It is well known that many medications have the potential to increase the risk of falls. These risks are particularly apparent in older adults who are often sensitive to the adverse effects of medications. There are a variety of complex mechanisms by which medications and other factors can contribute to falls including effects on cognition, blood pressure, posture, muscle strength and eyesight. The World Health Organisation reports 30-50% of residents in long-term care will experience at least one fall each year and of those who suffer a hip fracture from falling, 20% will die within 1 year. Beyond the immediate impacts, there may be long lasting implications for those who suffer from falls. Detrimental effects to confidence and quality of life may occur and many individuals find themselves forced to shift to a higher level of care following a fall.
By analysing pharmacoepidemiological data gathered from thousands of comprehensive medication reviews, we can quantitatively assess and stratify falls risk. Using this method, we can assign a level of falls risk based on a combination of factors including age, gender, genomics, medications, pathology and medical conditions. We are currently developing a system to assess these variables and this will enable us to produce specific, tailored medication regimens for the elderly. We envisage that our approach will be able to highlight for prescribers, situations whereby their chosen approach to the management of an individual may confer extra risk of a serious adverse outcome such as a fall. The key to our approach is anticipating risk in advance and delivering proactive advice to prevent adverse outcomes before they occur. As well as delivering better clinical outcomes, we feel that this will be reflected in improved quality of life, reduced health care costs and diminished medicolegal risk.
We believe that our multi-dimensional approach to providing highly specific medication recommendations is unique in the market. Recommendations offered by current prescribing software are often not user specific and typically only assess direct medication-medication interactions. By analysing multiple different variables, our system will provide evidence-based, age-specific recommendations which are tailored to each individual patient.
Version 1 - Cloud based app built for pharmacoepidemiological data
Version 2 - Cloud database used for business analytics
Version 3 (current phase) - Auto-notification enabler aka "rules" engine built, DNA genotyping and pathology markers added
Version 4 (future phase) - Prescribing decision support with machine learning capability
Web-based App Flow Diagram
User Journey Map
'Ward Medication Management is the largest provider of clinical pharmacy services in the Australian aged care setting, and we are experts in medication analysis.’
Ward Medication Management is part of the Texas Medical Center (TMCx) Accelerator Digital Health
I understand that the following is what the TMCx is looking for from the startups in its cohort:
Companies that meet the following requirements should apply for consideration:
- You have at least one full-time founder
- You have a working prototype
- We have a preference for pre-revenue companies with previous pilots or early-revenue companies, but it is not required.
“We are in TMCx to validate, refine our system design and formulate a go-to market strategy in the USA with the hope of creating a global footprint for our company,” said Stuart Ward, CEO, Ward Medication Management.
Feedback and Questions
1. Would this be a situation where the patient takes a genetic test and using your tool they receive personalized advice on multiple medication?
Genomic testing allows us to understand an individual’s expression of certain hepatic enzymes which are responsible for the metabolism and therapeutic effects of many medications. By testing this variable, we can predict the response and risk of adverse effects from some medications and offered tailored advice specific to that person.
2. How would you identify patients suitable for the tool especially in the context of fall prevention?
Any person taking 5 or more medications is usually a good starting point for considering a medication review. For every medication which is added to a regimen, the risk of drug interactions and adverse effects increases exponentially. In relation to identifying those particularly at risk of falls we can specifically look at known risk factors and target these patients. There are many complex mechanisms by which medications can contribute to falls and our goal is to identify these and add them into our algorithms for detecting adverse events.
3. Have you thought about how the information from the tool could be communicated from the pharmacist to the older adult/caregiver?
Our primary goal is to proactively alert prescribers to medication risks and offer prescribing decision point in a primary prevention setting. Our app would also aim to provide the patient or carer with a simplified version of the doctor's report/recommendations.
4. Is the customer the pharmacist or the older adult/caregiver?
The customer of our app is the doctor.
5. Would your medication tool keep medical lists for older adults current and deal with the ‘lag’ in documenting up-to-date medication lists?
Our app would be able to store medication lists for patients and these lists would be accessible to the patient via a patient interface on the app.
6. Is Ward Medication Management specific for fall prevention or for multiple physical side effects from medication?
Ward Medication Management aims to prevent all types of medication related harm with falls prevention making up an important component of our work.
7. How do pharmacists currently give fall prevention advice to patients taking multiple medications?
In our specific field, we provide falls prevention advice directly to the doctor in the form of medication recommendations in our comprehensive medication reviews. We also provide education sessions to nursing staff which can help to reduce the incidence of medication-related adverse effects.