Falls Prevention Last year the local Health Overview and Scrutiny - - PowerPoint PPT Presentation

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Falls Prevention Last year the local Health Overview and Scrutiny - - PowerPoint PPT Presentation

Falls Prevention Last year the local Health Overview and Scrutiny Committee raised falls prevention as a key issue within Staffordshire. Resulting analysis found that falls admissions in over 65s in East Staffordshire were


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Falls Prevention

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  • Last year the local Health Overview and Scrutiny

Committee raised falls prevention as a key issue within Staffordshire.

  • Resulting analysis found that falls admissions in over

65s in East Staffordshire were significantly higher than regional and national levels and hip fracture rates were slightly higher than regional and national levels.

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Current Figures – East Staffs CCG

Average Cost Per Spell for Patients Aged Over 65 - Financial Year 2012/2013 With a fracture £4,929.20 Without a fracture £1,883.49

2012/2013 Total Cost With a fracture £778,813.80 Without a fracture £951,163.17 Total £1,729,976.90

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High risk drugs that can contribute to a fall Moderate risk drugs that can contribute to a fall Low risk drugs that can contribute to a fall Antidepressants ACE inhibitors/ARB's Calcium -channel blocker Antimuscarinics Alpha-blockers Nitrates Anti-psychotic ( including atypical) AntiArrhythmics Oral Anti Diabetic drugs Benzodiazepine and hypnotics Antiepileptic's Proton Pump Inhibitors and H2 Receptor Antagonist Dopaminergic drugs used Parkinson's disease Antihistamines Beta- blockers Diuretics Opiate analgesics

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Risk Factors - four or more place patients at higher risk

  • Balance disorder
  • Previous falls
  • Visual/hearing/cognitive impairment
  • Poly pharmacy
  • Poor mobility
  • Alcohol >1 unit /day
  • Orthostatic hypertension
  • Over 65 years old

Maria Smith Pharm MR Pharms Berkshire falls prevention

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Retrospective audit of 75 patients that had a previously fallen 40% - prescribed a “red drug” 72% prescribed a “amber drug” 26% were being prescribed both red and amber at the time of the fall 33% of the falls would appear due to medicines related Conclusion : several patients had changes in their Anti- hypertensive medication and initiations of

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Cochrane review 2012

Recommended that a withdrawal/review should be considered for psychotropic medication( Antipsychotics, Hypnotics and Anti-depressants.) Based on two trials

  • Pitt 2007- Falls Education by clinical pharmacists in GP

Practices.

  • Campbell 1999 – Randomized trial of withdrawal/review of

Psychotropic medication.

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CSU modelling against the Campbell 1999 trial on Psychotropic medication modification/review

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How can Pharmacies prevent falls ? :

DISCUSSION

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Contact : Claire Dearden

Clinical Audit Facilitator Medicine Management East Staffs Clinical Commissioning group Email : claire.dearden@northstaffss.nhs.uk Phone 01283 507135 Mobile 07966874847