Azab Marina, Novella Alessio, Pasina Luca
Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
Med Princ Pract. 2025;34(1):57-65. doi: 10.1159/000542109. Epub 2024 Oct 21.
The study aimed to assess the relationship between the Fit fOR The Aged (FORTA) score - a classification system designed to evaluate medication appropriateness in older adults - and several negative outcomes, including impaired cognitive performance, functional status, adverse clinical events, and all-cause mortality at 3, 6, and 12 months after hospital discharge.
This retrospective study utilized data from the ELICADHE cohort, a cluster-randomized trial conducted across 20 Italian internal medicine and geriatric wards. The study included patients aged 75 and older with complete FORTA score assessments. Demographics, medication history, and comorbidities were collected. The FORTA classification system assessed medication appropriateness. FORTA scores were calculated and FORTA score cut-offs (3 and 5) were applied. Statistical analyses included descriptive statistics, survival analysis with Cox regression, logistic regression, and negative-binomial regression using SAS 9.4 and RStudio 12.1. Ethical approval was obtained.
Of the 506 patients included, 171 (33.8%) were fully assessable with complete FORTA scores. The study found no significant association between higher FORTA scores and impaired cognitive performance, functional status, or mortality. Additionally, no clear relationship was observed between FORTA scores and adverse clinical events or mortality. The analysis indicated that age was a significant factor associated with mortality and adverse clinical events.
The study did not find a significant relationship between the FORTA score and negative outcomes in older patients discharged from internal medicine and geriatric wards. Further research is needed to define specific FORTA score cut-off values and expand the criteria to improve medication assessment in this population.
The study aimed to assess the relationship between the Fit fOR The Aged (FORTA) score - a classification system designed to evaluate medication appropriateness in older adults - and several negative outcomes, including impaired cognitive performance, functional status, adverse clinical events, and all-cause mortality at 3, 6, and 12 months after hospital discharge.
This retrospective study utilized data from the ELICADHE cohort, a cluster-randomized trial conducted across 20 Italian internal medicine and geriatric wards. The study included patients aged 75 and older with complete FORTA score assessments. Demographics, medication history, and comorbidities were collected. The FORTA classification system assessed medication appropriateness. FORTA scores were calculated and FORTA score cut-offs (3 and 5) were applied. Statistical analyses included descriptive statistics, survival analysis with Cox regression, logistic regression, and negative-binomial regression using SAS 9.4 and RStudio 12.1. Ethical approval was obtained.
Of the 506 patients included, 171 (33.8%) were fully assessable with complete FORTA scores. The study found no significant association between higher FORTA scores and impaired cognitive performance, functional status, or mortality. Additionally, no clear relationship was observed between FORTA scores and adverse clinical events or mortality. The analysis indicated that age was a significant factor associated with mortality and adverse clinical events.
The study did not find a significant relationship between the FORTA score and negative outcomes in older patients discharged from internal medicine and geriatric wards. Further research is needed to define specific FORTA score cut-off values and expand the criteria to improve medication assessment in this population.
本研究旨在评估“适合老年人的用药评估”（FORTA）评分（一种旨在评估老年人用药合理性的分类系统）与多种不良结局之间的关系，这些不良结局包括认知功能受损、功能状态、不良临床事件以及出院后3个月、6个月和12个月时的全因死亡率。
这项回顾性研究利用了ELICADHE队列的数据，该队列是一项在20个意大利内科和老年病房进行的整群随机试验。研究纳入了年龄在75岁及以上且有完整FORTA评分评估的患者。收集了人口统计学、用药史和合并症信息。FORTA分类系统评估用药合理性。计算FORTA评分并应用FORTA评分临界值（3分和5分）。统计分析包括描述性统计、使用Cox回归的生存分析、逻辑回归以及使用SAS 9.4和RStudio 12.1进行的负二项回归。获得了伦理批准。
在纳入的506例患者中，171例（33.8%）有完整的FORTA评分且可进行全面评估。研究发现较高的FORTA评分与认知功能受损、功能状态或死亡率之间无显著关联。此外，未观察到FORTA评分与不良临床事件或死亡率之间存在明确关系。分析表明年龄是与死亡率和不良临床事件相关的重要因素。
本研究未发现内科和老年病房出院的老年患者中FORTA评分与不良结局之间存在显著关系。需要进一步研究来确定特定的FORTA评分临界值并扩大标准，以改善该人群的用药评估。
本研究旨在评估“适合老年人的用药评估”（FORTA）评分（一种旨在评估老年人用药合理性的分类系统）与多种不良结局之间的关系，这些不良结局包括认知功能受损、功能状态、不良临床事件以及出院后3个月、6个月和12个月时的全因死亡率。
这项回顾性研究利用了ELICADHE队列的数据，该队列是一项在20个意大利内科和老年病房进行的整群随机试验。研究纳入了年龄在75岁及以上且有完整FORTA评分评估的患者。收集了人口统计学、用药史和合并症信息。FORTA分类系统评估用药合理性。计算FORTA评分并应用FORTA评分临界值（3分和5分）。统计分析包括描述性统计、使用Cox回归的生存分析、逻辑回归以及使用SAS 9.4和RStudio 12.1进行的负二项回归。获得了伦理批准。
在纳入的506例患者中，171例（33.8%）有完整的FORTA评分且可进行全面评估。研究发现较高的FORTA评分与认知功能受损、功能状态或死亡率之间无显著关联。此外，未观察到FORTA评分与不良临床事件或死亡率之间存在明确关系。分析表明年龄是与死亡率和不良临床事件相关的重要因素。
本研究未发现内科和老年病房出院的老年患者中FORTA评分与不良结局之间存在显著关系。需要进一步研究来确定特定的FORTA评分临界值并扩大标准，以改善该人群的用药评估。
