November 15, 2018

UW Researchers Gray and Phelan to study the impact of deprescribing to reduce falls in older adults

Older adult hands holding medication

UW Pharmacy’s Shelly Gray and UW Medicine’s Elizabeth Phelan are teaming up to identify ways to prevent falls in older adults. Their study, “Reducing Central Nervous System (CNS)-active Medications to Prevent Falls and Injuries in Older Adults (STOP-FALLS),” will identify medication safety improvements to reduce fall-related injuries and other adverse health outcomes.

“Falls in older adults are a significant public health issue, and many older adults are on risky medications that may cause falling because they cause side effects such as dizziness, drowsiness and impaired cognitive abilities. This study will help health care providers and patients reduce use of these risky medications, including opioids and benzodiazepines, to prevent falls. Finding ways to optimize medication use and safety in older adults is the major mission of the Plein Center.”—Shelly Gray, Director, Plein Center for Geriatric Pharmacy and Shirley & Herb Bridge Endowed Professor at UWSOP

Shelly Gray, Director, Plein Center for Geriatric Pharmacy and Shirley & Herb Bridge Endowed Professor at UWSOP

Shelly Gray, Director, Plein Center for Geriatric Pharmacy and Shirley & Herb Bridge Endowed Professor at UWSOP

Gray and Phelan received a $3M grant from the Centers for Disease Control and Prevention (CDC) to study the effect of reducing the use of medications, such as benzodiazepines and opioids, on preventing falls and other unintentional injuries in older adults. These medications are prescribed for conditions such as pain, anxiety and sleep disorders. The team will study the impact that deprescribing can have on people’s safety and reducing the risk of falling, particularly given the impact multiple medications can have on a person’s physical and cognitive functioning.

Deprescribing is a process whereby the pharmacist and physician review a person’s medications to see if any medications may be causing harm or may no longer be helping the patient. Sometimes a medication that was safe when the person was younger now may pose a risk as they age because the body changes. By going through this review and making adjustments, some patients experience reduced side effects.

“There has been surprisingly little attention as yet to addressing the role of medications in falls and injuries by the practice community. We need practical, patient-centered, and health-system-relevant approaches to curtail unnecessary use of CNS-active medications, and prevent their future use, if we are to ever see sustained reductions in fall-related injury rates and avert the adverse, life-changing consequences that result when an older person is seriously injured from a fall,” —Dr. Elizabeth Phelan, geriatrician and medical director, Fall Prevention Clinic, Harborview Medical Center, and an Associate Professor of Medicine, University of Washington School of Medicine.

Dr. Elizabeth Phelan, geriatrician and medical director, Fall Prevention Clinic, Harborview Medical Center, and an Associate Professor of Medicine, University of Washington School of Medicine

Dr. Elizabeth Phelan, geriatrician and medical director, Fall Prevention Clinic, Harborview Medical Center, and an Associate Professor of Medicine, University of Washington School of Medicine

Reducing fall rates is important. In just ten years, from 2007 to 2016, the death rate caused by falls for older adults has increased 30% in the U.S. If rates continue to rise, the Centers for Disease Control and Prevention (CDC) says we can expect seven fall deaths every hour by 2030. One in five falls causes a serious injury such as broken bones or head injury and sends about three million older adults to the emergency room every year at a cost of about $50 billion dollars, most of which is shouldered by Medicare and Medicaid.

The grant is one of three funded by the CDC’s National Center for Injury Prevention and Control (Injury Center) that will focus on medication management of opioids and benzodiazepines to reduce falls among adults aged 65 years and older. The research will be conducted at Kaiser Permanente Washington with Dr. Karen Sherman serving as the site lead.

This award is one of three extramural research cooperative agreements funded (RFA-CE18-004) to focus on medication management of opioids and benzodiazepines to reduce falls among adults 65 and older.

 

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