Pharmacotherapy as a risk factor of fall from the clinical pharmacist’s perspective


Authors: doc. PharmDr. Josef Malý, Ph.D. 1,2;  PharmDr. Alena Valko 2;  PharmDr. Martin Doseděl, Ph.D. 1
Authors‘ workplace: Katedra sociální a klinické farmacie, Farmaceutická fakulta UK v Hradci Králové 1;  Oddělení klinické farmacie, Nemocniční lékárna, FN Motol, Praha 2
Published in: Geriatrie a Gerontologie 2019, 8, č. 4: 164-167
Category: Case Reports

Overview

Patient falls belong among the major adverse events in health care facilities, with a major impact on patient morbidity, mortality and health care costs. A large number of factors can be involved in a fall, many of which can be influenced with the aim to minimize the fall consequences. Such risk factors include some medicines used by the patient. Based on the literature, drugs affecting the nervous and cardiovascular systems are considered the most risky. Recent works emphasize the essential impact of multidisciplinary approach in fall management in health care facilities. The aim of this paper is to show the options of identification, solution and prevention of a drug caused fall from the perspective of clinical pharmacist.

Keywords:

fall – clinical pharmacist – health care facility – fall risk-increasing drug – multidisciplinary cooperation


Sources

1. Aryee E, James SL, Hunt GM, Ryder, HF. Identifying protective and risk factors for injurious falls in patients hospitalized for acute care: a retrospective case-control study. BMC Geriatr. 2017; 17(1): 260.

2. Bloch F, Thibaud M, Tournoux-Facon C, et al. Estimation of the risk factors for falls in the elderly: can meta-analysis provide a valid answer? Geriatr Gerontol Int 2013; 13(2): 250–263.

3. Chiu MH, Lee HD, Hwang HF, et al. Medication use and fall-risk assessment for falls in an acute care hospital. Geriatr Gerontol Int 2015; 15(7): 856–863.

4. Ústav zdravotnických informací a statistiky ČR. Centrální systém hlášení nežádoucích událostí – Metodika Nežádoucí událost: PÁD. Verze 01/2017 (Internet). (Praha (Česká republika)): shnu.uzis.cz; c2017 (cited 2018 Dec 29). Available from: www.shnu.uzis.cz/res/file/metodicke_dokumenty/pad_metodika_plna_verze_metodiky(1).pdf.

5. Ministerstvo zdravotnictví České republiky. Minimální požadavky pro zavedení interního systému hodnocení kvality a bezpečí poskytovaných zdravotních služeb. In: Věstník Ministerstva zdravotnictví České republiky, ročník 2015, částka 16 (Internet). (Praha (Česká republika)): mzcr.cz; c2015 (cited 2018 Dec 29). Available from: www.mzcr.cz/legislativa/dokumenty/vestnik-c16/2015_10927_3242_11.html.

6. Callis N. Falls prevention: Identification of predictive fall risk factors. Appl Nurs Res 2016; 29: 53–58.

7. de Jong MR, Van der Elst M, Hartholt KA. Drug-related falls in older patients: implicated drugs, consequences, and possible prevention strategies. Ther Adv Drug Saf 2013; 4(4): 147–154.

8. Deandrea S, Lucenteforte E, Bravi F, et al. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology 2010; 21(5): 658–868.

9. Lee JY, Holbrook A. The efficacy of fall-risk-increasing drug (FRID) withdrawal for the prevention of falls and fall-related complications: protocol for a systematic review and meta-analysis. Syst Rev 2017; 6(1): 33.

10. Seppala LJ, Wermelink AMAT, de Vries M, et al. EUGMS task and Finish group on fall-risk-increasing drugs.Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: II. Psychotropics. J Am Med Dir Assoc 2018; 19(4): 371.e11-371.e17.

11. de Vries M, Seppala LJ, Daams JG, et al. EUGMS Task and Finish Group on Fall-Risk-Increasing Drugs. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: I. Cardiovascular Drugs. J Am Med Dir Assoc 2018; 19(4): 371.e1-371.e9.

