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Community pharmacist intervention for falls prevention (replaced - see below)

Merged here: https://challenges.openideo.com/challenge/fall-prevention/ideas/detecting-risks-of-falling-at-health-check-stations

Photo of Nita Lakhani

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Who is your idea designed for and how does it enable older adults to live their best possible life by preventing falls?

My idea is designed for older adults at risk of falls, but could be applied to anyone at risk, including those on multiple medications. Pharmacists can screen, identify and mitigate risk factors to prevent falls in older adults, thereby enabling them to live their best possible lives.

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 For example, pharmacists may recommend that psychotropic medications be withdrawn gradually in older adults at risk of falling from excessive daytime drowsiness.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. 

What early, lightweight experiment might you try out in your own community to find out if the idea will meet your expectations?

I suggest engaging a small number of community pharmacists to take STEADI's training program and use their toolkit to screen older adults at risk of falls. Pharmacists would then provide education and suggest mitigation strategies in collaboration with the patient's primary care physician. Pharmacists and patients who try this program would be invited to focus groups to share their experiences, what worked and what didn't work, to inform a potentially larger-scale intervention.

What skills, input, or guidance from the OpenIDEO community would be most helpful in building out or refining your idea?

Similar existing interventions that the OpenIDEO community is aware of would provide insights into how best to structure a pharmacist-led falls prevention intervention. Ideas on how to prototype such an intervention would be much appreciated.

How long has your idea existed?

  • 0-3 months

This idea emerged from

  • An Individual

Tell us about your work experience:

I have a pharmacy background and am interested in the application of design thinking principles to solve wicked healthcare problems.

How would you describe this idea while in an elevator with someone?

Community pharmacists can play a key role in falls prevention through screening older adults who may be at risk, assessing and mitigating risk factors, planning and implementing interventions to help older adults live their best possible lives.

How does your idea demonstrate our Criteria of Affordability?

My idea suggests pharmacists bill existing public health programs for this essential service. In Ontario, the Ontario Drug Benefit Program for seniors allows pharmacists to bills for Meds Check services. What if a Falls Check service was simply added to this at a minimal additional cost? In the U.S., Medicare for seniors could be leveraged to provide funding for this essential service that would ultimately reduce healthcare costs by preventing falls and resulting injuries.

Attachments (1)

Falls prevention at flu clinics.pdf

Falls prevention awareness combined with flu clinics as part of falls prevention month promotional material from the Public Health Agency of Ontario.

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Photo of Chris Ashford
Team

Nita Lakhani this is a great idea. I hope you can get the traction you need in Toronto. We could use something like this in our product. Medication interaction is a powerful factor in fall risk assessment. Do you care to comment on potential availability in the US?

Photo of Nita Lakhani
Team

Hi Chris! Thanks for your comment and apologies for my delayed response. I've been working on my integrated team idea available here: https://challenges.openideo.com/challenge/fall-prevention/ideas/detecting-risks-of-falling-at-health-check-stations

I can't comment on potential availability in the U.S. as I'm from Toronto, Canada and have never lived or worked in the U.S. It's my understanding from internet research that Medicare funds medication reviews conducted by pharmacists in the U.S. We have a very similar program in Ontario that I included in our merged team idea. Cheers.

Photo of Chris Ashford
Team

Thank you Nita and good luck!

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