Older adults are at a heightened risk of falls, which can lead to serious health complications and increased healthcare expenses. Identifying and managing fall risk-increasing drugs (FRIDs) through a structured deprescribing process could offer a promising solution to mitigate these risks. This study explores the effectiveness of a deprescribing intervention using the ARMOR tool in reducing fall risks and assesses its cost-effectiveness within the geriatric population.
Study Design and Methods
The research is an open-label, parallel-group randomized controlled academic trial. It aims to recruit individuals aged 60-80 years who are on five or more prescribed medications, including at least one FRID. Comprehensive data collection will include demographics, medical conditions, medication lists, orthostatic hypotension, and fall history details. The fall concern will be measured using the Fall Efficacy Scale, while fall risk will be evaluated using the Timed Up and Go test and Tinetti Performance-Oriented Mobility Assessment tool.
Treating physicians participating in the study will be randomized based on seniority to employ the ARMOR tool for deprescribing FRIDs. Participants will document their experiences in diaries, with monthly phone follow-ups to track falls and any adverse events. Physical assessments to determine fall risk will be conducted every three months over the span of one year. Additionally, the rationality of prescription drugs will be evaluated using the World Health Organization’s core indicators.
Expected Outcomes and Impact
The study, funded by the Indian Council of Medical Research-Safe and Rational Use of Medicine, is set to begin in April 2024 and conclude by 2026. The primary outcomes will be measured by the frequency of falls and changes in fall risk scores. The cost-effectiveness analysis will include calculating the incremental cost-effectiveness ratio. Any adverse events related to the deprescribing process will be meticulously recorded.
Practical Inferences for Healthcare Professionals
Healthcare professionals can derive several actionable insights from this study:
- Implementing the ARMOR tool can systematically reduce the risk of falls in elderly patients.
- Regular follow-ups and physical assessments are crucial for monitoring the effectiveness of deprescribing interventions.
- Evaluating the rationality of prescribed medications can help optimize drug regimens and improve patient outcomes.
This trial aims to deliver critical insights into the efficacy and cost-effectiveness of the ARMOR tool for reducing falls among older adults on FRIDs. The findings will be highly relevant for healthcare professionals, policymakers, and researchers dedicated to geriatric care and fall prevention strategies.
Original Article: JMIR Res Protoc. 2024 Jun 11;13:e55638. doi: 10.2196/55638.
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