3 questions to… Marie Herr, on the occasion of the publication of Issues in Health Economics (230), February 2018: Frailty of Elderly People and the Consumption of Medications: Inappropriate Polypharmacy and Prescriptions, written with Nicolas Sirven, Hélène Grondin, Sylvain Pichetti and Catherine Sermet
The assessment of frailty is based on five declarative criteria indicating a loss of physiological reserves: unintentional weight loss, fatigue, lack of physical activity, reduced mobility and muscle weakness. An individual is considered fragile if it presents at least three of these criteria, and pre-fragile if it presents one or two. Concerning medications, we are interested in the consumption of many medications, in other words in polypharmacy, and in the prescription of drugs having a priori a poor benefit/risk ratio in the elderly subject.
We show that fragile individuals are more often multi-medicated than non-fragile individuals, and that they have an increased risk of receiving anticholinergic medications. In other words, we show that fragile persons are more exposed to the risks inherent in polypharmacy and anticholinergic drugs, even though they a priori have less capacity to cope with adverse drug reactions.
The representativeness of the study sample in relation to the national population as well as the use of reimbursement data by the French National Health Insurance System are the main strengths of this study. However, the interpretation of the results must take into account the lack of objective measurement of mobility and muscle strength as well as the limited size of the study sample.
Interview by Anna Marek