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

Poudel, A., Hubbard, R.E., Nissen, L., & Mitchell, C (2013) Frailty: A key indicator to minimize inappropriate medication in older people. QJM, 106(10), pp. 969-975.

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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 path that 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 therapeutic guidelines are applicable only to healthy older adults and cannot be generalized to frail patients. These discrepancies should be addressed either by developing new criteria or by refining the existing tools for frail older people. The first and foremost 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 need for 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.

Impact and interest:

9 citations in Scopus
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7 citations in Web of Science®

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ID Code: 91993
Item Type: Journal Article
Refereed: Yes
Keywords: Age Factors, Comorbidity, Geriatric Assessment, Inappropriate Prescribing, Life Expectancy
DOI: 10.1093/qjmed/hct146
ISSN: 1460-2393
Divisions: Current > Schools > School of Clinical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Deposited On: 19 Jan 2016 02:20
Last Modified: 21 Jan 2016 04:05

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