Falls Flashcards
What are contributing factors for falls with aging?
- Lean body mass
- Decreased B-adrenergic stimulation sensitivity (heart)
- Decreased baroreceptor activity
- Decreased cardiac output
- CNS decline
- Pulmonary decline
- Vision decline
- Loss of bone mass
T/F: Loop diuretics have been shown to cause an great increase in fall risk while antihypertensives do not
TRUE
T/F: Evidence shows TCAs carry a higher risk of hip fracture than SSRIs
FALSE
SSRIs might actually be worse
T/F: Evidence shows first generation antipsychotics carry a risk of hip fracture while second generations do not
FALSE
2nd gens just carry a lower risk
T/F: Evidence shows opioids have a significant hip fracture risk while other analgesics and NSAIDs do not
TRUE
T/F: Fall risk between multiple drugs is additive
FALSE
It can be synergistic according to some data
What is drug-burden index (DBI)?
A method of measuring a patient’s total exposure to anticholinergic and sedative drugs
What classes of drugs are FRIDs across all data?
- Any psychotropic
- Antidepressants
- Sedatives/hypnotics
- Antipsychotics
- Tranquilizers
What is a major determinant of an intervention team’s success for fall reduction?
The control that the team has over the implementation of the intervention (THEY generally need to be the ones implementing it to be successful)
What are barriers to fall prevention strategies?
- Lack of provider expertise
- Geographic barriers between providers and patients
- Incomplete adoption of self-management
- Lack of financial/organizational support
What is a problem with many current fall prevention interventions?
Most do not include medication evaluation
How should we implement goal A - helping older adults know that drugs cause falls
- Let older adults know that falling is a common adverse event of some medications
- Have an annual medication review by a provider (esp. pharmacist)
- Focus on falls and fall prevention
- Increase awareness about drugs causing falls
- Implement drug use into self-management programs
- Empower older adults and caregivers
How should we implement goal B - have providers consider fall risk with medication therapy
- Support providers with recommendations and med reviews
- Develop a systematic method for knowing how med combos can cause falls
- Improve education of healthcare providers
- Use MTM services with Med Part D
Which fall prevention program has a points system for different drug classes associated with the risk they carry?
AHRQ
What is the most comprehensive FRID evaluation tool?
Dr. Wahler’s MaRCs clinical decision support tool
