Current evidence on the impact of medication optimization or pharmacological interventions on frailty or aspects of frailty: a systematic review of randomized controlled trials

被引：38

作者：

Pazan, Farhad ^{[1
]}

Petrovic, Mirko ^{[2
]}

Cherubini, Antonio ^{[3
]}

Onder, Graziano ^{[4
]}

Cruz-Jentoft, Alfonso J. ^{[5
]}

Denkinger, Michael ^{[6
,7
]}

van der Cammen, Tischa J. M. ^{[8
]}

Stevenson, Jennifer M. ^{[9
]}

Ibrahim, Kinda ^{[10
]}

Rajkumar, Chakravarthi ^{[11
]}

Bakken, Marit Stordal ^{[12
]}

Baeyens, Jean-Pierre ^{[13
,14
]}

Crome, Peter ^{[15
]}

Fruehwald, Thomas ^{[16
]}

Gallaghar, Paul ^{[17
]}

Gudmundsson, Adalsteinn ^{[18
]}

Knol, Wilma ^{[19
,20
]}

O'Mahony, Denis ^{[21
]}

Pilotto, Alberto ^{[22
,23
]}

Ronnemaa, Elina ^{[24
]}

Antonio Serra-Rexach, Jose ^{[25
,26
,27
,28
]}

Soulis, George ^{[29
]}

van Marum, Rob J. ^{[30
]}

Ziere, Gijsbertus ^{[31
,32
]}

Mair, Alpana ^{[33
]}

Burkhardt, Heinrich ^{[34
]}

Neumann-Podczaska, Agnieszka ^{[35
]}

Wieczorowska-Tobis, Katarzyna ^{[36
,37
]}

Fernandes, Marilia Andreia ^{[38
]}

Gruner, Heidi ^{[39
]}

Dallmeier, Dhayana ^{[40
,41
]}

Beuscart, Jean-Baptiste ^{[42
]}

van der Velde, Nathalie ^{[43
]}

Wehling, Martin ^{[1
]}

机构：

[1] Heidelberg Univ, Fac Med Mannheim, Clin Pharmacol Mannheim, Theodor Kutzer Ufer 1-3, D-68167 Mannheim, Germany

[2] Univ Ghent, Dept Internal Med & Paediat, Sect Geriatr, Ghent, Belgium

[3] INRCA Ist Nazl Ricovero & Cura Anziani, Dept Geriatr Med, Ancona, Italy

[4] Ist Super Sanita, Dept Cardiovasc Endocrine Metab Dis & Aging, Rome, Italy

[5] Hosp Univ Ramon y Cajal IRYCIS, Serv Geriatria, Madrid, Spain

[6] Univ Ulm, Dept Geriatr, Ulm, Germany

[7] Agaplesion Bethesda Hosp, Geriatr Ctr Ulm Alb Donau, Ulm, Germany

[8] Delft Univ Technol, Fac Ind Design Engn, Delft, Netherlands

[9] Kings Coll London, Inst Pharmaceut Sci, London, England

[10] Southampton Univ, Acad Geriatr Med, Fac Med, Southampton, Hants, England

[11] Brighton & Sussex Med Sch, Geriatr & Stroke Med, Brighton, E Sussex, England

[12] Univ Bergen, Dept Clin Sci, Bergen, Norway

[13] AZ Alma, Eeklo, Belgium

[14] Univ Luxembourg, Esch Sur Alzette, Luxembourg

[15] Keele Univ, Newcastle Under Lyme, England

[16] Social Med Ctr East, Dept Acute Geriatr, Vienna, Austria

[17] Univ Coll Cork, Sch Med, Cambridge, England

[18] Univ Iceland, Landspitali Univ, Geriatr K4, Reykjavik, Iceland

[19] Univ Utrecht, Univ Med Ctr Utrecht, Dept Geriatr Med, Geriatr, Utrecht, Netherlands

[20] Univ Utrecht, Univ Med Ctr Utrecht, Expertise Ctr Phanmacotherapy Old Persons, Utrecht, Netherlands

[21] Cork Univ Hosp, Univ Coll Cork, Dept Med, Cork, Ireland

[22] Galliera Hosp, Dept Geriatr Care Orthogeriatr & Rehabil, Genoa, Italy

[23] Univ Bari, Dept Interdisciplinary Med, Bari, Italy

[24] Dept Publ Hlth & Caring Sci Geriatr, Uppsala, Sweden

[25] Hosp Gen Univ Gregorio Maranon, Geriatr Dept, Madrid, Spain

[26] Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain

[27] CIBERFES, Consorcio Invest Biomed Red Fragilidad & Envejeci, Madrid, Spain

[28] Univ Complutense Madrid, Fac Med, Med Dept, Madrid, Spain

[29] Henry Dunant Hosp Ctr, Outpatient Geriatr Assessment Unit, Athens, Greece

[30] Free Univ Amsterdam, Dept Gen Med & Geriatr Med, Amsterdam, Netherlands

[31] Univ Med Ctr Rotterdam, Dept Internal Med, Sect Geriatr Med, Erasmus MC, Rotterdam, Netherlands

[32] Maasstad Hosp, Dept Geriatr Med, Rotterdam, Netherlands

[33] Scottish Govt, Effect Prescribing & Therapeut, Edinburgh EH1 3DG, Midlothian, Scotland

[34] Heidelberg Univ, Univ Hosp Mannheim, Med Dept 4, Geriatr, Mannheim, Germany

[35] Poznan Univ Med Sci, Geriatr Lab, Palliat Med Dept, Poznan, Poland

[36] Poznan Univ Med Sci, Dept Palliat Med, Poznan, Poland

[37] Univ Hosp Lords Transfigurat, Palliat Med Unit, Poznan, Poland

[38] Ctr Hosp Univ Lisboa Cent, Hosp Curry Cabral, Dept Internal Med, Lisbon, Portugal

[39] Ctr Hosp Univ Lisboa Cent, Internal Med Dept 7 2, EPE, Hosp Curry Cabral Ctr, Lisbon, Portugal

[40] AGAPLESION Bethesda Clin Ulm, Ulm, Germany

[41] Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USA

[42] Univ Lille, ULR 2694, CHU Lille, METR Evaluat Technol Sante & Prat Med, F-59000 Lille, France

[43] Free Univ Amsterdam, Dept Geriatr Med, Amsterdam, Netherlands

来源：

EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY | 2021年 / 77卷 / 01期

关键词：

Frailty; Prefrailty; Polypharmacy; Medication optimization; Inappropriate drug treatment; Older people; OLDER MEN; EMERGENCY-DEPARTMENT; CLINICAL-PRACTICE; PHYSICAL FUNCTION; MUSCLE; TESTOSTERONE; QUALITY; CARE; COMBINATION; PERFORMANCE;

D O I：

10.1007/s00228-020-02951-8

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

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.

引用

页码：1 / 12

页数：12

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