A new report on strategies for geriatric drug development and assessment determined that drugs need to consider age as well as other factors that older adults face such as cognitive impairment, frailty and polypharmacy. This is according to the International Union of Basic and Clinical Pharmacology (IUPHAR) Geriatric Committee, which published the report.
The strategies specifically focused on integrating frailty as a factor in drug development. The report, published in the Journal of the American Geriatrics Society earlier this month, includes 12 principles pertaining to frailty in reference to drug development. The recommendations include measuring frailty at the start of when a person goes on a drug they’ll likely take regularly. Frailty should also be gauged as an outcome of treatment, the report stated.
The authors encouraged frailty to be a part of all phases of drug evaluation. Some of the principles include noting frailty as a subgroup in research, taking into consideration the biology of physical frailty, and using artificial intelligence to organize data to better grasp the complexities of how drugs affect people with frailty, specifically.
Frail older adults tend to be less mobile and often need assistance with activities of daily living. The adults may or may not have cognitive dysfunction. As a result, they may not be considered in clinical trials due to getting to visits or completing stressful tasks, the authors noted. That’s why clinical trials should allow for video calls and home visits.
“Involvement of people with frailty, their caregivers and their healthcare practitioners can help inform design of clinical trials that people with frailty can feasibly and safely participate in,” the authors wrote. “Furthermore, members of scientific review and ethics committees should be trained to assess the issues of inclusion of frail patients in clinical trials.”
Another issue that the authors raised is that low- and middle-income countries have a higher prevalence of frailty compared to high-income countries.
“The definition of successful aging differs with ethnicity and societal factors, and this needs to be considered in designing objective and patient reported outcome measures,” the authors wrote.
