RISK MANAGEMENT IN THE GERONTOLOGICAL PATIENT POPULATION

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Background. Understanding the adverse effects of medicines is an important element of pharmacovigilance (PV) by all stakeholders, especially applicants and healthcare professionals. However, this alone is not enough to ensure the effectiveness of pharmacotherapy. The process of reducing its risks is no less important and all available resources should be used for this, both on the part of the applicant and on the part of healthcare professionals and patients. Managing the risks of medicines is of particular importance for gerontological patients, given the demographic characteristics of today and the steady increase in the number of elderly patients requiring treatment. Aim: To analyze modern approaches to managing risks inherent in medicines, which are, in particular, prescribed to gerontological patients, as well as the tools and methods used for this. Materials and methods. bibliosemantic, analytical, expert assessments, modeling. Results. Risks inherent in drugs are divided into important and unimportant. On the part of the applicant, risk management can be carried out through routine and additional risk minimization measures (RMM). It is known that not all, even important risks, require management, especially the use of additional RMM. Medical professionals, in addition to those risk management measures developed by applicants, may use other methods and tools, for example, “START/STOP criteria”, “Biers criteria” or “FORTA list”, etc., in order to ensure the implementation of pharmacotherapy and minimize the impact of risks on the benefit of the medicines. The implementation of pharmacotherapy may be accompanied by a number of risks. There are particularly vulnerable groups of patients with regard to the consequences of drug use, which, in particular, include the gerontological cohort of patients. The risks of pharmacotherapy of geriatric patients can be divided into the following groups:increase in adverse effects of drug use; increase in the incidence of concomitant diseases; high probability of infection; increase in mortality; increase in financial resources spent on the elimination of adverse effects of treatment and management of geriatric patients. There are risk factors that contribute to the manifestation of risks of treatment of geriatric patients. All identified risk factors of pharmacotherapy of geriatric patients can be divided into four groups according to the cause of their occurrence: caused by the characteristics of the patient's body; caused by concomitant diseases; caused by treatment; due to the specifics of the provision of medical care. Conclusion. Applicants and healthcare professionals should take rational and risk-proportionate measures to minimize the impact of risks on the effectiveness and safety of pharmacotherapy, especially when it is carried out in vulnerable cohorts of patients, including gerontological ones. Important, but unfortunately not yet frequently used in real clinical practice, risk minimization tools include the “START/STOP Criteria”, “Biers Criteria” or “FORTA List”, the implementation of which should become an effective factor in improving the quality and safety of pharmacotherapy in geriatric patients

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