Pazan2021_Article_CurrentEvidenceOnTheImpactOfMe.pdf (416.27 kB)
Current evidence on the impact of medication optimization or pharmacological interventions on frailty or aspects of frailty: a systematic review of randomized controlled trials
journal contribution
posted on 2023-06-10, 00:35 authored by Farhad Pazan, Mirko Petrovic, Antonio Cherubini, Graziano Onder, Alfonso J Cruz-Jentoft, Michael Denkinger, Tischa J M van der Cammen, Jennifer M Stevenson, Kinda Ibrahim, Chakravarthi RajkumarChakravarthi Rajkumar, Marit Stordal Bakken, Jean-Pierre Baeyens, Peter Crome, Thomas Frühwald, Paul Gallaghar, othersBackground 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.
History
Publication status
- Published
File Version
- Published version
Journal
European Journal of Clinical PharmacologyISSN
0031-6970Publisher
SpringerExternal DOI
Volume
77Page range
1-12Event location
GermanyDepartment affiliated with
- Clinical and Experimental Medicine Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2021-08-10First Open Access (FOA) Date
2021-08-10First Compliant Deposit (FCD) Date
2021-08-10Usage metrics
Categories
No categories selectedKeywords
Licence
Exports
RefWorks
BibTeX
Ref. manager
Endnote
DataCite
NLM
DC