VALFORTA

• Verfasst von: Wehling, Martin [VerfasserIn]
• Verfasst von: Burkhardt, Heinrich [VerfasserIn]
• Verfasst von: Pazan, Farhad [VerfasserIn]
• Verfasst von: Throm, Christina [VerfasserIn]
• Verfasst von: Weiß, Christel [VerfasserIn]
• Titel: VALFORTA
• Titelzusatz: a randomised trial to validate the FORTA (Fit fOR The Aged) classification
• Verf.angabe: Martin Wehling, Heinrich Burkhardt, Alexandra Kuhn-Thiel, Farhad Pazan, Christina Throm, Christel Weiss, Helmut Frohnhofen
• E-Jahr: 2016
• Jahr: 18 January 2016
• Umfang: 6 S.
• Fussnoten: Gesehen am 28.03.2019
• Titel Quelle: Enthalten in: Age & ageing
• Ort Quelle: Oxford : Oxford Univ. Press, 1972
• Jahr Quelle: 2016
• Band/Heft Quelle: 45(2016), 2, Seite 262-267
• ISSN Quelle: 1468-2834
• DOI: doi:10.1093/ageing/afv200
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 166248285X

Abstract

Trial design: to further validate the FORTA (Fit fOR The Aged) concept, a bicentric randomised, controlled trial was run in two geriatric clinics. Methods: patients (≥65 years, ≥3 drugs or ≥60 years, ≥6 drugs) with three relevant diseases and hospitalisation for ≥5 days were randomised. In the intervention, but not the control group, a FORTA team instructed ward physicians on FORTA. FORTA is the first positive/negative listing approach labelling medications used to treat chronic illnesses in older patients from A (indispensable), B (beneficial), C (questionable) to D (avoid). The primary end point was the FORTA score: sum of medication errors classified as over-, under- and mistreatment. Consecutive patients were randomised to the intervention and control ward; outcome assessment was blinded. Results: four hundred and nine patients (age 81.5 years, 64% female, hospitalisation 17.4 days) were included. The primary end point was significantly (P < 0.0001) more reduced in the intervention versus control groups (2.7 ± 2.25 versus 1 ± 1.8, mean ± SD, intergroup comparison of admission/discharge differences). Over- and under-treatment scores and use of A (increase) and D (decrease) drugs were significantly improved (P < 0.01). The total number of adverse drug reactions (ADRs) was significantly reduced by FORTA (P < 0.05, number needed to treat is 5). Activities of daily living and renal failure improved significantly (P < 0.05). Blood pressure remained constant in the intervention, but decreased significantly in the control group. Conclusion: applying FORTA to hospitalised geriatric patients leads to improvement of medication quality and may improve secondary clinical end points (e.g. ADRs). The concept is amenable to successful communication and implementation.