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Optimising geriatric care

Ageing is usually accompanied by multimorbidities, making clinical management a more complex task. The incidence of adverse drug reactions (ADRs) through prescription of potentially inappropriate medications is steadily rising as a result.

Health

Currently, clinical care for the multimorbid older population is not standardised and no clear-cut guidelines exist. EU-funded researchers are working on optimising pharmacological and non-pharmacological therapy for them through the project SENATOR. A key part of the project is design and validation of a software engine tool called SENATOR that optimises geriatric care using drug-based and non-drug–based therapies. Already, project members have made considerable progress with regard to software scope, design and construction. Mobile testing of this application is ongoing. Through a large database of older hospitalised patients, researchers identified significant risk factors for ADRs and successfully developed software interfaces to calculate ADR risk in older persons (ADRROP). A comprehensive literature review of non-drug therapies for geriatric conditions was also completed. Researchers have already summarised available non-drug treatments for delirium and included it in the SENATOR software tool. Project partners also mapped drug–disease interactions using anatomical therapeutic chemical (ATC) and international classification of diseases (ICD-10) codes. They translated the screening tools for older people's prescriptions and treatment from English into four other languages. Besides this, translations of standardised drug–drug and drug–disease interactions lists will be integrated into the SENATOR application. Linking drug ATC codes with drug prices could prove invaluable to health policy decision makers and governments in minimising drug costs. Period 1 of the SENATOR randomised clinical trial has already begun and testing of the ADRROP scale is ongoing in recruited patients. This should help to further refine this risk score tool. In parallel, researchers also reviewed the economic value and efficacy of SENATOR software in comparison to current geriatric care techniques. Around 6 % of acute admissions among the elderly are due to ADRs, out of whom 6–21 % experience new ADRs during hospitalisation. Successful clinical trial outcomes should help in standardising and personalising geriatric care through comprehensive patient review via SENATOR software. Reduced incidence of ADRs will in turn reduce health care costs and improve patient quality of life.

Keywords

Geriatric care, ageing, multimorbidities, adverse drug reactions, ADR risk

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