title: [Polypharmacy in the elderly - choosing wisely by using the FORTA list].
abstract: Multimorbidity and polypharmacy are threats to elderly patients; improvement of medication is important and a novel listing approach - the FORTA [Fit fOR The Aged] list - should support this in clinical practice. Here, we aim to describe procedural details of successful application of FORTA. FORTA labels range from A (indispensable), B (beneficial), C (questionable) to D (avoid), depending on evidence for safety, efficacy and overall age-appropriateness. As an implicit tool, it is only applicable if medical details of the patient are known. The process starts with history taking and diagnostic assessment including disease grading. This is the base for FORTA-assisted selection of drugs to avoid overtreatment (drug not necessary), undertreatment (condition not or not sufficiently treated by positively labeled drugs) or mistreatment (drugs indicated, but negatively rather than positively labeled drug chosen). Selection is followed by secondary analyses, e. g. regarding dosing or contraindications. The medication scheme is updated in reflection of wanted clinical effects (e. g. blood pressure lowering) and side effects (e. g. dizziness).
authors.affiliation: Klinische Pharmakologie an der Medizinischen Fakultät Mannheim der Universität Heidelberg.
authors.forename: Martin
authors.initials: M
authors.lastname: Wehling
authors.affiliation: Klinische Pharmakologie an der Medizinischen Fakultät Mannheim der Universität Heidelberg.
authors.forename: Christina
authors.initials: C
authors.lastname: Throm
mesh_terms: D000368:Aged; D011307:Drug Prescriptions / Q000592:standards / Q000706:statistics & numerical data; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D019338:Polypharmacy