Impact of a Pharmacy-Led Fall Prevention Program for Institutionalized Older People.

Abstract

OBJECTIVE\nTo evaluate the impact of pharmacy interventions on recurrence of falls in older people.\n\n\nDESIGN\nProspective case-crossover study.\n\n\nSETTING\nLECOM Health Nursing and Rehabilitation (LNR) and Senior Living Center (SLC) and Millcreek Community Hospital older adult behavioral health and inpatient rehabilitation units (IRU).\n\n\nPARTICIPANTS\nTwenty and 15 residents of the SLC and LNR, respectively, and 5 and 2 patients of the older adult behavioral health unit and IRU, respectively, experienced a fall during the 8-week study period.\n\n\nINTERVENTIONS\nMedication reviews were conducted by a pharmacist assessing for fall risk-increasing drugs (FRIDs). Adverse effects, drug interactions, and nonpharmacologic causes were evaluated, and recommendations were made to reduce future fall risk.\n\n\nMAIN OUTCOME MEASURES\nRecommendation acceptance rate, FRID use, and incidence of recurrent falls.\n\n\nRESULTS\nEighty percent of fall risk-reduction recommendations were accepted and implemented by the medical team. The mean number of potential FRIDs prescribed per participant was reduced from 3.71 to 3.38. There was a 12.4% reduction in recurrent falls after pharmacy intervention (P = 0.0336; odds ratio [95% confidence interval] = 1.783 [1.045-3.112]).\n\n\nCONCLUSION\nPharmacist interventions for older people who experience a fall were associated with a high acceptance rate by health care providers, a reduction in FRID use, and decreased rate of recurrent falls.