Deprescribing to reduce falls in older adults
Dr. Elizabeth Phelan, associate professor (Division of Gerontology and Geriatric Medicine) and Dr. Shelly Gray (UW School of Pharmacy) are teaming up to identify ways to prevent falls in older adults. Dr. Elizabeth Phelan is the medical director of the Fall Prevention Clinic at Harborview Medical Center.
Their study, “Reducing Central Nervous System (CNS)-active Medications to Prevent Falls and Injuries in Older Adults (STOP-FALLS),” will identify medication safety improvements to reduce fall-related injuries and other adverse health outcomes.
Phelan and Gray received a $3M grant from the Centers for Disease Control and Prevention (CDC) to study the effect of reducing the use of medications such as benzodiazepines and opioids (prescribed for conditions such as pain, anxiety, and sleep disorders) on preventing falls and other unintentional injuries in older adults.
"Falls in older adults are a significant public health issue," said Gray. "And many older adults are on risky medications that may cause falling because they cause side effects such as dizziness, drowsiness and impaired cognitive abilities."
The team will study the impact that deprescribing can have on people’s safety and reducing the risk of falling, particularly given the impact multiple medications can have on a person’s physical and cognitive functioning.
Deprescribing
Deprescribing is a process whereby the pharmacist and physician review a person’s medications to see if any medications may be causing harm or may no longer be helping the patient. Sometimes a medication that was safe when the person was younger now may pose a risk as they age because the body changes.
By going through this review and making adjustments, some patients experience reduced side effects.
“There has been surprisingly little attention as yet to address the role of medications in falls and injuries by the practice community," said Phelan.
Reducing fall rates
In just ten years, from 2007 to 2016, the death rate caused by falls for older adults has increased 30% in the U.S. If rates continue to rise, the CDC says we can expect seven fall deaths every hour by 2030. One in five falls causes a serious injury such as broken bones or head injury and sends about three million older adults to the emergency room every year at a cost of about $50 billion dollars, most of which is shouldered by Medicare and Medicaid.
The grant is one of three funded (RFA-CE18-004) by the CDC’s National Center for Injury Prevention and Control (Injury Center) that will focus on medication management of opioids and benzodiazepines to reduce falls among adults aged 65 years and older. The research will be conducted at Kaiser Permanente Washington with Dr. Karen Sherman serving as the site lead.