175
Views
12
CrossRef citations to date
0
Altmetric
Perspectives

New drugs and patient-centred end-points in old age: setting the wheels in motion

&

References

  • Mangoni AA. Geriatric medicine in an aging society: up for a challenge? Front Med (Lausanne). 2014;1:10.
  • Haider SI, Johnell K, Thorslund M, et al. Trends in polypharmacy and potential drug-drug interactions across educational groups in elderly patients in Sweden for the period 1992–2002. Int J Clin Pharmacol Ther. 2007;45(12):643–653.
  • Aparasu RR, Mort JR, Brandt H. Polypharmacy trends in office visits by the elderly in the United States, 1990 and 2000. Res Social Adm Pharm. 2005;1(3):446–459.
  • Nishtala PS, Salahudeen MS. Temporal trends in polypharmacy and hyperpolypharmacy in older New Zealanders over a 9-year period: 2005-2013. Gerontology. 2015;61(3):195–202.
  • Maher RL, Hanlon J, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf. 2014;13(1):57–65.
  • Christensen K, Doblhammer G, Rau R, et al. Ageing populations: the challenges ahead. Lancet. 2009;374(9696):1196–1208.
  • Golden AG, Tewary S, Dang S, et al. Care management’s challenges and opportunities to reduce the rapid rehospitalization of frail community-dwelling older adults. Gerontologist. 2010;50(4):451–458.
  • Buckinx F, Rolland Y, Reginster JY, et al. Burden of frailty in the elderly population: perspectives for a public health challenge. Arch Public Health. 2015;73(1):19.
  • Clegg A, Young J, Iliffe S, et al. Frailty in elderly people. Lancet. 2013;381(9868):752–762.
  • Prescriptions Dispensed in the Community. Statistics for 1997 to 2007: Leeds (UK): Health & Social Care Information Centre, 2008 July 31. Report No.: IC 2008 10.
  • Mannucci PM, Nobili A, Investigators R. Multimorbidity and polypharmacy in the elderly: lessons from REPOSI. Intern Emerg Med. 2014;9(7):723–734.
  • Galvin R, Moriarty F, Cousins G, et al. Prevalence of potentially inappropriate prescribing and prescribing omissions in older Irish adults: findings from The Irish LongituDinal Study on Ageing study (TILDA). Eur J Clin Pharmacol. 2014;70(5):599–606.
  • Kuijpers MA, van Marum RJ, Egberts AC, et al. Relationship between polypharmacy and underprescribing. Br J Clin Pharmacol. 2008;65(1):130–133.
  • Routledge PA, O’Mahony MS, Woodhouse KW. Adverse drug reactions in elderly patients. Br J Clin Pharmacol. 2004;57(2):121–126.
  • Popa MA, Wallace KJ, Brunello A, et al. Potential drug interactions and chemotoxicity in older patients with cancer receiving chemotherapy. J Geriatr Oncol. 2014;5(3):307–314.
  • Greene M, Steinman MA, McNicholl IR, et al. Polypharmacy, drug-drug interactions, and potentially inappropriate medications in older adults with human immunodeficiency virus infection. J Am Geriatr Soc. 2014;62(3):447–453.
  • Herr M, Robine JM, Pinot J, et al. Polypharmacy and frailty: prevalence, relationship, and impact on mortality in a French sample of 2350 old people. Pharmacoepidemiol Drug Saf. 2015;24(6):637–646.
  • Gomez C, Vega-Quiroga S, Bermejo-Pareja F, et al. Polypharmacy in the elderly: a marker of increased risk of mortality in a population-based prospective study (NEDICES). Gerontology. 2015;61(4):301–309.
  • Sganga F, Landi F, Ruggiero C, et al. Polypharmacy and health outcomes among older adults discharged from hospital: results from the CRIME study. Geriatr Gerontol Int. 2015;15(2):141–146.
  • Gnjidic D, Hilmer SN, Blyth FM, et al. Polypharmacy cutoff and outcomes: five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes. J Clin Epidemiol. 2012;65(9):989–995.

