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The role of health workers in managing medication to prevent falls

Falls are a significant health concern among older adults, with medications being a main factor in influencing falls risk. It’s crucial for healthcare providers who work with older adults to understand the impact of medications on falls and the strategies available to reduce these risks.

How do medications contribute to falls in older adults?

Falls cause substantial injuries and hospital visits among older adults, with approximately 30% of those aged 65 and over experiencing at least one fall each year. Research indicates that medications contribute to 10-25% of these falls through various mechanisms, including polypharmacy—the use of multiple medications. Each additional medication increases the risk of falling by about 14%, particularly if they cause side effects like drowsiness or sudden drops in blood pressure​. Older adults are more susceptible to adverse drug reactions, such as confusion, dizziness, and muscle weakness, due to changes in how their bodies process medications.

Regularly checking medications can help to reduce falls risk. Comprehensive assessments and reviews help identify and address any medication-related issues. The World Guidelines for Falls Prevention and Management for Older Adults emphasise the importance of assessing fall risk before prescribing medications known to increase this risk. These guidelines were developed by a task force of 96 multidisciplinary experts from 39 countries, aiming to provide evidence-based recommendations for healthcare professionals globally​.

Healthcare providers can refer to the World Guidelines for Falls Prevention and the Western Australia Health Department guidelines for further evidence and recommendations.

In Western Australia, several tools and services support medication review:
  • Home Medicines Review (HMR): Conducted by an accredited pharmacist with the patient’s GP, this review thoroughly examines all medications to spot and resolve any problems contributing to falls risk.
  • Residential Medication Management Review (RMMR): Similar to HMR, this review is for aged care residents, aiming to optimize medication use and minimize risks.
  • MedsCheck and Diabetes MedsCheck: Available through community pharmacies, these services offer opportunities for patients to have their medications reviewed by a pharmacist, ensuring understanding and identifying potential issues.

Falls risk assessment tools, such as the Falls Risk for Older People in the Community (FROP-Com) and the Falls Risk Assessment Tool (FRAT), are available to assess various risk factors, including medications. Primary Health workers play a crucial role, with regular consultations and reviews essential for adjusting medications and reducing polypharmacy​.

Evidence shows the impact of regular medication reviews

According to the World Falls Guidelines, regular medication reviews can reduce falls risk by up to 20%​. A study found that comprehensive medication reviews improved quality of life scores by 15% among older adults​, and patients who underwent medication reviews reported a 25% reduction in medication-related side effects​. By regularly checking medications, educating patients, and coordinating with healthcare providers, we can significantly reduce the incidence of falls and improve the quality of life for older adults in our community.

Learn more about how to prevent falls in older adults

The Stay On Your Feet® Improve Your Health Campaign runs from September to November this year. The campaign provide information and resources relating to medication, nutrition and cognition to prevent falls and promote healthy ageing.

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