Hellinger Benjamin J, Gries André, Bertsche Thilo, Remane Yvonne
Emergency Department, Observation Unit, Leipzig University Medical Center, 04103 Leipzig, Germany.
Pharmacy, Leipzig University Medical Center and Medical Faculty, 04103 Leipzig, Germany.
Geriatrics (Basel). 2025 Mar 17;10(2):46. doi: 10.3390/geriatrics10020046.
: In older patients, falls constitute a significant public health concern and a major cause of hospital admission. Fall-risk-increasing drugs (FRIDs) represent a key risk factor for falls. Therefore, modifying these drugs represents an important strategy for preventing recurrent falls and further patient harm. The objective of this study was to evaluate a structured interprofessional collaboration between physicians and pharmacists on managing FRIDs in older patients who present to the emergency department (ED) after a fall. : This study was performed in the ED of a tertiary care hospital. Patients who were >65 years old and presented to the ED after a fall were included. A routine care group was included between 1 March 2020 and 31 May 2020. A pharmaceutical care group was included between 1 September 2023 and 30 November 2023. In the pharmaceutical care group, a clinical pharmacist supported the physicians in identifying and managing FRIDs. Possible solutions for improving FRID prescription were discussed interprofessionally. The number of FRIDs at ED admission and discharge, as well as the number of FRID modifications, were evaluated. : A total of 107 patients were enrolled in each group. There were 85 patients in the routine care group and 89 patients in the pharmaceutical care group, with at least 1 FRID prescribed at ED admission ( = 0.483). At ED discharge, there were 85 patients in the routine care group and 68 patients in the pharmaceutical care group, with at least 1 FRID prescribed at ( = 0.010). There were seven FRID modifications in the routine care group compared to 125 FRID modifications in the pharmaceutical care group. : In this study, the interprofessional collaboration between physicians and pharmacists led to a reduced number of FRIDs being prescribed and more FRID modifications in older patients at ED discharge. Further research is required to ascertain the feasibility of integrating this single intervention into a multifactorial fall prevention program.
在老年患者中，跌倒构成了重大的公共卫生问题，也是住院的主要原因。增加跌倒风险的药物（FRIDs）是跌倒的一个关键风险因素。因此，调整这些药物是预防反复跌倒和进一步伤害患者的重要策略。本研究的目的是评估医生和药剂师之间在管理跌倒后到急诊科（ED）就诊的老年患者的FRIDs方面的结构化跨专业协作。
本研究在一家三级护理医院的急诊科进行。纳入年龄大于65岁且跌倒后到急诊科就诊的患者。2020年3月1日至2020年5月31日纳入常规护理组。2023年9月1日至2023年11月30日纳入药物治疗组。在药物治疗组中，临床药剂师协助医生识别和管理FRIDs。跨专业讨论了改善FRID处方的可能解决方案。评估了急诊科入院和出院时的FRIDs数量以及FRID调整的数量。
每组共纳入107例患者。常规护理组有85例患者，药物治疗组有89例患者，急诊科入院时至少开具了1种FRID（P = 0.483）。急诊科出院时，常规护理组有85例患者，药物治疗组有68例患者，至少开具了1种FRID（P = 0.010）。常规护理组有7次FRID调整，而药物治疗组有125次FRID调整。
在本研究中，医生和药剂师之间的跨专业协作导致急诊科出院时老年患者开具的FRIDs数量减少，FRID调整增多。需要进一步研究以确定将这一单一干预措施纳入多因素跌倒预防计划的可行性。
