Category: Federal Forum Posters
Purpose: Falls are the most common and costly medication-related safety event in older adults. Older Veterans have a high prevalence of fall risk factors and preventing falls has been the focus of several Veteran Affairs (VA) Safety Initiatives. A robust body of evidence supports medications as a major causal factor for falls in older adults. Thus, this project was created to develop and pilot a centralized deprescribing intervention for Veterans at high risk for falls.
Methods: Veterans age 65 years and older screening positive for fall risk on primary care screening within the past year will be identified using the VA Regional Data Warehouse. Veterans with an active prescription for one or more psychotropic or anticholinergic medications will be included. Veterans with life expectancy less than six months, receiving hospice/palliative care, residing in a nursing/assisted living facility, or with target medication(s) already discontinued will be excluded. Chart review will be performed to extract the following: fall-related medication history, dose reduction attempts in last six months, and medical problems associated with the target medication(s). An electronic-consult including up to four deprescribing recommendations will be sent to the primary care or mental health provider. The provider can approve, amend, or opt out of the recommendation. Once approved, the Veteran will be called to implement the plan. Patients will have a telephone follow-up at one month and chart abstraction follow-up at one year. Proportion of patients with deprescribing recommendations, proportion of recommendations accepted and implemented at one month and one year, Drug Burden Index at baseline, one month, and one year, and ED/acute visits for fall or fall-related injury after one year will be evaluated.
Results: Not applicable
Conclusion: Not applicable
Aaron Adams– PGY2 Geriatric Pharmacy Resident, Durham VA Medical Center, Durham, NC