Project identifies strategies to prevent falls, hospitalisations

Pharmacy-generated alerts when a resident starts or changes medicine and a falls-risk status on medication charts are among new strategies identified to help prevent falls in aged care.

PREVENT team members Sarah Hosking, Tina Cooper, Professor Simon Bell and Dr Janet Sluggett.

Pharmacy-generated alerts when a resident starts or changes medicine and a falls-risk status on medication charts are among new strategies to help prevent falls in aged care identified by a provider and university collaboration.

Less intensive blood pressure lowering and greater access to mobile imaging services are other effective strategies to prevent falls and fall-related hospitalisations, the Resthaven and Monash University’s Centre for Medicine Use and Safety project PREVENT found.

Falls, which can result in loss of confidence, injuries and fractures, are one of the leading causes of hospitalisations from residential aged care.

Project PREVENT brought together clinical pharmacists, ambulance service representatives, a geriatrician, general practitioner, registered nurses, physiotherapists and consumer representatives to proactively identify new strategies to prevent falls and fall-related hospitalisations.

Monash University’s Professor Simon Bell said these new strategies they identified together to prevent injurious falls and unnecessary hospital transfers could underpin new approaches to improve resident wellbeing.

“Many of the strategies identified could be trialled by pharmacists, GPs and aged care providers to help prevent fall-related hospitalisations,” Professor Bell told Australian Ageing Agenda.

“Medications are often a modifiable risk factor for falling. Psychotropic and some cardiovascular medications can increase the risk of falling, particularly when these medications are initiated or doses changed.”

The team conducted an in-depth review of 47 consecutive fall-related hospitalisations and identified the root causes of falls.

The project PREVENT expert panel then recommended the following strategies:

  • adding ‘falls risk status’ on medication charts
  • pharmacy-generated alerts when falls-risk medications are initiated or doses changed
  • targeted falls risk medication reviews
  • possible reassessment of treatment goals, such as less intensive blood pressure lowering.

The panel also identified the potential importance of access to subsidised mobile imaging services.

Resthaven executive manager residential services said going to hospital was a traumatic experience so any steps to prevent unnecessary hospitalisations were steps in the right direction.

“The study highlighted the need for a collaborative approach to understand frailty, falls risk and medication management regimes and the impact of these complexities within the constraints of the current aged care system,” she said.

Medication reviews valuable

Professor Bell said the project also highlighted the importance of regular medication reviews.

“Project PREVENT also reinforces the value of residential medication management reviews (RMMRs) to help ensure each resident’s medication regimen is consistent with their current goal of care,” he said.

This is consistent with the Royal Commission into Aged Care Quality and Safety Interim Report and its recommendation to increase uptake, eligibility, quality and follow-up of RMMRs, Professor Bell said.

The project was jointly funded by Resthaven and the Centre for Research Excellence in Frailty and Healthy Ageing.

Project PREVENT findings were published in Aging Clinical and Experimental Research in November. Access them here.

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Tags: Aging Clinical and Experimental Research, Centre for Medicine Use and Safety project, Dr Janet Sluggett, monash-university, news-4, PREVENT, Professor Simon Bell, residential medication management reviews, resthaven, rmmr, royal commission into aged care quality and safety, Sarah Hosking, slider, tina-cooper,

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