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Primary care screening tool helps identify falls-risk patients

By Lilian Anekwe

A new tool developed in primary care could help GPs identify which of their elderly patients are at increased risk of falls.

The screening tool identifies those patients on multiple medications who are at greater risk of falls in the elderly population, and helps GPs target the one in five at high risk.

Researchers conducted a literature review of the evidence base for medicine-related falls, and used it to construct a medicine-related risk of falls assessment tool.

The tool considered various factors including age, sex, medical conditions, falls history, alcohol intake and medication use.

Points were allocated on a sliding scale ranging from 3, for drugs including hypnotics, to -1, for factors that reduce the risk of falls including calcium and vitamin D supplement.

The tool was then trialled in a GP practice in Leicester and used to screen every patient on the practice register aged over 65.

Out of 101 patients, the screening tool identified 44, or 43.6% as being at low risk, 36 or 35.6% at medium risk and 21, or 20.8% at high risk of falls.

The most commonly prescribed medicines associated with falls were angiotensin converting enzyme inhibitors and diuretics, with 32.7% and 25.7% of patients assessed taking them respectively.

There was a statistically significant difference between the risk score seen in patients taking more than 10 medicines compared with those taking less than four, which the researchers said was evidence that polypharmacy is an important risk factor for falls.

Lead researcher Sandra Hall, head of pharmacy practice at De Montfort University in Leicester, said: ‘It is possible to develop an evidence-based falls risk screening tool that includes the risks associated with medicines, and the tool could be used to identify patients with greater needs for falls prevention interventions.'

The research was presented at the British Pharamaceutical Conference earlier this month.

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