PhD defence: The role of the community pharmacist in fall prevention

Summary

One-third of people aged ≥ 65 years falls at least once annually. Falls are an increasing public health problem. Among a diversity of risk factors for falls, medication use is considered as one of great importance. It therefore seems useful to include pharmacists in fall prevention.

In this thesis, we aimed to answer the question how pharmacists can contribute to fall prevention and how pharmacy-led fall prevention services can be implemented, including their barriers and facilitators. In this thesis the perspectives of patients, pharmacists, and other health care providers, for the provision of pharmacy-led fall prevention services were assessed.

We found that community pharmacists are currently limited involved in fall prevention. They however indicated the wish to be more involved. Other health care providers, including physiotherapists, practice nurses and home care nurses, experience suboptimal collaboration with pharmacists in fall prevention. Most patients are currently unaware of that their medications could have fall risk-increasing effects. 

The following facilitators were identified for community pharmacists to provide fall prevention care: patient engagement, good multidisciplinary collaboration, knowledge about fall risk-increasing drugs and deprescribing, and sufficient pharmacist communication skills. Lack of time and lack of reimbursement were often identified as barriers for implementation. 

In conclusion, pharmacists are in the position to contribute to fall prevention. At least, community pharmacists’ role in fall prevention should include the identification and adaptation of use of fall risk-increasing drugs in patients at risk of falls. They should, however, take up the gauntlet and increase their visibility in fall prevention.