ABSTRACT
OBJECTIVE: To evaluate the impact of pharmacy interventions on recurrence of falls in older people. DESIGN: Prospective case-crossover study. SETTING: LECOM Health Nursing and Rehabilitation (LNR) and Senior Living Center (SLC) and Millcreek Community Hospital older adult behavioral health and inpatient rehabilitation units (IRU). PARTICIPANTS: Twenty 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. INTERVENTIONS: Medication 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. MAIN OUTCOME MEASURES: Recommendation acceptance rate, FRID use, and incidence of recurrent falls. RESULTS: Eighty 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]). CONCLUSION: Pharmacist 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.
