The long term effects of comprehensive geriatric assessment on pharmocotherapy of elderly

Objective: It is the aim of our study to evaluate the effects of polypharmacy, which is a crucial health problem in the elderly, on individuals; and to analyze the reflections of comprehensive geriatric assessment (CGA) - guided drug therapy rationalization on polypharmacy and its consequences in the long term. Method: In this retrospective and longitudinal study, the files of 515 patients who were over 60 years old, had admitted to the Department of Geriatrics of Dokuz Eylül University between February 2015 and October 2018, met the inclusion and exclusion criteria, and had no missing data were included. At first admission; medication history, sociodemographic characteristics, presence of geriatric syndrome, comorbidities, laboratory findings, CGA parameters and frailty status were recorded. Patients'drug therapies have been reconstructed after CGA, with the guidance of Beers Criteria. Patients whose number of drugs had been decreased after the reconstruction were reevaluated after 6 months and data of the two visits were compared. Results: Mean age of 515 patients (68,7% female) was 74,13 ± 7,29 years. At first admission, mean drug number was 5, 11 ± 3, 34. 246 patients stated taking less than 5 drugs (non-polypharmacy group) while remaining 269 patients were taking 5 or more drugs (polypharmacy group). At first admission in polypharmacy group, prevalence of geriatric syndromes and frailty were higher, and CGA scores were poorer than non-polypharmacy group. After drug rationalization with CGA, mean drug number has decreased to 4,76 ± 2,72. By the analysis of follow-up data from 219 patients whose number of drugs had been decreased, it was revealed that Yesavage Geriatric Depression Scale (YGDS), Mini Nutritional Assessment (MNA) and Tinetti Performance Oriented Mobility Assessment (POMA) scores were improved, and the number of frail patients were reduced. Conclusion: We recommend patient management to be planned with the guidance of CGA; so that cognitive, nutritutional, physical, and pychosocial status can be improved and frailty can be reduced in geriatric patients.