Authors (including presenting author) :
Chan HT(1), Mak YF(2), Lam WM(3), Chu KY(1), Ho WM(1), Yuen YH(1), Chan TF(1), Lee CP(4), Cheung KL(4), Leung WYS(1)
Affiliation :
(1)Pharmacy Department, Queen Elizabeth Hospital, (2) Geriatric Team, Department of Medicine, Queen Elizabeth Hospital, (3) Geriatric Day Hospital, Queen Elizabeth Hospital, (4) School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong
Introduction :
Falls are associated with high morbidity and mortality rate. The use of fall risk increasing drugs (FRIDs) is one of the major risk factors causing falls in elderly people. The Geriatric Day Hospital (GDH) aids to manage the patient’s rehabilitation after a recent fall and to prevent subsequent fall or fall-related admission by a multidisciplinary team.
Objectives :
The primary objective is to review the pharmacist-led pilot service in GDH whether it reduces the number of FRIDs. The secondary objective is to reduce fall risk in elderly patients by comparing the number of repeated falls and the number of fall-related hospital admission over the study period.
Methodology :
A 6-month pilot service in GDH was conducted by the pharmacists in geriatric team in Queen Elizabeth Hospital. Fall referral patients aged 65 or above and taking at least one FRID were included in this pilot service. The primary outcome is the change in use of chronic medications and FRIDs in study group. The secondary outcomes are the rate of repeated falls and fall-related hospital admission at 8-week and 6-month post-intervention, and the number and types of pharmacist interventions.
Result & Outcome :
One hundred and nineteen patients were referred to the pilot service in GDH. The percentage reduction of total number of FRIDs and high risk FRIDs were 2.8% (P=0.028) and 4.5% (P=0.006) respectively. The repeated fall rate was significantly lower in study group at 6-month post-intervention (25.4% vs 16.0%; P=0.059). The fall-related admission rate at 6-month post-intervention was also lower in study group (14.8% vs 7.6%; P=0.059). Overall, 83 drug-related problems were identified. 81.9% of pharmacist interventions were accepted and implemented by geriatricians. The pharmacist-led pilot service in GDH significantly reduced the number of FRIDs in elderly patients with fall history. Medication review and patient education on fall prevention by pharmacists enhanced safety and quality of patient’s medications.
