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Medication review and falls
- David P Alldred (19 February 2009)
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David P Alldred, Pharmacy lecturer School of Healthcare, Baines Wing, University of Leeds, LS2 9JT
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This was a very interesting trial, particularly the finding that the major difference in the intervention group that led to a reduction in fallers was a review of medication. It would have been useful for the changes in medication to have been described with an attempt to explicitly link medication changes to a reduction in fallers. The authors state that medication review may produce counter- intuitive results as demonstrated by the HOMER study (1). However, a major flaw of HOMER was that the pharmacist reviewers did not have access to the medical notes. A RCT of pharmacist-conducted medication review in care homes, in which the pharmacists had access to the medical notes, demonstrated a statistically and clinically significant reduction in falls (RR 0.59, 95%CI 0.49-0.70) (2). The authors' findings also correlate with my experience that some GPs are reluctant to discontinue medication and that the rationalisation of medicines occurs to a greater extent in secondary care. Dr David Alldred MRPharmS, PhD References 1. HOLLAND, R., E. LENAGHAN, I. HARVEY, R. SMITH, L. SHEPSTONE, A. LIPP, M. CHRISTOU, D. EVANS, and C. HAND. 2005. Does home based medication review keep older people out of hospital? The HOMER randomised controlled trial. British Medical Journal, 330, pp. 293. 2.ZERMANSKY, AG, Alldred DP, Petty DR, Raynor DK, Freemantle N, Eastaugh J, Bowie P. 2006. Clinical medication review by a pharmacist of elderly people living in care homes - randomised controlled trial. Age and Ageing, 35, pp. 586-591. Conflict of Interest:None declared |
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