Each year, 2.5 million people 65 and older are treated in emergency departments for falls, resulting in over 700,000 hospitalizations, according to the Centers for Disease Control and Prevention, which also notes that falls are among the 20 most expensive medical conditions, with an average hospital cost for a fall-related injury of $35,000, leading to an estimated burden of $34 billion annually on the health care system.
With those statistics in mind, the research team, which includes ETSU Bill Gatton College of Pharmacy faculty members Drs. Zach Walls, Peter Panus, Brian Odle, Kelly Covert and Samuel Karpen, as well as Dr. Courtney Hall, an associate professor in the ETSU College of Clinical and Rehabilitative Sciences Department of Physical Therapy and a research health scientist at the James H. Quillen VA Medical Center, is focusing its efforts on preventing falls by looking at the role prescription medications play.
To prevent falls, those providing geriatric care need to be able to identify individuals who are most at risk in order to provide more targeted and efficient interventions and, currently, a quick, cheap and easy metric for assessing fall risk is not available.
“A number of drugs – especially those affecting the central nervous system, like sleep medication and psychoactive drugs – are known to increase the risk of falls, yet they are still commonly prescribed in older adults. Our goal is to better understand the impact of prescription drugs on mobility in order to predict those at risk for falls based on their medications,” said Hall, the primary investigator on the grant. “The ultimate goal would be that even before a physician has seen a patient that doctor could put the patient’s medications into an app and it would alert to fall risks.”
That red flag garnered from a medication index would then result in a comprehensive evaluation of the person to assess additional non-drug related fall risks and determine ways to prevent potential falls for the patient.
Through their collaborative efforts, the researchers at ETSU have developed two different drug indices: the Quantitative Drug Index (QDI), which was generated using the interdisciplinary clinical expertise of pharmacists and physical therapists, and the Medication-based Index of Physical function (MedIP), which was derived computationally using “big data” analytics regarding drug adverse effects and side effects that might affect fall risk. Both indices could be used to quickly and cheaply assess fall risk in older adults.
The researchers are currently working to validate each index. Once validated, the hope is to create an app so that they could be adopted by health care workers almost immediately. Hall is hopeful at least one index, if determined to be effective, will be adopted for use in the VA system.
“Ultimately, introduction of these indices into clinical practice will improve health care and reduce risk for millions of older individuals,” she said.