#32 Pharmacovigilance in older adults – Giovanni Furlan

Drug Safety Matters

Medication-related-harm (MRH) is especially prevalent in older adults due to changing physiology as the body ages, increased frailty, and the incidence of polypharmacy in this patient group. Giovanni Furlan, Worldwide Safety Site Lead for Thessaloniki of Pfizer discusses what makes this patient group so vulnerable to adverse drug reactions, how poor representation and using age alone to define older adults exacerbates this problem, and suggests ways forward in monitoring drug safety in older patients.

Tune in to find out:

• What makes older adults especially at risk of experiencing adverse drug reactions and medication errors
• Why frailty is far more useful than age in predicting adverse drug reaction risk
• How pharmacovigilance in older patients may be improved through pharmaceutical practice and better representation in clinical trials.

Want to know more?

This interview all started with Giovanni's Uppsala Reports article on how age is insufficient a measure of adverse event risk. Read it here.

For a summary of the key points discussed in this interview, read Giovanni’s paper on the status of drug safety in geriatric patients.

If our discussion of frailty piqued your interest, read this paper on the biology of frailty and how this impacts clinical pharmacology, this multi-centre cohort study that shows frailty is significantly correlated with MRH, and this commentary advocating for consideration of MRH as a geriatric syndrome, which needs to be managed as such.
As Giovanni mentioned in the interview, Harlan Krumholz was the first to describe post-hospital syndrome. Learn more about this syndrome by reading his paper.

For more on prescribing cascades, their prevention, detection, and reversal, read this paper by Brath and colleagues.

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Capitole

1. #32 Pharmacovigilance in older adults – Giovanni Furlan (00:00:00)

2. Introduction (00:00:15)

3. Welcome Giovanni! (00:01:22)

4. Why older adults are more at risk of experiencing adverse reactions to medicines (00:02:40)

5. Why age alone should not be used as the defining characteristic in this patient group (00:12:11)

6. Older adults are underrepresented in clinical trials and its impact on pharmacovigilance (00:15:58)

7. Post-hospital syndrome in older patients (00:24:21)

8. How pharmaceutical practice is being tailored to older patients (00:35:00)

9. What more can be done to improve pharmacovigilance in elderly patients (00:40:50)

10. Outro (00:46:43)