Deprescribing medicines in the acute setting to reduce falls risk
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objectives
The objective of this study was to identify medicines that contribute to falls
and assess whether review led to deprescribing of potentially inappropriate
medication in elderly falls patients
Methods
Admissions data for elderly patients was examined to identify those whose
presenting complaint included a fall. Medication lists were obtained from these
patients and inpatient prescribing checked. Patients were followed up until
discharge to determine when any medication review took place and whether
or not their prescriptions changed as a result. In particular falls-risk medicines
were identified from the admission lists, compared to discharge prescriptions
and deprescribing detail obtained.
Results
One or more falls-risk associated medicine was found in 65% of patients aged
70 years and older, admitted following a fall.
The mean number of regular medicines on admission was 6.8 per patient and
problematic polypharmacy was found in 57%.
Medicines review was carried out in 86% of patients and 8.5% of admission
medicines were deprescribed.
Pharmacist involvement in medicines review led to a significant reduction of
falls risk medicines (0.53 per patient, p=0.002)
Conclusion
Inappropriate prescribing and polypharmacy are found frequently in elderly
patients at admission following a fall. Comprehensive medicines reviews
should be carried out in all such patients with the objective of deprescribing or
reducing doses to minimise risk of harm. Involvement of
The objective of this study was to identify medicines that contribute to falls
and assess whether review led to deprescribing of potentially inappropriate
medication in elderly falls patients
Methods
Admissions data for elderly patients was examined to identify those whose
presenting complaint included a fall. Medication lists were obtained from these
patients and inpatient prescribing checked. Patients were followed up until
discharge to determine when any medication review took place and whether
or not their prescriptions changed as a result. In particular falls-risk medicines
were identified from the admission lists, compared to discharge prescriptions
and deprescribing detail obtained.
Results
One or more falls-risk associated medicine was found in 65% of patients aged
70 years and older, admitted following a fall.
The mean number of regular medicines on admission was 6.8 per patient and
problematic polypharmacy was found in 57%.
Medicines review was carried out in 86% of patients and 8.5% of admission
medicines were deprescribed.
Pharmacist involvement in medicines review led to a significant reduction of
falls risk medicines (0.53 per patient, p=0.002)
Conclusion
Inappropriate prescribing and polypharmacy are found frequently in elderly
patients at admission following a fall. Comprehensive medicines reviews
should be carried out in all such patients with the objective of deprescribing or
reducing doses to minimise risk of harm. Involvement of
Date Issued
2016-08-19
Date Acceptance
2016-07-27
Citation
European Journal of Hospital Pharmacy: Science and Practice, 2016
ISSN
2047-9964
Publisher
BMJ Publishing Group
Journal / Book Title
European Journal of Hospital Pharmacy: Science and Practice
Volume
24
Copyright Statement
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Publication Status
Accepted