Ageing, Polypharmacy and Changes in the Therapeutic Value of Drugs in the Aged Unit
Leader: Assoc. Prof. PharmDr. Daniela Fialová, PhD.
Ageing of the population and processes accompanying aging (geriatric frailty, geriatric syndromes, polymorbidity and polypharmacy etc.) significantly affect therapeutic value of drugs and drug regimens in older adults. Due to the lack of information from clinical trials, older patients are often treated by non-geriatric drug regimens (nongeriatric doses, indications, etc. with insufficient consideration of geriatric syndromes and symptomes, aspects of geriatric frailty etc.). Suboptimal prescribing in older patients (potentially inappropriate or inappropriate prescribing) is therefore highly prevalent and have a negative impact on health, morbidity and mortality in older adults, as well as negative socio-economic consequences on healthcare and social care systems in Europe and other countries.
Goals of Research Unit
A/ to study trends in population ageing, geriatric morbidity and mortality (including drug-related morbidity and mortality) and their socio-economic consequences, with a special focus on Central and Eastern Europe in a close collaboration with Western European countries and some developing countries (particularly India and Ethiopia)
B/ to describe and evaluate potentially inappropriate and inappropriate prescribing in older patients in different settings of care and changes in the therapeutic value of drugs/drug procedures in geriatric patients (including OTC medicines and parapharmaceuticals). Our research focuses particularly on:
- studies describing prevalence, risk factors, negative consequences and strategies for improvements of suboptimal geriatric prescribing, including irrational geriatric polypharmacy at national, EU and international levels
- methodological research approaches based on long-term experience from cross-sectional and outcome international studies applying interRAI instruments, comprehensive geriatric assessment (CGA) and different explicit and implicit geriatric criteria of potentially inappropriate/inappropriate prescribing in older patients (e.g. the EU-7 (PIM) criteria, STOPP/START criteria, Beers criteria (different versions), Czech National Expert Panel Consensus of Drugs/Drug procedures Potentially Inappropriate in the AgeD (Fialová D. et al, 2013), Laroche´s criteria, PRISCUS criteria, IPET tool, MAI- index, STRIP algorhitms, Drug-Burden Index etc.).
C/ we develop and validate specific tools for evaluation and resolution of suboptimal geriatric prescribing, particularly clinical tools, algorhitms and SWs helping to discover problematic areas of inappropriate prescribing in older adults
D/ we develop and apply clinical guidelines and policy recommendations in geriatric clinical pharmacy in order to reduce inappropriate prescribing and resolve problematic polypharmacy in older adults, in a close collaboration with several research teams (see International collaboration) and EU policy partners and organizations, eg:
- UNECE- United Nations´ Economic Commission of Europe
- WHO - World Health Organization
- Age Platform Europe
- European Centre in Vienna
- these policy bodies are involved also in the EUROAGEISM H2020 project
Subunits of Research Unit/Chairs:
Subunit 1:
Rational geriatric pharmacotherapy, polypharmacy and suboptimal prescribing in older patients- risk factors, prevalence, negative outcomes and consequences, clinical and policy EU and international recommendations
Chair: Assoc. Prof. Daniela Fialová, PharmD, Ph.D.
See personal professional profile
Subunit 2:
World population ageing, preparedness of health and socioeconomic systems on population ageing, socio-economic and pharmacoeconomic consequences
Chair: Jan Kostřiba, PharmD, Ph.D.
Subunit 3:
Integrative medicine and non-pharmacological strategies reducing drug burden in older adults, specific features of non-pharmacological treatments, life-style recommendations and OTC drug use in ageing population
Chair: Jitka Pokladníková, PharmD, Ph.D.