Clinical pharmacist involvement in fall management in a polymorbid geriatric patient with a history of recurrent falls


Authors: Martin Doseděl;  Josef Malý;  Jan Vosátka;  Petr Mikolášek;  Iva Brabcová;  Hana Hajduchová;  Sylva Bártlová;  Valérie Tóthová;  Jiří Vlček
Authors‘ workplace: Ústav ošetřovatelství, porodní asistence a neodkladné péče, Zdravotně sociální fakulta, Jihočeská univerzita v Českých Budějovicích
Published in: Čes. slov. Farm., 2018; 67, 205-211
Category:

Overview

Patient falls represent a significant burden on healthcare facilities, particularly by prolonging hospitalization and increasing the cost of subsequent healthcare. In most cases, fall is caused by a combination of several modifiable and unmodifiable risk factors. The pharmacotherapy, which is often unreasonably administered in relation to patient health condition and drug combination, belongs among the modifiable risk factors. In this case report, the potential effect of pharmacotherapy on the patient fall-related risk as well as clinical pharmacy service that can contribute to reducing the risk of falls by engaging of clinical pharmacist in a multidisciplinary team with focus on the risks of pharmacotherapy and their management are shown.

Keywords:

fall – fall risk increasing drugs (FRIDs) – clinical pharmacist


Sources

1. Park H., Satoh H., Miki A., Urushihara H., Sawada Y. Medications associated with falls in older people: systematic review of publications from a recent 5-year period. European journal of clinical pharmacology 2015; 71(12), 1429–1440.

2. Callis N. Falls prevention: Identification of predictive fall risk factors. Applied nursing research: ANR 2016; 29, 53–58.

3. Ambrose A. F., Paul G., Hausdorff J. M. Risk factors for falls among older adults: a review of the literature. Maturitas 2013; 75(1), 51–61.

4. Lerdal A., Sigurdsen L. W., Hammerstad H., Granheim T. I., Gay C. L. Associations between patient symptoms and falls in an acute care hospital: A cross-sectional study. Journal of clinical nursing 2018; 27(9–10), 1826–1835.

5. Paul S. S., Harvey L., Canning C. G., Boufous S., Lord S. R., Close J. C., Sherrington C. Fall-related hospitalization in people with Parkinson’s disease. European journal of neurology 2017; 24(3), 523–529.

6. Bansal S., Hirdes J. P., Maxwell C. J., Papaioannou A., Giangregorio L. M. Identifying fallers among home care clients with dementia and Parkinson’s disease. Canadian journal on aging = La revue canadienne du vieillissement 2016; 35(3), 319–331.

7. Zhang X. Y., Shuai J., Li L. P. Vision and relevant risk factor interventions for preventing falls among older people: A Network Meta-analysis. Scientific reports 2015; 5, 10559.

8. Blachman N. L., Leipzig R. M., Mazumdar M., Poeran J. High-risk medications in hospitalized elderly adults: are we making it easy to do the wrong thing? Journal of the American Geriatrics Society 2017; 65(3), 603–607.

9. Meer H. G., Wouters H., van Hulten R., Pras N., Taxis K. Decreasing the load? Is a Multidisciplinary Multistep Medication Review in older people an effective intervention to reduce a patient’s Drug Burden Index? Protocol of a randomised controlled trial. BMJ open 2015; 5(12), e009213.

10. Databáze léků – Státní ústav pro kontrolu léčiv. SPC – Viregyt K, Corbilta, Gabanox, Exelon, Concor, Ciplox, Derin, Prestarium neo, Agen, Rosucard, Fosinopril-TEVA, Gopten, Valsacor, Micardis, Lorista. http://www.sukl.cz/modules/medication/search.php (29. 11. 2018).

11. Snow B. J., Macdonald L., Mcauley D., Wallis W. The effect of amantadine on levodopa-induced dyskinesias in Parkinson’s disease. A Double-blind, Placebo-controlled Study 2000; 23(2), 82–85.

