There are several risk factors for falls in older adults, including the use of 3 or more medications, especially psychotropic drugs (Leipzig et al., J Am Geriatr Soc 1999).
Community pharmacists are front-line healthcare providers that are well-positioned to screen for falls risk, mitigate risk factors and promote local falls prevention programs.
Several falls risk assessment tools exist, for example the Centers for Disease Control and Prevention's STEADI (Stopping Elderly Accidents, Deaths and Injuries) toolkit.
Community pharmacists could be trained to use these tools to identify older adults at risk of falls and suggest mitigation strategies such as medication reviews to reduce falls risk. For example, pharmacists may recommend that psychotropic medications be withdrawn gradually in older adults at risk of falling from excessive daytime drowsiness.
In Ontario, Canada, the public drug program for seniors pays pharmacists to conduct Meds Checks annually on those taking 3 or more prescription medications. A Falls Check intervention could be easily added to this service. Once a patient at risk is identified, the pharmacist would communicate with the patient and/or caregiver as well as the patient's primary care physician to prevent falls through education and referral to local falls prevention programs. In the U.S., funding for such a service would depend upon the state and the type of public programs that currently exist and could be combined with a falls prevention intervention.
A pharmacist-led falls prevention initiative may also be combined with another annual existing service such as influenza vaccination programs. This would ensure that more adults be screened regularly compared to only seniors on public drug programs. Such an initiative was suggested as part of Public Health Ontario's falls prevention month promotional materials (see attachment), but I am not aware that this was implemented broadly.