Polypharmazie als Folge der Multimorbidität älterer Menschen: rationalere Therapie durch die neue FORTA-Klassifikation?
Final Report Abstract
Based on our results, our work group has ascertained that the FORTA classification system with its newly-developed clinical aspect (FORTA List) may have great potential, not only in Germany, but also throughout Europe and other countries, to be used as an aid in optimizing the pharmacotherapy of the aged. Within the context of the FORTA Project as a whole, and according to feedback we have received both by the participating experts and by the participating physicians and clinical staff, we are helping to awaken a keen interest in improving quality of care for our elderly patients. Specifically, in the everyday clinical setting, we have observed that interdisciplinary efforts focusing attention on the pharmacotherapy of patients on an individual basis using the solid background of the FORTA concept not only help in the immediate, acute treatment of the patient at the bedside, but also contributed to the overall, and long-term education of and communication among the physicians and health care staff, thus possibly resulting in long-term and further-reaching benefits for both physicians and their elderly patients. The positive results of the VALFORTA trial which in terms of significance and clinical outcomes (NNT for avoidance of ADR by FORTA only 5) exceeded our expectations trigger the planning of a corresponding trial in general practices. A funding proposal is submitted simultaneously to the DFG. Presently, we prepare an update of the FORTA list by the same Delphi procedure as for FORTA 2012; most experts have agreed to serve again as raters. In parallel, this procedure will be performed in 5-6 European countries to finally build a European FORTA list.
Publications
- Drug therapy in the elderly: too much or too little, what to do? A new assessment system: fit for the aged. J Am Geriatr. Soc. 2008;133:2289-91
Wehling M.
- Multimorbidity and polypharmacy: how to reduce the harmful drug load and yet add needed drugs in the elderly? Proposal of a new drug classification: fit for the aged. J Am Geriatr Soc. 2009;57:560-1
Wehling M.
- Assessment of drug treatment in geriatrics wth the new FORTA criteria: preliminary clinical experience. Dtsch Med Wochenschr. 2011;136:1417-21
Frohnhofen H, Michalek C, Wehling M
- Erste klinische Erfahrungen mit der neuen FORTA- Klassifikation (Abstract). Z Gerontol Geriatr. 2012;45:21
Frohnhofen H, Wehling M, Michalek C
- Arzneitherapie für Ältere. 3rd Edition. Heidelberg: Springer; 2013
Wehling M, Burkhardt H
- Drug therapy for the elderly. Vienna: Springer; 2013
Wehling M.
- (2014) Antihypertensive Drugs in the Elderly: Risks and Benefits as Evaluated by the FORTA Method. J Gerontol Geriatr Res 3:4
Kuhn-Thiel AM, Wehling M
(See online at https://dx.doi.org/10.4172/2167-7182.1000171) - Effects of "Fit fOR The Aged" (FORTA) on pharmacotherapy and clinical endpoints - a pilot randomized controlled study. Eur J Clin Pharmacol. 70, 1261-7, 2014
Michalek, C., Wehling, M., Schlitzer, J., Frohnhofen, H.
(See online at https://doi.org/10.1007/s00228-014-1731-9) - FORTA authors/expert panel members (2014). Consensus validation of the FORTA (Fit fOR The Aged) List: a clinical tool for increasing the appropriateness of pharmacotherapy in the elderly. Drugs Aging 31: 131-140
Kuhn-Thiel AM, Weiß C, Wehling M
(See online at https://doi.org/10.1007/s40266-013-0146-0)
