Analysis of the relationship between patients’ fear of falling and prescriber acceptance of community pharmacists’ recommendations

Abstract

Background: Certain medications place older adults at higher risk for experiencing falls. This is a modifiable risk factor that may be managed by community pharmacists, but requires prescriber acceptance of recommendations. Previous studies indicate that prescriber acceptance of pharmacist recommendations may be impacted by patient-reported concerns. Objective: To examine the relationship between patient-reported fear of falling and prescriber acceptance of pharmacist recommendations. Methods: A prospective, observational study design was used. Eligible patients were age 65 and older and received care at one of 31 participating pharmacies. Patients were screened for falls risk using three evidence-based questions; patients screening positive were eligible for a comprehensive medication review. Data were collected via a prescriber response form. The primary outcome was the prescriber acceptance of pharmacist recommendations. Results: Pharmacists communicated 562 recommendations to prescribers, with 338 (60%) for patients who worried about falling. There was no significant difference in prescriber acceptance rate between those who worried about falling and those who did not (36.1% vs. 41.1%, X2 = 0.23, p = 0.43). However, patient pharmacy was a significant predictor of recommendation acceptance (p = 0.047). Conclusion: Prescribers were not more likely to consider a pharmacist’s recommendations regarding medications that contribute to falls risk for patients who worried about falling.

Keywords

• community pharmacy services
• medication therapy management
• interdisciplinary communication
• aged
• fall