Medications and falls: addressing the risk through pharmacist-led quality initiatives

Falls in older adults are common in the long-term care setting and are associated with functional decline, isolation, and depression. Increased attention is being given by Centers for Medicare and Medicaid services to have nursing homes implement quality assurance programs with the aim to reduce at least monthly medication reviews and monitors for therapeutic effectiveness as well as adverse consequences pharmacist-led team interventions to reduce fall risk in residents at a continuing care retirement community. One intervention is a fall risk evaluation form that notifies the assisted living care team of modifiable risk factors for residents who fall frequently. Examples include discontinuing psychotropic medications that effect gait or alter mental status. In conjunction with the nursing home care team, the pharmacist also created two other programs tha aim to (a) improve bone health by identifying residents who have low vitamin D levels, and evaluating their need for calcium and vitamin D supplementation, and (b) educate the nursing staff of specific medication side effects that increase fall risk.