Frailty and Medication Appropriateness in Rural Adults: Proposing Interventions through Pharmacist–Physician Collaborative Efforts

Background: Frailty and polymedication are closely interrelated. Addressing these concurrent conditions in primary care settings relies on the utilization of potentially inappropriate medication (PIM) lists and medication reviews (MRs), particularly in rural areas, where healthcare professionals ser...

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Detalhes bibliográficos
Autores: García García, Cristina, Ocaña, José M., Alacreu, Mónica, Moreno Royo, Lucrecia, Martínez López, Luis Antonio
Tipo de documento: artigo
Data de publicação:2024
País:España
Recursos:Universidad de Castilla-La Mancha
Repositório:RUIdeRA. Repositorio Institucional de la UCLM
OAI Identifier:oai:ruidera.uclm.es:10578/43088
Acesso em linha:https://www.mdpi.com/journal/jcm
https://hdl.handle.net/10578/43088
Access Level:Acceso aberto
Palavra-chave:Community pharmacy
Frailty
Polymedication
Potentially inappropriate medications
Primary care
Rural
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spelling Frailty and Medication Appropriateness in Rural Adults: Proposing Interventions through Pharmacist–Physician Collaborative EffortsGarcía García, CristinaOcaña, José M.Alacreu, MónicaMoreno Royo, LucreciaMartínez López, Luis AntonioCommunity pharmacyFrailtyPolymedicationPotentially inappropriate medicationsPrimary careRuralBackground: Frailty and polymedication are closely interrelated. Addressing these concurrent conditions in primary care settings relies on the utilization of potentially inappropriate medication (PIM) lists and medication reviews (MRs), particularly in rural areas, where healthcare professionals serve as the sole point of access to the medical system. The aim of this study was to examine the relationship between medication appropriateness and variables related to frailty in a rural municipality in order to propose potential strategies for therapy optimization. Methods: This cross-sectional study included all adult community dwellers aged 50 and above officially registered in the municipality of Tiriez (Albacete, Spain) in 2023 (n = 241). The primary outcome variable was frailty (assessed using the fatigue, resistance, ambulation, illness, and loss of weight (FRAIL) scale). The independent variables were age, gender, medication regimen, history of falls, comorbidities, PIMs (evaluated using the screening tool of older persons’ prescriptions (STOPP) 2023 criteria), fall-risk-increasing drugs (FRID), and anticholinergic burden (ACB). Results: The prevalence of frailty was approximately 20%. FRID and ACB scores were statistically associated (p-value < 0.001) with frailty, 1.1 ± 1.3 vs. 2.5 ± 1.7, and 1.0 ± 1.3 vs. 2.8 ± 2.5, respectively. Regardless of age, frailty was observed to be more prevalent among females (odds ratio (OR) [95% confidence interval (CI)]: 3.5 [1.5, 9.0]). On average, 2.1 ± 1.6 STOPP criteria were fulfilled, with the prolonged use of anxiolytics and anti-peptic-ulcer agents being the most frequent. Priority interventions (PIs) included opioid dose reduction, benzodiazepine withdrawal, and the assessment of antidepressant and antiplatelet treatment plans. Conclusions: The optimization of medication in primary care is of paramount importance for frail patients. Interventional measures should focus on ensuring the correct dosage and combination of drugs for each therapeutic regimen.MDPI202520252024info:eu-repo/semantics/articleapplication/pdfapplication/pdfhttps://www.mdpi.com/journal/jcmhttps://hdl.handle.net/10578/43088reponame:RUIdeRA. Repositorio Institucional de la UCLMinstname:Universidad de Castilla-La ManchaInglésinfo:eu-repo/semantics/openAccessoai:ruidera.uclm.es:10578/430882026-05-27T07:36:41Z
dc.title.none.fl_str_mv Frailty and Medication Appropriateness in Rural Adults: Proposing Interventions through Pharmacist–Physician Collaborative Efforts
title Frailty and Medication Appropriateness in Rural Adults: Proposing Interventions through Pharmacist–Physician Collaborative Efforts
spellingShingle Frailty and Medication Appropriateness in Rural Adults: Proposing Interventions through Pharmacist–Physician Collaborative Efforts
