Use of a fall risk evaluation in a community-based pharmacy

Abstract

BackgroundFalls in older adults are a serious public health concern. They increase health care expenditure and account for more than $30 billion in direct medical costs. Medication-related problems can contribute to fall risk, and community-based pharmacists are well positioned to intervene, given their role in monitoring ongoing medications. ObjectivesTo evaluate the integration of a fall risk screening assessment (i.e., Stopping Elderly Accidents, Deaths, and Injuries [STEADI]) into community pharmacy practice and to report on the targeted medication management interventions that pharmacists made for patients aged 50 years or older with a fall risk potential. Practice descriptionA service-oriented independent pharmacy in the Midwest United States that uses an in-house clinical software program to perform a prospective drug utilization review and document clinical interventions. Practice innovationA 3-item STEADI fall risk screening assessment was administered from October 15, 2018, to January 31, 2019, to 311 pharmacy patrons aged 50 years or older taking high-risk medications. EvaluationFor those with a positive screen for fall risk, the 12-item STEADI fall risk assessment was administered. A pharmacist performed a comprehensive medication review (CMR) for these patients. Education and medication recommendations were provided. ResultsFifty-three patients (17%) responded “Yes” to at least 1 prescreening question. The mean total STEADI fall risk score was 5.7 out of 12. The most commonly reported STEADI item was a worry regarding falling (75.5%) and sometimes feeling unsteady when walking (67.9%). Education regarding falls was provided to all the patients who received the study CMR, but only 6 medication changes were made to the prescribers, of which 4 were accepted. ConclusionThe STEADI assessment was useful in identifying patients who were potentially at a risk of falls. More work pertaining to deprescribing high-risk medications for at-risk patients seems to be needed.