BMJ  2007;334:169-170 (27 January), doi:10.1136/bmj.39101.381655.1F

Letters

Preventing falls

Clinical medication review is effective in care homes

Further to the systematic review of Oliver et al on strategies to prevent falls and fractures in hospitals and care homes,¹ evidence from a recent clinical trial by colleagues and myself shows that clinical medication review by a pharmacist of care home residents and their treatment is associated with a substantial and significant (P<0.0001) reduction in the number of falls from 1.3 to 0.8 falls per patient in six months (secondary outcome).² Since very little else has been shown to reduce the high incidence of falls in care home residents, this evidence is of particular value.

Our intervention also led to an increase in the number of drug changes per subject (2.4 versus 3.1, P<0.0001), but no difference in the number of general practitioner consultations, cognitive state, activities of daily living, or the number or cost of prescribed drugs. The reduction in hospitalisations did not reach significance.

¹ Pharmacy Practice and Medicines Management Group, Healthcare Studies, University of Leeds LS2 9JT zermansky@btinternet.com

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Competing interests: None declared.

References

1. Oliver D, Connelly JB, Victor CR, Shaw FE, Whitehead A, Genc Y, et al. Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review and meta-analysis. BMJ 2007;334:82-5. (13 January.)[Abstract/Free Full Text]
2. Zermansky AG, Alldred DP, Petty DR, Raynor DK, Freemantle N, Eastaugh J, et al. Clinical medication review by a pharmacist of elderly people living in care homes--randomised controlled trial. Age Ageing 2006;35:586-91.[Abstract/Free Full Text]

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Relevant Article

Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review and meta-analyses

David Oliver, James B Connelly, Christina R Victor, Fiona E Shaw, Anne Whitehead, Yasemin Genc, Alessandra Vanoli, Finbarr C Martin, and Margot A Gosney
BMJ 2007 334: 82. [Abstract] [Full Text] [PDF]