impact of Pharmacy-Directed Medication Management for Patients Experiencing Falls in a Veterans Affairs Community Living Center

Sr Care Pharm. 2020 Mar 1;35(3):126-135. doi: 10.4140/TCP.n.2020.126.

Abstract

OBJECTIVE: To analyze medication interventions prior to and following implementation of the Pharmacy Medication Related Falls Risk Assessment consult service in an older adult population. DESIGN: Retrospective chart review. SETTING: This study involved patients admitted to the Cincinnati Veterans Affairs Medical Center's (VAMC) Community Living Center (CLC), an institutional practice setting. PATIENTS, PARTICIPANTS: Any patient who experienced a fall while admitted to the CLC during fiscal years 2013 or 2018 was considered for inclusion. Patients were excluded if falls were not evaluated by a provider, the patient expired within 10 days after falling, or falls in fiscal year 2018 that did not have a pharmacy consult placed. Fifty falls from each fiscal year were selected. MAIN OUTCOME MEASURES: The primary endpoint encompassed the number of pharmacy medication interventions made within 10 days postfall, with a secondary endpoint evaluating subsequent falls within 30 days of initial event. RESULTS: Following consult implementation, a larger number of pharmacist recommendations (40 vs. 123) and subsequent interventions (accepted recommendations) within ten days postfall (12 vs. 49) were completed. There were 14 subsequent falls within 30 days of the initial event for both fiscal years. A larger percentage of falls and patients experiencing falls from each fiscal year did not receive previous medication interventions. CONCLUSION: Consult implementation increased the number of pharmacist recommendations and subsequent interventions for patients within ten days postfall, reducing the risk of adverse effects, drug-drug interactions, subsequent falls, and polypharmacy.

MeSH terms

  • Accidental Falls
  • Aged
  • Humans
  • Pharmaceutical Services*
  • Pharmacists
  • Retrospective Studies
  • Veterans*