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Collaborative medication reviews – assisting older Australians to stay on their feet

This guest article is written by Dr Andrew Stafford, a pharmacist with over 15-years’ experience working across both academia and clinical practice in residential care. Dr. Andrew Stafford shares his perspective as a pharmacist working with older people – the impact of falls on the community, their families, and on their mental health. He delves into the influence medications can have on falls in older adults, and what role a pharmacist can play in preventing falls from happening.

As a pharmacist who specialises in working with older people, it’s unfortunate that I so often witness the devastating effects a fall can have on the quality of life of both the person who fell and their families. Aside from physical injury, falls can also significantly impact upon a person’s mental health through increased anxiety and lost confidence. Sadly, many older people never fully recover from a fall, so prevention is critical in minimising falls- related harm.

Because falls tend to result from multiple interacting risk factors, it’s important for falls prevention activities to involve multidisciplinary teams of health professionals. Whilst there’s no definitive rules as to who should be in a falls- prevention team, there should always be a team member with expertise in medication management such as a pharmacist or medical practitioner. This is because medication can substantially increase the risk of falls in susceptible people, and medication review is a key means of helping older people to remain healthy and independent.

Many medications can increase falls risk, ranging from psychotropic medications for depression and anxiety, to cardiovascular medications for hypertension and ischemic heart disease. Minimising the falls risk associated with these medications is not straightforward, as they are often prescribed for very appropriate reasons and cannot be readily ceased. Consequently, an individualised medication review is required to carefully evaluate the risks and benefits of a person’s medications, and develop strategies to minimise the risks and maximise the benefits.

Pharmacists and general practitioners have provided collaborative medication reviews for older Australians for over 20 years. These services are an ideal means to identify and address a person’s falls risk through prescribing optimisation and education provision. Many doctors for whom I have undertaken reviews include them as part of their patient’s annual comprehensive medical assessments, to account for people’s changing circumstances as they age. It’s my hope that the medication reviews I do help to prevent some of the falls- related trauma that these people may otherwise experience.

Read more about how you can assist older adults to manage their medicines here.

Stay On Your Feet® is provided by Injury Matters and funded by the Western Australian Department of Health.

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Government of Western Australia Department of Health Injury Matters
Injury Matters acknowledge the Whadjuk Noongar people as the traditional custodians of the land on which we live and work, and recognises Aboriginal and Torres Strait Islander peoples continuing connection to land, waters and community across Western Australia.