VALFORTA: a randomised trial to validate the FORTA (Fit fOR The Aged) classification
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 inter...
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| Main Authors: | , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
18 January 2016
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| In: |
Age & ageing
Year: 2016, Volume: 45, Issue: 2, Pages: 262-267 |
| ISSN: | 1468-2834 |
| DOI: | 10.1093/ageing/afv200 |
| Online Access: | Verlag, Volltext: https://doi.org/10.1093/ageing/afv200 Verlag, Volltext: https://academic-oup-com.ezproxy.medma.uni-heidelberg.de/ageing/article/45/2/262/2195343 
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| Author Notes: | Martin Wehling, Heinrich Burkhardt, Alexandra Kuhn-Thiel, Farhad Pazan, Christina Throm, Christel Weiss, Helmut Frohnhofen |
| Summary: | 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. |
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| Item Description: | Gesehen am 28.03.2019 |
| Physical Description: | Online Resource |
| ISSN: | 1468-2834 |
| DOI: | 10.1093/ageing/afv200 |