Frailty and Medication Appropriateness in Rural Adults: Proposing Interventions through Pharmacist-Physician...

Area of Science:

• Gerontology
• Primary Care Medicine
• Clinical Pharmacy

Background:

• Frailty and polymedication are significant issues in primary care, particularly in rural settings.
• Potentially inappropriate medication (PIM) lists and medication reviews (MRs) are key tools for managing these conditions.
• Healthcare professionals in rural areas are often the sole medical contact for patients.

Purpose of the Study:

• To investigate the association between medication appropriateness and frailty indicators in a rural population.
• To identify strategies for optimizing pharmacotherapy in frail older adults.
• To analyze the relationship between frailty, PIMs, fall-risk-increasing drugs (FRID), and anticholinergic burden (ACB).

Main Methods:

• Cross-sectional study of 241 community dwellers aged 50+ in Tiriez, Spain (2023).
• Frailty assessed using the FRAIL scale; PIMs evaluated with Screening Tool of Older Person's Prescriptions (STOPP) 2023 criteria.
• Independent variables included age, gender, medication regimen, falls history, comorbidities, FRID, and ACB.

Main Results:

• Approximately 20% of the population exhibited frailty.
• Higher FRID and ACB scores were significantly associated with frailty (p < 0.001).
• Frailty was more prevalent in females (OR: 3.5 [1.5, 9.0]); prolonged use of anxiolytics and anti-peptic agents were common PIMs.

Conclusions:

• Medication optimization in primary care is essential for frail patients.
• Interventions should target correct drug dosage and combinations for individual therapeutic regimens.
• Addressing FRID and ACB is critical for managing frailty in older adults.