P-491: The FORTA (Fit fOR The Aged) List 2018: a crucial update of a clinical tool for the optimization of drug treatment in older adults

摘要

Many trials have demonstrated that older adults are often subjects to inappropriate prescribing. The main reason for this problem is that for most of the drugs there is no evidence regarding efficacy and safety in older adults. This problem is worsened by the high prevalence of multimorbidity and therefore polypharmacy in this population. To increase the appropriateness of pharmacotherapy in older adults, we have developed a clinical aid called the FORTA List. FORTA was originally invented by Wehling and validated and expanded by 20 experts in a Delphi consensus procedure. In addition, we assessed FORTA's usefulness in a pilot clinical trial as well as in a controlled prospective trial. These trials showed that FORTA significantly increases the quality of pharmacotherapy and reduces the frequency of adverse drug reactions. As an evidence-based document the FORTA List needs regular updates as the field of geriatric pharmacology progresses rapidly. Thus, we performed a new Delphi survey to update this helpful clinical tool. This Delphi consensus procedure involved 22 experts who evaluated the proposal of 4 initiators. The new FORTA List now contains 296 items and 30 indications. Thus, 23 entries and one indication were added to its former version. In conclusion, the updated list now incorporates one additional chronic condition and contains more drugs used to treat older adults.