Community pharmacists\u2019 perceptions on providing fall prevention services: a mixed-methods study

Marle Gemmeke,Eline A Rodijk,Katja Taxis,Marcel L Bouvy,Ellen S Koster

doi:10.1007/s11096-021-01277-4

Marle Gemmeke, Eline A Rodijk + Show 3 more

Open Access

https://doi.org/10.1007/s11096-021-01277-4

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Abstract

Background Pharmacists may contribute to fall prevention particularly by identifying and deprescribing fall risk-increasing drugs (FRIDs) in patients with high fall risk. Objective To assess community pharmacists’ perceptions on providing fall prevention services, and to identify their barriers and facilitators in offering these fall prevention services including deprescribing of FRIDs. Setting A mixed-methods study was conducted with Dutch pharmacists. Method Quantitative (ranking statements on a Likert scale, survey) and qualitative data (semi-structured interviews) were collected. Out of 466 pharmacists who were invited to participate, 313 Dutch pharmacists ranked statements, about providing fall prevention, that were presented during a lecture, and 205 completed a survey. To explore pharmacists’ perceptions in-depth, 16 were interviewed. Quantitative data were analysed using descriptive statistics. All interviews were audiotaped and transcribed verbatim. The capability opportunity motivation-behaviour model was applied to interpret and analyse the findings of qualitative data. Main outcome measure Community pharmacists’ views on providing fall prevention. Results Pharmacists stated that they were motivated to provide fall prevention. They believed they were capable of providing fall prevention by FRID deprescribing. They perceived limited opportunities to contribute. Major barriers included insufficient multidisciplinary collaboration, patient unwillingness to deprescribe FRIDs, and lack of time. Facilitators included goal-setting behaviour, financial compensation, and skilled communication. Conclusion Despite the complex decision-making process in medication-related fall prevention, community pharmacists are motivated and feel capable of providing fall prevention. Opportunities for pharmacists to provide fall prevention services should be enhanced, for example by implementing multidisciplinary agreements.

Highlights

Worldwide, one third of community-dwelling persons aged 65 years and older falls at least annually [1, 2]
Multidisciplinary agreements defining community pharmacists’ tasks would support pharmacists to collaborate in fall prevention
The development of clinical decision tools could facilitate fall risk-increasing drugs (FRIDs) deprescribing by community pharmacists

Summary

Introduction

One third of community-dwelling persons aged 65 years and older falls at least annually [1, 2]. The number of falls is growing due to increased life expectancy and aging of the general population [2]. Falling is a multifactorial problem caused by many underlying factors, such as mobility and vision problems [4], and medication use has often been associated with increased fall risk. For. International Journal of Clinical Pharmacy example, fall risk-increasing drugs (FRIDs) include cardiovascular and psychotropic drugs because of their potential to cause fall-related side effects [5,6,7]. Prevention of falls is gaining attention among community pharmacists [8,9,10]. Pharmacists may contribute to fall prevention by identifying and deprescribing fall risk-increasing drugs (FRIDs) in patients with high fall risk

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Discussion

Conclusion