Clinical and economic outcomes of a fall-focused pharmaceutical intervention program.
The effects of a fall-focused pharmaceutical intervention program (FFPIP) on the clinical and economic outcomes of elderly patients who fall while residing in a rehabilitation center are described. The objectives of this retrospective observational study were to identify the differences in the number of patient falls among elderly patients before and after pharmaceutical interventions, identify the cost savings related to decreasing the number of falls, and determine whether a relationship exists between falls among the elderly and specific medication classes. A data collection tool was developed by the investigators to record demographics and medication use. Two hundred patients were randomly selected from the preintervention (October 1, 1999-September 30, 2000) and postintervention (October 1, 2000-September 30, 2001) periods. Two data collectors collected data from patient medical records to test the data collection tool and ensure accuracy. The number of patient falls was reduced in the postintervention group by 47%, resulting in a future savings of $7.74 per patient per day. The use of several classes of medication also decreased in the postintervention period: cardiovascular agents, 10.7%; analgesics, 6.3%; psychoactive drugs, 18.2%; and sedatives and hypnotics, 13.9%. Patients most likely to fall were male, greater than 76 years of age, had a cardiovascular- or orthopedic-related diagnosis, and were taking analgesics, cardiovascular agents, and central nervous system agents, yet the intervention had a more significant effect on female patients. Implementation of an FFPIP decreased falls by 47% and decreased the use of cardiovascular drugs, analgesics, psychoactive medications, and sedatives and hypnotics.
Haumschild
Mark J
MJ
Aventis Pharmaceuticals, Seminole, FL, USA. mark.haumschild@aventis.com
Karfonta
Terry L
TL
Haumschild
Mary S
MS
Phillips
Sharon E
SE
D000058:Accidental Falls / Q000191:economics / Q000517:prevention & control*; D000368:Aged; D003362:Cost-Benefit Analysis; D017723:Drug Utilization Review; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005431:Florida; D017048:Health Care Costs; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D012047:Rehabilitation Centers / Q000191:economics*; D012189:Retrospective Studies