12. Tiseo P. J., Foley K., Friedhoff L. T. An evaluation of the pharmacokinetics of donepezil HCl in patients with moderately to severely impaired renal function. British journal of clinical pharmacology 1998; 46(Suppl 1), 56–60.

13. Tisdale J. E., Jaynes H. A., Kingery J. R., Mourad N. A., Trujillo T. N., Overholser B. R., Kovacs R. J. Development and validation of a risk score to predict QT interval prolongation in hospitalized patients. Circulation Cardiovascular quality and outcomes. 2013; 6(4), 479–487.

14. Schächtele S., Tümena T., Gaßmann K-G., Fromm M. F., Maas R. Co-Prescription of QT-Interval Prolonging Drugs: An Analysis in a Large Cohort of Geriatric Patients. PloS One 2016; 11(5), e0155649-e.

15. Rosenson S. R. Statins: Actions, side effects, and administration. UpToDate Inc. [internet]. Poslední revize textu 27. 11. 2018. Dostupné na URL: www.uptodate.com (30. 11. 2018).

16. Moťovská Z., Varvařovský I., Ošťádal P. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS. Summary of the document prepared by the Czech Society of Cardiology. Cor et Vasa 2017; 59, e592–e612.

17. Raymond T. R. Major side effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. UpToDate Inc. [internet]. Poslední revize textu 27. 6. 2018. Dostupné na URL: www.uptodate.com (29. 11. 2018).

18. Goldman J. G., Vaughan C. L., Goetz C. G. An update expert opinion on management and research strategies in Parkinson‘s disease psychosis. Expert opinion on pharmacotherapy 2011; 12(13), 2009–2024.

19. Tachi T., Yokoi T., Goto C., Umeda M., Noguchi Y., Yasuda M., Minamitani M., Mizui T., Tsuchiya T., Teramachi H. Hyponatremia and hypokalemia as risk factors for falls. European journal of clinical nutrition 2015; 69(2), 205–210.

20. Dharmarajan T. S., Avula S., Norkus E. P. Anemia increases risk for falls in hospitalized older adults: an evaluation of falls in 362 hospitalized, ambulatory, long-term care, and community patients. Journal of the American Medical Directors Association 2006; 7(5), 287–293.

21. Duarte M., Bouça-Machado R., Domingos J., Godinho C., Ferreira J. J., and on behalf of central nervous system risk prompt display study group. Feasibility of using risk prompts to prevent falls, dehydration and pulmonary aspiration in nursing homes: a clinical study protocol. Pilot and feasibility studies 2018; 4, 39.

22. Dukas L. C., Schacht E., Mazor Z., Stahelin H. B. A new significant and independent risk factor for falls in elderly men and women: a low creatinine clearance of less than 65 ml/min. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 2005; 16(3), 332–338.

23. Halfon M., Phan O., Teta D. Vitamin D: a review on its effects on muscle strength, the risk of fall, and frailty. BioMed research international 2015; 2015, 953241.

24. Eusebi L. H., Rabitti S., Artesiani M. L., Gelli D., Montagnani M., Zagari R. M., Bazzoli F. Proton pump inhibitors: Risks of long-term use. Journal of gastroenterology and hepatology 2017; 32(7), 1295–1302.

25. Červený R., Topinková E. Geriatrie: Doporučené diagnostické a terapeutické postupy pro všeobecné praktické lékaře. Praha: Společnost všeobecného lékařství ČLS JEP 2014.

26. Malý J., Doseděl M., Vosátka J., Malá-Ladová K., Kuběna A. A., Brabcová I., Hajduchová H., Bártlová S., Tóthová V., Vlček J. Pharmacotherapy as major risk factor of falls – analysis of 12 months experience in hospitals in South Bohemia. J Appl Biomed 2019 (in press).

Labels
Pharmacy Clinical pharmacology
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account