Current evidence on the impact of medication optimization or pharmacological interventions on frailty or aspects of frailty: a systematic review of randomized controlled trials
Current evidence on the impact of medication optimization or pharmacological interventions on frailty or aspects of frailty: a systematic review of randomized controlled trials
Background
Frailty and adverse drug effects are linked in the fact that polypharmacy is correlated with the severity of frailty; however, a causal relation has not been proven in older people with clinically manifest frailty.
Methods
A literature search was performed in Medline to detect prospective randomized controlled trials (RCTs) testing the effects of pharmacological interventions or medication optimization in older frail adults on comprehensive frailty scores or partial aspects of frailty that were published from January 1998 to October 2019.
Results
Twenty-five studies were identified, 4 on comprehensive frailty scores and 21 on aspects of frailty. Two trials on comprehensive frailty scores showed positive results on frailty although the contribution of medication review in a multidimensional approach was unclear. In the studies on aspects related to frailty, ten individual drug interventions showed improvement in physical performance, muscle strength or body composition utilizing alfacalcidol, teriparatide, piroxicam, testosterone, recombinant human chorionic gonadotropin, or capromorelin. There were no studies examining negative effects of drugs on frailty.
Conclusion
So far, data on a causal relationship between drugs and frailty are inconclusive or related to single-drug interventions on partial aspects of frailty. There is a clear need for RCTs on this topic that should be based on a comprehensive, internationally consistent and thus reproducible concept of frailty assessment.
Frailty, Inappropriate drug treatment, Medication optimization, Older people, Polypharmacy, Prefrailty
1-12
Pazan, Farhad
96e26b86-36cc-42ea-b6ba-434893058f90
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
January 2021
Pazan, Farhad
96e26b86-36cc-42ea-b6ba-434893058f90
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Pazan, Farhad
,
et al.
(2021)
Current evidence on the impact of medication optimization or pharmacological interventions on frailty or aspects of frailty: a systematic review of randomized controlled trials.
European Journal of Clinical Pharmacology, 77 (1), .
(doi:10.1007/s00228-020-02951-8).
Abstract
Background
Frailty and adverse drug effects are linked in the fact that polypharmacy is correlated with the severity of frailty; however, a causal relation has not been proven in older people with clinically manifest frailty.
Methods
A literature search was performed in Medline to detect prospective randomized controlled trials (RCTs) testing the effects of pharmacological interventions or medication optimization in older frail adults on comprehensive frailty scores or partial aspects of frailty that were published from January 1998 to October 2019.
Results
Twenty-five studies were identified, 4 on comprehensive frailty scores and 21 on aspects of frailty. Two trials on comprehensive frailty scores showed positive results on frailty although the contribution of medication review in a multidimensional approach was unclear. In the studies on aspects related to frailty, ten individual drug interventions showed improvement in physical performance, muscle strength or body composition utilizing alfacalcidol, teriparatide, piroxicam, testosterone, recombinant human chorionic gonadotropin, or capromorelin. There were no studies examining negative effects of drugs on frailty.
Conclusion
So far, data on a causal relationship between drugs and frailty are inconclusive or related to single-drug interventions on partial aspects of frailty. There is a clear need for RCTs on this topic that should be based on a comprehensive, internationally consistent and thus reproducible concept of frailty assessment.
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More information
Accepted/In Press date: 30 June 2020
e-pub ahead of print date: 7 August 2020
Published date: January 2021
Keywords:
Frailty, Inappropriate drug treatment, Medication optimization, Older people, Polypharmacy, Prefrailty
Identifiers
Local EPrints ID: 445965
URI: http://eprints.soton.ac.uk/id/eprint/445965
ISSN: 0031-6970
PURE UUID: e57afa75-14c8-4c87-8b15-98ed90f936b3
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Date deposited: 15 Jan 2021 17:33
Last modified: 17 Mar 2024 03:34
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Contributors
Author:
Farhad Pazan
Corporate Author: et al.
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