Abstract
OBJECTIVES: To evaluate the effects of a community pharmacy-based fall prevention intervention (STEADI-Rx) on the risk of falling and use of medications associated with an increased risk of falling. DESIGN: Randomized controlled trial. SETTING: A total of 65 community pharmacies in North Carolina (NC). PARTICIPANTS: Adults (age ≥65 years) using either four or more chronic medications or one or more medications associated with an increased risk of falling (n = 10,565). INTERVENTION: Pharmacy staff screened patients for fall risk using questions from the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) algorithm. Patients who screened positive were eligible to receive a pharmacist-conducted medication review, with recommendations sent to patients' healthcare providers following the review. MEASUREMENTS: At intervention pharmacies, pharmacy staff used standardized forms to record participant responses to screening questions and information concerning the medication reviews. For participants with continuous Medicare Part D/NC Medicaid coverage (n = 3,212), the Drug Burden Index (DBI) was used to assess exposure to high-risk medications, and insurance claims records for emergency department visits and hospitalizations were used to assess falls. RESULTS: Among intervention group participants (n = 4,719), 73% (n = 3,437) were screened for fall risk. Among those who screened positive (n = 1,901), 72% (n = 1,373) received a medication review; and 27% (n = 521) had at least one medication-related recommendation communicated to their healthcare provider(s) following the review. A total of 716 specific medication recommendations were made. DBI scores decreased from the pre- to postintervention period in both the control and the intervention group. However, the amount of change over time did not differ between these two groups (P =.66). Risk of falling did not change between the pre- to postintervention period or differ between groups (P =.58). CONCLUSION: We successfully implemented STEADI-Rx in the community pharmacy setting. However, we found no differences in fall risk or the use of medications associated with increased risk of falling between the intervention and control groups. J Am Geriatr Soc 68:1778-1786, 2020.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1778-1786 |
| Number of pages | 9 |
| Journal | Journal of the American Geriatrics Society |
| Volume | 68 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 1 2020 |
Bibliographical note
Funding Information:This work was supported by Cooperative Agreement Number 1 U01 CE002769‐01 from the Centers for Disease Control and Prevention and grant number 1C1CMS331338 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the US Department of Health and Human Services or any of its agencies. The research presented here was conducted by the awardee. Findings might or might not be consistent with or confirmed by the findings of the independent evaluation contractor.
Publisher Copyright:
© 2020 The American Geriatrics Society
Keywords
- aging
- community pharmacy
- falls
- health services
- medication