Background and importance As the worldwide population ages, chronologically ‘old’ patients are becoming a diverse group with different healthcare needs. Frailty has been suggested as an alternative to chronological age for identifying patients at risk of poorer health outcomes. It is proposed that patient frailty could help to prioritise patients who can benefit most from pharmacist-led medication review.
Aim and objectives To examine a relationship between patient frailty and (1) specific high-risk medication use criteria and (2) potentially inappropriate prescribing using the Medication Appropriateness Index (MAI).
Material and methods A convenience sample of 58 patients was obtained from patients reviewed by a Geriatric Emergency Medicine Service. Data including medication lists, medical history, age, sex and Clinical Frailty Scale score was gathered. These data were used to assess how many high-risk medication criteria each patient met. A subgroup of 40 patients had the Medication Appropriateness Index (MAI) tool applied. A correlation coefficient was calculated using Excel (Microsoft Office 2019) to investigate the relationships between CFS and high-risk medication criteria, and CFS and MAI.
Results The correlation coefficient between CFS and high-risk medication use criteria was calculated as 0.13. A higher correlation coefficient of 0.4 was found for the relationship between CFS and MAI. Patients’ CFS score ranged from 3 to 8. In the 58 patient sample 45% of patients had a CFS score = 6 (moderately frail), 96% of patients had at least one high-risk criteria present, polypharmacy was present in 85% of patients and 48% of participants were taking at least one ‘high-risk’ drug. All 40 patients who had the MAI tool applied scored ≥1, the range was 1–29 per patient. 31% (103/331) of drugs examined were deemed inappropriate by meeting one or more of the criteria outlined in the MAI tool.
Conclusion and relevance This study failed to identify a specific level of frailty at which pharmacist intervention may be of most benefit. However, the group of patients included in this study are at high risk of adverse drug effects and are a population that should be prioritised for pharmacist review.
References and/or acknowledgements Thanks to Aisling Kerr, Deirdre Lynch and colleagues in the pharmacy department and GEMS, CUH.
Conflict of interest No conflict of interest
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