The status of drug evaluation in older adults in the United Kingdom: Bridging the representation gap.

Walker, Lauren E ORCID: 0000-0002-3827-4387 and Pirmohamed, Munir ORCID: 0000-0002-7534-7266 (2024) The status of drug evaluation in older adults in the United Kingdom: Bridging the representation gap. Journal of the American Geriatrics Society.

Access the full-text of this item by clicking on the Open Access link.

Official URL: http://dx.doi.org/10.1111/jgs.18817

Abstract

Older adults are persistently underrepresented in clinical drug trials worldwide, despite increasing multiple long-term conditions and significant prescribing in this demographic. We discuss systemic challenges such as the exclusion of people with comorbid conditions and the lack of assessment for comorbidities as modifiers of treatment effects and highlight the rising trend of polypharmacy, especially among the oldest age groups, which is linked to a significant percentage of unplanned hospitalizations and medication errors. The consequences of these trends prompted the United Kingdom National Overprescribing review, culminating in a set of recommendations for drug development tailored to older adults. Building on this, two critical reports released in April 2023 by the International Longevity Centre (ILC) and the Nuffield Council on Bioethics (NCOB) are discussed. These reports emphasize the importance of diversity and inclusion in clinical trials, advocating for ethical frameworks and methodologies that cater to the complex needs of older adults. The development of inclusive criteria, innovative statistical methodologies, and the integration of patient-reported outcomes are needed to address the persistent barriers to older adult participation in research, suggesting that pragmatic trials, exemplified by the UK's RECOVERY trial during the COVID-19 pandemic, could pave the way for more inclusive research practices.

Item Type:	Article
Uncontrolled Keywords:	aging, clinical trials, drug development
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User:	Symplectic Admin
Date Deposited:	16 Apr 2024 10:26
Last Modified:	16 Apr 2024 10:28
DOI:	10.1111/jgs.18817
Open Access URL:	https://doi.org/10.1111/jgs.18817
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3180375