Database of medication for the elderly
Aging causes changes in bodily functions and increases the prevalence of diseases, which makes the elderly particularly susceptible to adverse reactions to pharmacotherapy. The purpose of the database of medication for the elderly is to support the clinical decision-making on the pharmacotherapy of patients over 75 years of age and to improve medication safety in primary health care.
Like in other health care databases, the medicinal substances are classified into categories A, B, C and D. The category indicates how suitable the medicinal substance is for persons over 75 years of age. The categories are based on a multidisciplinary clinical consensus.
- A (green): Suitable for the elderly. The medicinal substance can be used as in younger patients. Changes due to aging do not affect the dose or frequency of administration, and the adverse reaction profile is not different from that of younger patients.
- B (grey): There is little research evidence, practical experience or efficacy in persons over 75 of age.
- C (yellow): Suitable for the elderly, with certain reservations. The medicinal substance can be used by the elderly, but the dose might either have to be reduced, or the frequency of administration decreased due to mild or moderate renal insufficiency or a significant risk of interactions or adverse reactions.
- D (red): Avoid using the product for elderly people. Use is possible only in exceptional cases or on a one-off basis. Changes due to aging predispose the elderly to adverse or dangerous reactions to the drug, The risk of adverse reactions typically exceeds the benefits.
The legend for each pharmaceutical substance contains information on the effects and dosing of the substance and the most typical adverse reactions and interactions. The legend does not contain indications or contraindications.
Using the database in health care
The database is primarily intended for physicians and other health care professionals. It must be borne in mind that individual cases might require the use of category D medicinal products. The pharmacotherapy must be started, changed or discontinued under the supervision of a physician.
Updates to the database
Preparation for the creation of the database of medication for the elderly started in a workgroup set by the Centre for Pharmacotherapy Development (ROHTO) in 2008, and the database was completed in August 2010.
The database is currently being updated by a team of experts in pharmacotherapy, who will review the classification and legend of each medicinal substance. In the first part of the update, about a hundred category D substances were updated (the update was published on 3 December 2013). The team will continue to update other medicinal substances that will be included in the database, which means that there might be more category D substances.
After the update round is complete, the database will contain a classification and a recommendation for use of a medicinal substance or combination thereof in elderly patients.