et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing 2015; 44(2): 213–218. Dostupné z DOI: <http://dx.doi.org/10.1093/ageing/afu145>.
  21. Fialová D, Topinková E, Ballóková A et al. Expertní konsensus ČR 2012 v oblasti léčiv a lékových postupů potenciálně nevhodných ve stáří. Oddíl I. Vhodnost volby léčiv a dávkovacích schémat u geriatrických pacientů Oddíl II Interakce lék-nemoc ve stáří. (2012 CZ expert consensus for potentially inappropriate medication use in old age: Appropriate choice of drugs and drug dosing in geriatric patients (Section I.), drug-disease interactions in the old age (Section II.) Klinická Farmakol Farm 2013; 27(1): 18–28.
  22. Fialová D, Topinková E, Matějovská-Kubešová H et al. Racionální farmakoterapie ve stáří. Expertní konsensus ČR 2012 v oblasti léčiv a lékových postupů potenciálně nevhodných u seniorů. Geri Gero 2013; 2(1): 5–15.
  23. Topinková E, Fialová D, Matějovská Kubešová H. Potenciálně nevhodná (riziková) léčiva u seniorů: Expertní konsensus pro Českou republiku 2012. Praktický lékař 2012; 92(1): 11–22.
  24. Fialová D, Topinková E. Koncept léčiv nevhodných ve stáří – farmakologické a farmakoepidemiologické aspekty. Remedia 2005; 15(4–5): 410–417.
  25. [American Geriatric Society 2015 Beers Criteria Update Expert Panel]. American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc 2015; 63(11): 2227–2246. Dostupné z DOI: <http://dx.doi.org/10.1111/jgs.13702>.
  26. [American Geriatrics Society 2012 Beers Criteria Update Expert Panel]. American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2012; 60(4): 616–631. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1532–5415.2012.03923.x>.
  27. Laroche ML, Charmes JP, Bouthier F et al. Inappropriate medications in the elderly. Clin Pharmacol Ther 2009; 85(1): 94–97. Dostupné z DOI: <http://dx.doi.org/10.1038/clpt.2008.214>.
  28. Rognstad S, Brekke M, Fetveit A et al. The Norwegian General Practice (NORGEP) criteria for assessing potentially inappropriate prescriptions to elderly patients. A modified Delphi study. Scand J Prim Health Care 2009; 27(3): 153–159. Dostupné z DOI: <http://dx.doi.org/10.1080/02813430902992215>.
  29. Kongkaew C, Noyce PR, Ashcroft DM. Hospital admissions associated with adverse drug reactions: a systematic review of prospective observational studies. Ann Pharmacother 2008; 42(7): 1017–1025. Dostupné z DOI: <http://dx.doi.org/10.1345/aph.1L037>.
  30. Steinman MA, Hanlon JT. Managing medications in clinically complex elders: “There‘s got to be a happy medium”. JAMA 2010; 304(14): 1592–1601. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2010.1482>.
  31. Leendertse AJ, Egberts AC, Stoker LJ et al. [HARM Study Group]. Frequency of and risk factors for preventable medication-related hospital admissions in the Netherlands. Arch Intern Med 2008; 168(17): 1890–1896. Dostupné z DOI: <http://dx.doi.org/10.1001/archinternmed.2008.3>.
  32. Leendertse AJ, Van Den Bemt PM, Poolman JB et al. Preventable hospital admissions related to medication (HARM): cost analysis of the HARM study. Value Health 2011; 14(1): 34–40. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jval.2010.10.024>.
  33. Sorensen L, Stokes JA, Purdie DM et al. Medication reviews in the community: results of a randomized, controlled effectiveness trial. Br J Clin Pharmacol 2004; 58(6): 648–664. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1365–2125.2004.02220.x>.
  34. Hanlon JT, Schmader KE, Ruby CM et al. Suboptimal prescribing in older inpatients and outpatients. J Am Geriatr Soc 2001; 49(2): 200–209.
  35. Cornuault L, Mouchel V, Phan Thi TT et al. Identification of variables influencing pharmaceutical interventions to improve medication review efficiency. Int J Clin Pharm 2018; 40(5):1175–1179. Dostupné z DOI: <http://dx.doi.org/10.1007/s11096–018–0668-y>.
  36. Koncepce oboru klinická farmacie – historie oboru, definice, cíle, pregraduální a postgraduální vzdělávání, činnosti klinických farmaceutů (část I., vzdělávací část). Česká a slovenská farmacie 2016; Supplementum. Dostupné z WWW: <https://www.prolekare.cz/casopisy/ceska-slovenska-farmacie/2016/dokumenty/supplementum-koncepce-oboru-klinicka-farmacie-37>.
  37. Somers A, Mallet L, van der Cammen T et al. Applicability of an adapted medication appropriateness index for detection of drug-related problems in geriatric inpatients. Am J Geriatr Pharmacother 2012; 10(2): 101–109. Dostupné z DOI: <http://dx.doi.org/10.1016/j.amjopharm.2012.01.003>.
  38. Hanlon JT, Lindblad CI, Gray SL. Can clinical pharmacy services have a positive impact on drug-related problems and health outcomes in community-based older adults? Am J Geriatr Pharmacother 2004; 2(1): 3–13.
  39. Toivo T, Dimitrow M, Puustinen J et al. Coordinating resources for prospective medication risk management of older home care clients in primary care: procedure development and RCT study design for demonstrating its effectiveness. BMC Geriatrics 2018; 18(1): 74. Dostupné z DOI: <http://dx.doi.org/10.1186/s12877–018–0737-z>.
Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 11

2018 Issue 11

Most read in this issue

This topic is also in:


Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account