* Key study on the cut-offs and adverse effects of polypharmacy in the older population

  • Gnjidic D, Hilmer SN, Blyth FM, et al. High-risk prescribing and incidence of frailty among older community-dwelling men. Clin Pharmacol Ther. 2012;91(3):521–528.
  • Mangoni AA. Predicting and detecting adverse drug reactions in old age: challenges and opportunities. Expert Opin Drug Metab Toxicol. 2012;8(5):527–530.
  • Rochon PA, Gurwitz JH. Optimising drug treatment for elderly people: the prescribing cascade. BMJ. 1997;315(7115):1096–1099.
  • Mitrou P, Raptis SA, Dimitriadis G. Thyroid disease in older people. Maturitas. 2011;70(1):5–9.
  • Jackson SH, Jansen PA, Mangoni AA. Off-label prescribing in older patients. Drugs Aging. 2012;29(6):427–434.
  • Ruxton K, Woodman RJ, Mangoni AA. Drugs with anticholinergic effects and cognitive impairment, falls and all-cause mortality in older adults: A systematic review and meta-analysis. Br J Clin Pharmacol. 2015;80(2):209–220.
  • Hilmer SN, Mager DE, Simonsick EM, et al. Drug burden index score and functional decline in older people. Am J Med. 2009;122(12):1142-9 e1-2.
  • Gokula M, Holmes HM. Tools to reduce polypharmacy. Clin Geriatr Med. 2012;28(2):323–341.
  • Nightingale G, Hajjar E, Swartz K, et al. Evaluation of a pharmacist-led medication assessment used to identify prevalence of and associations with polypharmacy and potentially inappropriate medication use among ambulatory senior adults with cancer. J Clin Oncol. 2015;33(13):1453–1459.
  • Patterson SM, Cadogan CA, Kerse N, et al. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev. 2014;10:CD008165.
  • Mangoni AA, Jackson SH. Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. Br J Clin Pharmacol. 2004;57(1):6–14.

* Comprehensive reviews of the available evidence on age-related changes in pharmacokinetics and pharmacodynamics

* Comprehensive reviews of the available evidence on age-related changes in pharmacokinetics and pharmacodynamics

  • Mangoni AA, Jansen PA, Jackson SH. Under-representation of older adults in pharmacokinetic and pharmacodynamic studies: a solvable problem? Expert Rev Clin Pharmacol. 2013;6(1):35–39.
  • Johnston C, Hilmer SN, McLachlan AJ, et al. The impact of frailty on pharmacokinetics in older people: using gentamicin population pharmacokinetic modeling to investigate changes in renal drug clearance by glomerular filtration. Eur J Clin Pharmacol. 2014;70(5):549–555.
  • Wynne HA, Cope LH, Herd B, et al. The association of age and frailty with paracetamol conjugation in man. Age Ageing. 1990;19(6):419–424.
  • Williams FM, Wynne H, Woodhouse KW, et al. Plasma aspirin esterase: the influence of old age and frailty. Age Ageing. 1989;18(1):39–42.
  • Mitchell SJ, Kane AE, Hilmer SN. Age-related changes in the hepatic pharmacology and toxicology of paracetamol. Curr Gerontol Geriatr Res. 2011;2011:624156.
  • He X, Clarke SJ, McLachlan AJ. Clinical pharmacology of chemotherapy agents in older people with cancer. Curr Gerontol Geriatr Res. 2011;2011:628670.
  • Clegg A, Relton C, Young J, et al. Improving recruitment of older people to clinical trials: use of the cohort multiple randomised controlled trial design. Age Ageing. 2015;44(4):547–550.
  • Herrera AP, Snipes SA, King DW, et al. Disparate inclusion of older adults in clinical trials: priorities and opportunities for policy and practice change. Am J Public Health. 2010;100(Suppl 1):S105–12.
  • Polasek TM, Patel F, Jensen BP, et al. Predicted metabolic drug clearance with increasing adult age. Br J Clin Pharmacol. 2013;75(4):1019–1028.
  • Koyanagi T, Nakanishi Y, Murayama N, et al. Age-related changes of hepatic clearances of cytochrome P450 probes, midazolam and R-/S-warfarin in combination with caffeine, omeprazole and metoprolol in cynomolgus monkeys using in vitro-in vivo correlation. Xenobiotica. 2015;45(4):312–321.
  • Huizer-Pajkos A, Kane AE, Howlett SE, et al. Adverse geriatric outcomes secondary to polypharmacy in a mouse model: the influence of aging. J Gerontol A Biol Sci Med Sci. 2015; in press.
  • Strougo A, Yassen A, Krauwinkel W, et al. A semiphysiological population model for prediction of the pharmacokinetics of drugs under liver and renal disease conditions. Drug Metab Dispos. 2011;39(7):1278–1287.
  • Rowland Yeo K, Aarabi M, Jamei M, et al. Modeling and predicting drug pharmacokinetics in patients with renal impairment. Expert Rev Clin Pharmacol. 2011;4(2):261–274.
  • Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31(7):1281–1357.
  • Beckett NS, Peters R, Fletcher AE, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358(18):1887–1898.
  • Callisaya ML, Sharman JE, Close J, et al. Greater daily defined dose of antihypertensive medication increases the risk of falls in older people–a population-based study. J Am Geriatr Soc. 2014;62(8):1527–1533.
  • Tinetti ME, Han L, Lee DS, et al. Antihypertensive medications and serious fall injuries in a nationally representative sample of older adults. JAMA Intern Med. 2014;174(4):588–595.
  • Scuffham P, Chaplin S, Legood R. Incidence and costs of unintentional falls in older people in the United Kingdom. J Epidemiol Community Health. 2003;57(9):740–744.
  • Stel VS, Smit JH, Pluijm SM, et al. Consequences of falling in older men and women and risk factors for health service use and functional decline. Age Ageing. 2004;33(1):58–65.
  • Mossello E, Pieraccioli M, Nesti N, et al. Effects of low blood pressure in cognitively impaired elderly patients treated with antihypertensive drugs. JAMA Intern Med. 2015;175(4):578–585.
  • Abbatecola AM, Bo M, Barbagallo M, et al. Severe hypoglycemia is associated with antidiabetic oral treatment compared with insulin analogs in nursing home patients with type 2 diabetes and dementia: results from the DIMORA study. J Am Med Dir Assoc. 2015;16(4):349 e7–12.
  • Pilotto A, Noale M, Maggi S, et al. Hypoglycemia is independently associated with multidimensional impairment in elderly diabetic patients. Biomed Res Int. 2014;2014:906103.
  • Lipska KJ, Ross JS, Wang Y, et al. National trends in US hospital admissions for hyperglycemia and hypoglycemia among Medicare beneficiaries, 1999 to 2011. JAMA Intern Med. 2014;174(7):1116–1124.
  • Majumdar SR, Hemmelgarn BR, Lin M, et al. Hypoglycemia associated with hospitalization and adverse events in older people: population-based cohort study. Diabetes Care. 2013;36(11):3585–3590.
  • Scott IA, Hilmer SN, Reeve E, et al. Reducing inappropriate polypharmacy: the process of deprescribing. JAMA Intern Med. 2015;175(5):827–834.

