As our population ages, attention focuses on ways to improve health outcomes for older adults, and to prevent injuries and harm. For older adults, falls are common and costly. Falls are caused by many things, one of which is the use of certain medications. A Falls Risk Increasing Drug (FRID) is a medication that the literature demonstrates can contribute to falling among older adults.
David Mott, professor and Division Chair of the Social and Administrative Sciences Division, has been conducting research focused on the idea that pharmacists can review and modify older adults’ use of FRIDs, making medication use by older adults safe, and potentially preventing falling due to medication use.
Mott and his research team received two research grants from the UW Institute for Clinical and Translation Research (UW ICTR) to study this topic. Both grant projects involved partnerships with the UW-Madison School of Medicine and Public Health (UW-SMPH), county-based Aging and Disability Resource Centers (ADRCs), county-based Aging Units (AUs), and the Community and Academic Aging Research Network (CAARN). The first grant funded a pilot study for a community pharmacist to provide face-to-face medication review sessions with older adults in Brown County. The grant utilized a team of experts from the UW-Madison School of Pharmacy and UW-SMPH to develop a list of FRIDs, to develop a clinical algorithm to guide the review and modification of FRID use, to train pharmacists to use the clinical algorithm, and to use fundamentals of motivational interviewing during the review session. The randomized control trial revealed that a significantly larger proportion of older adults using FRIDs, who met with the pharmacist had their FRID use modified by the pharmacist, compared with a group of older adults that did not meet with the pharmacist. “The pharmacist in our pilot study was able to modify FRID use to a higher degree than a previous study published in the literature. We think including OTC medications and training the pharmacist to use motivational interviewing techniques were key to the impact of the pharmacist in modifying FRID use,” Mott said. The second grant funded an expansion of the pilot study, to four counties and eleven pharmacists. Preliminary results suggest that pharmacists were effective in modifying FRID use among older adults enrolled in the study.
The results of both studies indicate that community pharmacists can have an impact on making medication use safer for older adults in Wisconsin. Mott and his research partners have been in discussions with health systems in Wisconsin about utilizing pharmacists to review FRID use by older adults. A larger research grant is being planned that will expand the research to older adults living in rural communities of Wisconsin.