Training and Toolkit Resources to Support Implementation of a Community Pharmacy Fall Prevention Service

Abstract

Community pharmacies are an ideal setting to manage high-risk medications and screen older adults at risk for falls. Appropriate training and resources are needed to successfully implement services in this setting. The purpose of this paper is to identify the key training, tools, and resources to support implementation of fall prevention services. The service was implemented in a network of community pharmacies located in North Carolina. Pharmacies were provided with onboard and longitudinal training, and a project coach. A toolkit contained resources to collect medication information, identify high-risk medications, develop and share recommendations with prescribers, market the service, and educate patients. Project champions at each pharmacy received a nine-question, web-based survey (Qualtrics) to identify usefulness of the training and resources. The quantitative data were analyzed using descriptive statistics. Thirty-one community pharmacies implemented the service. Twenty-three project champions (74%) completed the post-intervention survey. Comprehensive onboard training was rated as more useful than longitudinal training. Resources to identify high-risk medications, develop recommendations, and share recommendations with prescribers were considered most useful. By providing appropriate training and resources to support fall prevention services, community pharmacists can improve patient care as part of their routine workflow.

Using the Drug Burden Index to identify older adults at highest risk for medication-related falls

“…These patients were eligible to receive a medication review provided by a pharmacist associated with the pharmacy where they obtained their medications. As part of the medication review, the pharmacist evaluated the patient's medication regimen using evidence-based algorithms developed by the study team to: (1) identify medications associated with an increased risk of falling and (2) provide therapeutic recommendations to reduce risk [37]. Pharmacists conducting the medication reviews were aware of participants' responses to the key STEADI questions.…”

Community pharmacists’ perceptions on providing fall prevention services: a mixed-methods study

“…Examples of statements were as follows: “I have enough knowledge to recognize FRIDs” and “At the moment, I contribute to fall prevention”. Through discussion, the research team developed the statements, which were based on literature findings, until they all agreed on sufficient applicability [ 9 , 10 , 17 ]. The presentation software Mentimeter ( www.mentimeter.com ) was employed to display the statements and record the responses.…”

“…The topics were: current fall prevention activities of pharmacists, fall risk assessment during medication review, needs for assistance for further implementation of fall prevention, and needs for a guideline to deprescribe FRIDs. Topics were based on literature findings, and through discussion, the research team developed the survey until they all agreed on sufficient applicability [ 9 , 10 , 17 ]. The survey also collected background information, including age, gender, and years of work experience.…”

“…The interviews were guided by a topic list that included the following topics: knowledge of FRIDs, deprescribing, multidisciplinary collaboration, and helpful tools for deprescribing (see Supplementary Information S2). Topics were identified based on literature, themes that arose out of the survey, and themes that emerged during short talks with community pharmacists about fall prevention during the regional meetings of the KNMP [ 9 , 10 , 17 ]. The topic list was evaluated after the first three interviews, and only a few questions were slightly adjusted.…”

“…For example, fall risk-increasing drugs (FRIDs) include cardiovascular and psychotropic drugs because of their potential to cause fall-related side effects [5][6][7]. Hence, prevention of falls is gaining attention among community pharmacists [8][9][10].…”