* Position paper on the rationale for de-prescribing and possible de-prescribing protocols

  • Frank C, Weir E. Deprescribing for older patients. CMAJ. 2014;186(18):1369–1376.
  • Reeve E, Shakib S, Hendrix I, et al. Review of deprescribing processes and development of an evidence-based, patient-centred deprescribing process. Br J Clin Pharmacol. 2014;78(4):738–747.
  • Fried TR, McGraw S, Agostini JV, et al. Views of older persons with multiple morbidities on competing outcomes and clinical decision-making. J Am Geriatr Soc. 2008;56(10):1839–1844.
  • Tinetti ME, McAvay GJ, Chang SS, et al. Contribution of multiple chronic conditions to universal health outcomes. J Am Geriatr Soc. 2011;59(9):1686–1691.

* Paper on the identification of non-traditional universal, patient-centered, end-points in older patients

  • Caillet P, Laurent M, Bastuji-Garin S, et al. Optimal management of elderly cancer patients: usefulness of the Comprehensive Geriatric Assessment. Clin Interv Aging. 2014;9:1645–1660.
  • Stuck AE, Siu AL, Wieland GD, et al. Comprehensive Geriatric Assessment: a meta-analysis of controlled trials. Lancet. 1993;342(8878):1032–1036.
  • Bachmann S, Finger C, Huss A, et al. Inpatient rehabilitation specifically designed for geriatric patients: systematic review and meta-analysis of randomised controlled trials. BMJ. 2010;340:c1718.
  • Ellis G, Whitehead MA, Robinson D, et al. Comprehensive Geriatric Assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials. BMJ. 2011;343:d6553.
  • Pilotto A, Ferrucci L, Franceschi M, et al. Development and validation of a multidimensional prognostic index for one-year mortality from Comprehensive Geriatric Assessment in hospitalized older patients. Rejuvenation Res. 2008;11(1):151–161.

