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Optimization of Geriatric Pharmacotherapy: Role of Multifaceted Cooperation in the Hospital Setting

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Abstract

Because older patients are more vulnerable to adverse drug-related events, there is a need to ensure appropriate pharmacotherapy in these patients. This narrative review describes approaches to improve pharmacotherapy in older people in the hospital setting. Screening to identify older patients at risk of drug-related problems and adverse drug reactions (ADRs) is the first critical step within a multistep approach to geriatric pharmacotherapy. Two methods that have been developed are the GerontoNet ADR risk score and the Brighton Adverse Drug Reactions Risk (BADRI) model, which take into account a number of factors, the most important of which is the number of medicines. In order to reduce potentially inappropriate prescribing in older patients, different types of interventions exist, such as pharmacist-led medication reviews, educational interventions, computerized decision support systems, and comprehensive geriatric assessment. The effects of these interventions have been studied, sometimes in a multifaceted approach, by combining different techniques. None of the existing interventions shows a clear beneficial effect on patients’ health outcomes if applied in isolation; however, when these interventions are combined within the context of a multidisciplinary team, positive effects on patients’ health outcomes can be expected. Appropriate geriatric pharmacotherapy, global assessment of patients’ clinical and functional parameters, and integration of skills from different healthcare professionals are needed to address medical complexity of older adults.

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Acknowledgments

This article is based on a presentation given at the 42nd ESCP Symposium on the Implementation of Clinical Pharmacy Practice: Research, Education and Management, held in Prague, Czech Republic, 16–18 October 2013.

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Authors and Affiliations

  1. Department of Geriatrics, Ghent University Hospital, De Pintelaan 185, Ghent, Belgium

    Mirko Petrovic

  2. Department of Pharmacy, Ghent University Hospital, Ghent, Belgium

    Annemie Somers

  3. Centro Medicina dell’Invecchiamento, Department of Geriatrics, Policlinico A. Gemeli, Catholic University of the Sacred Heart, Rome, Italy

    Graziano Onder

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  1. Mirko Petrovic
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  3. Graziano Onder
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Correspondence to Mirko Petrovic.

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No sources of funding were received for the preparation of this review.

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Mirko Petrovic, Annemie Somers, and Graziano Onder declare no conflicts of interest in regard to this review.

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Petrovic, M., Somers, A. & Onder, G. Optimization of Geriatric Pharmacotherapy: Role of Multifaceted Cooperation in the Hospital Setting. Drugs Aging 33, 179–188 (2016). https://doi.org/10.1007/s40266-016-0352-7

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