García García, Cristina
Community pharmacy
Frailty
Polymedication
Potentially inappropriate medications
Primary care
Rural
title_short Frailty and Medication Appropriateness in Rural Adults: Proposing Interventions through Pharmacist–Physician Collaborative Efforts
title_full Frailty and Medication Appropriateness in Rural Adults: Proposing Interventions through Pharmacist–Physician Collaborative Efforts
title_fullStr Frailty and Medication Appropriateness in Rural Adults: Proposing Interventions through Pharmacist–Physician Collaborative Efforts
title_full_unstemmed Frailty and Medication Appropriateness in Rural Adults: Proposing Interventions through Pharmacist–Physician Collaborative Efforts
title_sort Frailty and Medication Appropriateness in Rural Adults: Proposing Interventions through Pharmacist–Physician Collaborative Efforts
dc.creator.none.fl_str_mv García García, Cristina
Ocaña, José M.
Alacreu, Mónica
Moreno Royo, Lucrecia
Martínez López, Luis Antonio
author García García, Cristina
author_facet García García, Cristina
Ocaña, José M.
Alacreu, Mónica
Moreno Royo, Lucrecia
Martínez López, Luis Antonio
author_role author
author2 Ocaña, José M.
Alacreu, Mónica
Moreno Royo, Lucrecia
Martínez López, Luis Antonio
author2_role author
author
author
author
dc.subject.none.fl_str_mv Community pharmacy
Frailty
Polymedication
Potentially inappropriate medications
Primary care
Rural
topic Community pharmacy
Frailty
Polymedication
Potentially inappropriate medications
Primary care
Rural
description Background: Frailty and polymedication are closely interrelated. Addressing these concurrent conditions in primary care settings relies on the utilization of potentially inappropriate medication (PIM) lists and medication reviews (MRs), particularly in rural areas, where healthcare professionals serve as the sole point of access to the medical system. The aim of this study was to examine the relationship between medication appropriateness and variables related to frailty in a rural municipality in order to propose potential strategies for therapy optimization. Methods: This cross-sectional study included all adult community dwellers aged 50 and above officially registered in the municipality of Tiriez (Albacete, Spain) in 2023 (n = 241). The primary outcome variable was frailty (assessed using the fatigue, resistance, ambulation, illness, and loss of weight (FRAIL) scale). The independent variables were age, gender, medication regimen, history of falls, comorbidities, PIMs (evaluated using the screening tool of older persons’ prescriptions (STOPP) 2023 criteria), fall-risk-increasing drugs (FRID), and anticholinergic burden (ACB). Results: The prevalence of frailty was approximately 20%. FRID and ACB scores were statistically associated (p-value < 0.001) with frailty, 1.1 ± 1.3 vs. 2.5 ± 1.7, and 1.0 ± 1.3 vs. 2.8 ± 2.5, respectively. Regardless of age, frailty was observed to be more prevalent among females (odds ratio (OR) [95% confidence interval (CI)]: 3.5 [1.5, 9.0]). On average, 2.1 ± 1.6 STOPP criteria were fulfilled, with the prolonged use of anxiolytics and anti-peptic-ulcer agents being the most frequent. Priority interventions (PIs) included opioid dose reduction, benzodiazepine withdrawal, and the assessment of antidepressant and antiplatelet treatment plans. Conclusions: The optimization of medication in primary care is of paramount importance for frail patients. Interventional measures should focus on ensuring the correct dosage and combination of drugs for each therapeutic regimen.
publishDate 2024
dc.date.none.fl_str_mv 2024
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://www.mdpi.com/journal/jcm
https://hdl.handle.net/10578/43088
url https://www.mdpi.com/journal/jcm
https://hdl.handle.net/10578/43088
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:RUIdeRA. Repositorio Institucional de la UCLM
instname:Universidad de Castilla-La Mancha
instname_str Universidad de Castilla-La Mancha
reponame_str RUIdeRA. Repositorio Institucional de la UCLM
collection RUIdeRA. Repositorio Institucional de la UCLM
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,198674

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