Pharmacists Have Role to Play in Minimizing Fall Risk

DECEMBER 13, 2016
Jeannette Y. Wick, RPh, MBA
Falls can cause significant mortality and morbidity in the aging population. In 2014, emergency health care providers treated 2.8 million seniors for falls, and an additional 27,000 older people died from falls. These statistics move falls to the top of the list of fatal and non-fatal injuries in people aged 65 years and older. Pharmacists need to remember that some medications increase fall risk, making medication use a modifiable risk factor.

The electronic journal Frontiers in Public Health addresses the link between falls and medication in an article published in November 2016. Pharmacists—as drug experts—can and should be cognizant of this connection.  Anticonvulsants, antidepressants, antipsychotics, benzodiazepines, opioids, or sedative hypnotics can increase older adults' risk for falls. Pharmacists can take steps to ask questions and counsel caution to patients to help prevent medication-related falls.

There are plenty of resources that pharmacists can use to minimize fall risk. Although none of the many screening tools for inappropriate medication use in seniors is perfect, selecting 1 or 2 and using them consistently (something that rarely happens currently) can be beneficial. Tools include the Medication Appropriate Index, Beers criteria, Screening Tool of Older Person’s Prescriptions (STOPP)/Screening Tool to Alert doctors to Right Treatment (START), and the Anticholinergic Burden Index.

Primary care physicians receive education about how to review and manage patients’ medications, however they frequently lack a structured process and are inconsistent when conducting medication reviews. Therefore, pharmacists have an opportunity to utilize medication management tools to improve patient care.

The authors suggest that pharmacists use a tool developed by the CDC—a consistent approach called the Screen, Assess, Facilitate, and Educate (). SAFE's 4 essential steps—screen, assess, formulae, and educate—ensure that pharmacists and other health care providers have done all that is possible to prevent medication-related falls.

SAFE is part of the CDC's STEADI program. It provides health care providers with the tools and resources they need to manage older patients’ fall risk.
Pharmacists should recommend vitamin D supplementation when appropriate for elders to improve bone, muscle, and nerve health.
 
Reference 
Karani MV, Haddad Y, Lee R. The Role of Pharmacists in Preventing Falls among America's Older Adults. Front Public Health. 2016; 9;4:250. 
 

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