TY - JOUR
T1 - Current evidence on the impact of medication optimization or pharmacological interventions on frailty or aspects of frailty
T2 - a systematic review of randomized controlled trials
AU - Pazan, Farhad
AU - Petrovic, Mirko
AU - Cherubini, Antonio
AU - Onder, Graziano
AU - Cruz-Jentoft, Alfonso J.
AU - Denkinger, Michael
AU - van der Cammen, Tischa J.M.
AU - Stevenson, Jennifer M.
AU - Ibrahim, Kinda
AU - Rajkumar, Chakravarthi
AU - Bakken, Marit Stordal
AU - Baeyens, Jean Pierre
AU - Crome, Peter
AU - Frühwald, Thomas
AU - Gallaghar, Paul
AU - Guðmundsson, Adalsteinn
AU - Knol, Wilma
AU - O’Mahony, Denis
AU - Pilotto, Alberto
AU - Rönnemaa, Elina
AU - Serra-Rexach, José Antonio
AU - Soulis, George
AU - van Marum, Rob J.
AU - Ziere, Gijsbertus
AU - Mair, Alpana
AU - Burkhardt, Heinrich
AU - Neumann-Podczaska, Agnieszka
AU - Wieczorowska-Tobis, Katarzyna
AU - Fernandes, Marilia Andreia
AU - Gruner, Heidi
AU - Dallmeier, Dhayana
AU - Beuscart, Jean Baptiste
AU - van der Velde, Nathalie
AU - Wehling, Martin
N1 - Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/1
Y1 - 2021/1
N2 - 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.
AB - 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.
KW - Frailty
KW - Inappropriate drug treatment
KW - Medication optimization
KW - Older people
KW - Polypharmacy
KW - Prefrailty
UR - http://www.scopus.com/inward/record.url?scp=85089194311&partnerID=8YFLogxK
U2 - 10.1007/s00228-020-02951-8
DO - 10.1007/s00228-020-02951-8
M3 - Review article
C2 - 32770278
AN - SCOPUS:85089194311
SN - 0031-6970
VL - 77
SP - 1
EP - 12
JO - European Journal of Clinical Pharmacology
JF - European Journal of Clinical Pharmacology
IS - 1
ER -