The FORTA (Fit fOR The Aged) List 2018: Third Version of a Validated Clinical Tool for Improved Drug Treatment in Older People

  • Farhad Pazan
  • Christel Weiss
  • Martin WehlingEmail author
Letter to the editor

Multimorbidity and widespread use of clinical guidelines are the main causes for highly prevalent polypharmacy in older people [1, 2]. Polypharmacy has been identified as a major risk factor for inappropriate drug treatment and adverse drug events in older patients [3, 4, 5], and is even associated with increased mortality [6, 7]. However, the use of multiple drugs to treat serious medical conditions is often vital, but should be differentiated into appropriate/beneficial or problematic applications by the critical review of medication schemes. Several listing approaches and tools have been developed to assist prescribers in choosing the appropriate drugs for their patients. The majority of these approaches (e.g., Beers criteria [8]) are drug-oriented listing approaches (DOLA) [9] and mostly focus on what not to prescribe in older patients. Their impact on relevant clinical outcomes (e.g., mortality or hospitalization) is still unclear [10], with the majority of randomized clinical...



FORTA List 2018 Initiators and Their Affiliations: Martin Wehling, MD (Creator of the FORTA Concept); Clinical Pharmacology, Center for Geriatric Pharmacology, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Heinrich Burkhardt, MD; 2nd, Medical Department, Center for Geriatrics, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. Stefan Schwarz, MD; Central Institute of Mental Health, Mannheim, Germany. Ulrich Wedding, MD; Division of Palliative Care, University Hospital Jena, Clinic for Internal Medicine II, Erlanger Allee 101, 07740 Jena, Germany.

Expert Panel Members (Raters) and Their Affiliations: Jürgen Bauer, MD; Geriatric Centre of the Medical Faculty of the University of Heidelberg, AGAPLESION Bethanien Hospital Heidelberg, Rohrbacher Straße 149, 69126 Heidelberg, Germany. Heiner K. Berthold, MD; Department of Internal Medicine and Geriatrics, Bielefeld Evangelical Hospital (EvKB), Schildescher Strasse 99, 33611 Bielefeld, Germany. Michael Denkinger, MD; AGAPLESION Bethesda Clinic Ulm, University Hospital Ulm, Zollernring 26, 89073 Ulm, Germany. Peter Dovjak, MD; Gmunden Hospital, Department of Acute Geriatric Medicine, Miller-von-Aichholz-Straße 49, A-4810 Gmunden, Austria. Helmut Frohnhofen, MD; Department of Nephrology, Geriatrics and Internal Medicine, Alfried Krupp Hospital Rüttenscheid, Alfried-Krupp-Straße 21, 45276 Essen, Germany. Markus Gosch, MD; Medical Clinic 2, Geriatric Department, University Hospital of the Paracelsus Medical University, Nürnberg Hospital North, Prof.-Ernst-Nathan-Str. 1, 90419 Nürnberg, Germany. Hans Gutzmann, MD; Hedwigshöhe Hospital, Clinic for Psychiatry, Psychotherapy and Psychosomatic Medicine, Höhensteig 1, 12526 Berlin, Germany. Isabella Heuser-Collier, MD; Charité University Hospital Berlin, Department of Psychiatry and Psychotherapy, University Medicine Berlin, Hindenburgdamm 30, 112203 Berlin, Germany. Friedemann Honecker, MD; General Internal Medicine, Hematology, Senology/Breast medicine, Tumor- und Brustzentrum ZeTuP, Silberturm, Rorschacherstrasse 150, 9006 St. Gallen, Switzerland. Michael Hüll, MD; Clinic for Geriatric Psychiatry and Psychotherapy, Center for Psychiatry Emmendingen, Neubronnstr. 25, 79312 Emmendingen, Germany. Bernhard Iglseder, MD; Department of Geriatric Medicine, Christian-Doppler-Klinik, Paracelsus Medical University, Ignaz-Harrer-Str. 79, 5020 Salzburg, Austria. Ulrich Jaehde, PhD; Friedrich-Wilhelms-University Bonn, Pharmaceutical Institute, Clinical Pharmacy, An der Immenburg 4, 53121 Bonn, Germany. Siegfried Kasper, MD; Department of Psychiatry and Psychotherapy, Medical University of Vienna, AKH, Währinger Gürtel 18-20, A-1090 Vienna, Austria. Gerald Kolb, MD; Department of Geriatric Medicine, Bonifatius Hospital Lingen gGmbH, Wilhelmstraße 13, 49808 Lingen (Ems), Germany. Reto W. Kressig, MD; University Basel, Memory Clinic – Academic Geriatric Medicine, Burgfelderstrasse 101, 4055 Basel, Switzerland. Anja Kwetkat, MD; Jena University Hospital, Department of Geriatric Medicine, Bachstraße 18, 07740 Jena, Germany. Thomas Münzer, MD, EAMA Board Member; Competence Center Healthy Ageing, Geriatric Clinic St. Gallen AG, Rorschacherstrasse 94, 9000 St. Gallen, Switzerland. Christoph Schindler, MD; Clinical Research Center Hannover, CRC- MHH Core Facility, Feodor-Lynen-Strasse 15, 30625 Hannover, Germany. Matthias Schuler, MD; Diakonissenhospital Mannheim, Geriatric Clinic, Speyerer Straße 91-93, 68163 Mannheim, Germany. Ralf-Joachim Schulz, MD; Geriatric Clinic at the St.-Marien Hospital, Kunibertkloster 11-13 50668 Köln, Germany. Ulrike Sommeregger, MD; Hietzing Hospital and Neurological Center Rosenhügel, Wolkersbergenstraße 1, 1130 Vienna, Department of Acute Geriatric Medicine, Donauspital, Langobardenstraße 122, 120 Vienna, Austria. Andrej Zeyfang, MD; Clinic for General Internal, Geriatric and Palliative Medicine, KLINIK OSTFILDERN-RUIT, Academic Educational hospital of the University Tübingen, Hedelfinger Str. 166, 73760 Ostfildern, Germany.

Compliance with Ethical Standards

Martin Wehling was employed by AstraZeneca R&D, Mölndal, as the director of discovery medicine (translational medicine) from 2003 to 2006, while on sabbatical leave from his professorship at the University of Heidelberg. Since returning to this position in January 2007, he has received lecturing and consulting fees from Sanofi-Aventis, Bayer, Berlin-Chemie, Boehringer-Ingelheim, Aspen, Novartis, Takeda, Roche, Pfizer, Bristol-Myers, Daichii-Sankyo, Lilly, Otsuka, Novo-Nordisk, Shire, and LEO Pharma. Farhad Pazan and Christel Weiss have no conflicts of interest that are directly relevant to the contents of this letter.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Farhad Pazan
    • 1
  • Christel Weiss
    • 2
  • Martin Wehling
    • 1
    Email author
  1. 1.Clinical Pharmacology, Medical Faculty MannheimRuprecht-Karls-University HeidelbergMannheimGermany
  2. 2.Department of Medical Statistics, Biomathematics and Information Processing, Medical Faculty MannheimHeidelberg UniversityMannheimGermany

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