Remote Falls Medication Review Service: Impact on Falls in Care Homes

Introduction

Immedicare, a digitally-enabled, round-the-clock NHS clinical service provides remote support to care homes nationwide, with approximately a quarter of clinical consultations pertaining to falls.

Falls in older people are often multifactorial, with medication being a significant modifiable risk factor.

In July 2024, Immedicare’s pharmacy team launched a targeted, remote falls medication review service (FMRS) to support residents who had fallen and were prescribed at least one medicine identified as contributing to falls, according to the STOPPFall tool (Seppala et al, A&A, 2021).

Method

The FMRS involved a comprehensive review of available medical records and consultation with care homes. Following each review, patient centred medication recommendations were sent to primary care teams. Three months after advice was issued, medical records were re- examined to assess whether recommendations were actioned and determine outcomes, including number of falls before and after the advice was actioned. The first 250 reviews following the service launch were analysed.

Results

Of the 250 patient-centred Falls medication reviews completed, medical records showed that recommendations were followed for 146 residents (58.4%). Ninety-five residents (38%) had medication stopped and/or reduced. For those residents, the average number of falls reported to Immedicare dropped from 2.3 in the two months before to 0.8 in the two months after the medication change. In comparison, those who continued their medication the mean number of falls decreased from 1.9 to 1.1 over the same time.

The difference between the two groups was statistically significant, where medication was stopped or reduced the fall rate over the next two months decreased for 46% of residents (RR 0.54, 95% CI 0.32–0.90, p=0.018).

Conclusion

The FMRS suggests that a remote targeted, patient-centred medication intervention can reduce fall rates in care home residents. Further evaluation with longer follow-up and broader data collection is warranted to substantiate these findings.