Alerting on adverse drug reactions: Falls prevention improvement through developing a computerized clinical support system: effectiveness of individualized medication withdrawal.

Falls in older adults (65+) are a major public health problem. A risk factor for falls is the use of certain medication classes. Within this project, we aim to prevent medication-related falls in older adults by developing, implementing, and testing a clinical decision support system (CDSS) for physicians and a patient portal for patients at falls clinics in the Netherlands. The clinical decision support system and patient portal are designed to help optimize the deprescribing of fall-risk increasing drugs (FRIDs).

Approximately one-third of older adults endure at least one fall every year. Fall-related injuries significantly reduce the quality of life in older adults and contribute to rising expenditures for the healthcare system. This highlights the need for more effective falls prevention interventions in geriatric care departments.

Interventions for falls have proven most effective when aimed at older adults at highest risk for falling. Moreover, in those older adults, an adjustable risk factor for falls is the use of certain medications known as FRIDs. As such, the aim of the ADFICE_IT project is to reduce falls incidences in high-risk older adults through the optimal deprescribing of FRIDs. To this aim, a CDSS was developed in collaboration with physicians and a patient portal in collaboration with patients and is currently being implemented and tested following the medical research council framework for complex health interventions. The CDSS calculates a patient’s risk of falling in the upcoming year, guides physicians through the structured deprescribing of FRIDs, and generates patient-specific medication advice (e.g., step-wise dosage reduction). This medication advice can, in turn, be accessed at home by the patient via the patient portal. The patient portal is also used as preparatory tool prior to the scheduled consultation with the physician.

The effectiveness of the ADFICE_IT intervention (i.e., the combined use of the CDSS and patient portal) on falls is currently being tested by means of a cluster randomized controlled trial in fall clinics at different hospitals across the Netherlands. A cost-effectiveness analysis and process-evaluation will be carried out to evaluate several additional aspects of the intervention. This project is funded by ZonMw.

More information about this and similar research projects related to personalized falls prevention in olders can be read on:

Researchers involved