FORTA(Fit-fOR-The-Aged)-based medication optimization: retrospective analysis of experiences from an unconventional outpatient service

Abstract

Purpose: To address potentially harmful polypharmacy in multimorbid older patients. Secondary to assess FORTA (Fit-fOR-The-Aged) utility in ambulatory patients. Methods: Consecutive patients attending a novel ambulatory service for gerontopharmacology were included in this retrospective analysis. Baseline data, diagnoses, previous drug treatment and recommended changes in medication were analysed and the change of the FORTA score (sum of over- and undertreatment errors) calculated. Results: The analysis of 182 cases revealed a high number of recommended medication alterations per case (9.81; 95% CI 9.13–10.50). The FORTA score was significantly reduced from 4.24 ± 2.30 to 0.80 ± 1.08 (P < 0.00001), as were under- and overtreatment errors if analysed separately. Conclusions: The large number of recommendations given in this special outpatient service points to a profound unmet medical need for improving medications in older patients. The FORTA approach was found to be useful to reduce both over- and undertreatment in multimorbid older patients.