* First paper describing the development and validation of the Multidimensional Prognostic Index in older patients

  • Katz S, Ford AB, Moskowitz RW, et al. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA. 1963;185:914–919.
  • Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–186.
  • Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975;23(10):433–441.
  • Vellas B, Guigoz Y, Garry PJ, et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition. 1999;15(2):116–122.
  • Bliss MR, McLaren R, Exton-Smith AN. Mattresses for preventing pressure sores in geriatric patients. Mon Bull Minist Health Public Health Lab Serv. 1966;25:238–268.
  • Conwell Y, Forbes NT, Cox C, et al. Validation of a measure of physical illness burden at autopsy: the cumulative illness rating scale. J Am Geriatr Soc. 1993;41(1):38–41.
  • Pilotto A, Sancarlo D, Panza F, et al. The Multidimensional Prognostic Index (MPI), based on a Comprehensive Geriatric Assessment predicts short- and long-term mortality in hospitalized older patients with dementia. J Alzheimers Dis. 2009;18(1):191–199.
  • Pilotto A, Addante F, Franceschi M, et al. Multidimensional prognostic index based on a Comprehensive Geriatric Assessment predicts short-term mortality in older patients with heart failure. Circ Heart Fail. 2010;3(1):14–20.
  • Sancarlo D, D’Onofrio G, Franceschi M, et al. Validation of a modified-multidimensional prognostic index (m-MPI) including the mini nutritional assessment short-form (MNA-SF) for the prediction of one-year mortality in hospitalized elderly patients. J Nutr Health Aging. 2011;15(3):169–173.
  • Sancarlo D, Pilotto A, Panza F, et al. A Multidimensional Prognostic Index (MPI) based on a Comprehensive Geriatric Assessment predicts short- and long-term all-cause mortality in older hospitalized patients with transient ischemic attack. J Neurol. 2012;259(4):670–678.
  • Pilotto A, Sancarlo D, Aucella F, et al. Addition of the multidimensional prognostic index to the estimated glomerular filtration rate improves prediction of long-term all-cause mortality in older patients with chronic kidney disease. Rejuvenation Res. 2012;15(1):82–88.
  • Gallucci M, Battistella G, Bergamelli C, et al. Multidimensional prognostic index in a cognitive impairment outpatient setting: mortality and hospitalizations. The Treviso Dementia (TREDEM) study. J Alzheimers Dis. 2014;42(4):1461–1468.
  • Volpato S, Bazzano S, Fontana A, et al. Multidimensional prognostic index predicts mortality and length of stay during hospitalization in the older patients: a multicenter prospective study. J Gerontol A Biol Sci Med Sci. 2015;70(3):325–331.
  • Giantin V, Valentini E, Iasevoli M, et al. Does the Multidimensional Prognostic Index (MPI), based on a Comprehensive Geriatric Assessment (CGA), predict mortality in cancer patients? Results of a prospective observational trial. J Geriatr Oncol. 2013;4(3):208–217.
  • Pilotto A, Rengo F, Marchionni N, et al. Comparing the prognostic accuracy for all-cause mortality of frailty instruments: a multicentre 1-year follow-up in hospitalized older patients. PLoS One. 2012;7(1):e29090.
  • D’Onofrio G, Sancarlo D, Addante F, et al. A pilot randomized controlled trial evaluating an integrated treatment of rivastigmine transdermal patch and cognitive stimulation in patients with Alzheimer’s disease. Int J Geriatr Psychiatry. 2015;30(9):965–975.

* Potential applications of the Multidimensional Prognostic Index as a patient-centered outcome in pharmacological interventions

  • Pilotto A, D’Onofrio G, Panza F, et al. Treatment of late-life major depressive disorder with selective serotonin reuptake inhibitors improves the multidimensional prognostic index. J Clin Psychopharmacol. 2012;32(5):726–729.

* Potential applications of the Multidimensional Prognostic Index as a patient-centered outcome in pharmacological interventions

  • Aronow WS. Blood pressure goals and targets in the elderly. Curr Treat Options Cardiovasc Med. 2015;17(7):394.
  • Bangalore S, Gong Y, Cooper-DeHoff RM, et al. 2014 eighth joint national committee panel recommendation for blood pressure targets revisited: results from the INVEST study. J Am Coll Cardiol. 2014;64(8):784–793.
  • James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507–520.
  • Mancia G, Fagard R, Narkiewicz K, et al. Target blood pressure in elderly hypertensive patients and in patients with diabetes mellitus. J Hypertens. 2014;32(8):1551–1552.
  • Grundy SM Cholesterol management in older persons. Am J Med. 2014;127(12):1140–1141.
  • Stone NJ, Blum CB Primary risk prevention in the elderly: use clinician-patient discussions, not automatic statin prescribing. Am J Med. 2015;128(8):804–806.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.