12. Seppala LJ, van de Glind EMM, Daams JG, et al. EUGMS Task and Finish Group on Fall-Risk-Increasing Drugs. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-analysis: III. Others. J Am Med Dir Assoc 2018; 19(4): 372e1-372e8.

13. Lord S, Sherrington C, Menz H, Close J. Falls in Older People. University Printing House, Cambridge: Cambridge University Press 2011.

14. Zia A, Kamaruzzaman SB, Tan MP. The consumption of two or more fall risk-increasing drugs rather than polypharmacy is associated with falls. Geriatr Gerontol Int 2017; 17(3): 463–470.

15. Dhalwani NN, Fahami R, Sathanapally H, et al. Association between polypharmacy and falls in older adults: a longitudinal study from England. BMJ Open 2017; 7(10): e016358.

16. Milos V, Bondesson Å, Magnusson M, et al. Fall risk-increasing drugs and falls: a cross-sectional study among elderly patients in primary care. BMC Geriatr 2014; 14: 40.

17. Caffiero N, Delate T, Ehizuelen MD, Vogel K. Effectiveness of a clinical pharmacist medication therapy management program in discontinuation of drugs to avoid in the elderly. J Manag Care Spec Pharm 2017; 23(5): 525–531.

18. Cheema E, Alhomoud FK, Kinsara ASA, et al. The impact of pharmacists-led medicines reconciliation on healthcare outcomes in secondary care: A systematic review and meta-analysis of randomized controlled trials. PLoS One 2018; 13(3): e0193510.

19. World Health Organization. Falls (Internet). (Geneva (Switzerland)): who.int; c2018 (cited 2018 Dec 27). Available from: www.who.int/news-room/fact-sheets/detail/falls

20. Valko A. Analýza vlivu farmakoterapie na riziko pádu. (Atestační práce). Praha: Institut postgraduálního vzdělávání ve zdravotnictví; 2018.

21. Micromedex Healthcare Series (Internet database). Greenwood Village, Colo: Thomson Reuters (Healthcare) Inc. Updated periodically.

22. Berry SD, Mittleman MA, Zhang Y, et al. New loop diuretic prescriptions may be an acute risk factor for falls in the nursing home. Pharmacoepidemiol Drug Saf. 2012 May;21(5):560–563.

23. Státní ústav pro kontrolu léčiv. Databáze léků – SPC Tiapridal (Internet). (Praha (Česká republika)): sukl.cz; c2018 (cited 2019 Sept 30). Available from: www.sukl.cz/modules/medication/search.php.

24. Fialová D, Topinková E, Ballóková A, Matějovská-Kubešová H. Expertní konsenzus ČR 2012 v oblasti léčiv a lékových postupů potenciálně nevhodných ve stáří. Klin Farmakol Farm 2013; 27(1): 18–28.

25. Maly J, Dosedel M, Kubena AA, et al. Analysis of the fall-related risk of pharmacotherapy in Czech hospitals: A case control study. J Eval Clin Pract. 2019 Sep 2. doi: 10.1111/jep.13270.

26. Kalvach Z, Zadák Z, Jirák R, et al. Geriatrie a gerontologie. 1. vyd. Praha: Grada Publishing 2004.

27. Linhartová A. Rizika léčby theofylinem u polymorbidní pacientky s polyfarmakoterapií. Remedia 2013; 23: 424–426.

28. Státní ústav pro kontrolu léčiv. Databáze léků – SPC Milurit 100 mg (Internet). (Praha (Česká republika)): sukl.cz; c2019 (cited 2019 Sept 30). Available from: www.sukl.cz/modules/medication/search.php.

29. Maly J, Dosedel M, Vosatka J, et al. Pharmacotherapy as major risk factor of falls – analysis of 12 months experience in hospitals in South Bohemia. J Appl Biomed 2019; 17(1): 53–60.

Labels
Geriatrics General practitioner for adults Orthopaedic prosthetics
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