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Study Overview

Implementation of a Deprescribing Medication Program to Evaluate Falls in Older Adults:

A-TAPER Guidance for Deprescribing Opioids and Benzodiazepines

Falls among older adults in the United States account for 2.8 million injuries, 800,000 hospitalizations, and 28,000 deaths per year (1). Observational studies show consistent associations between falls and certain medications. It is widely accepted that falls-related morbidity and mortality could be reduced if systems were in place to identify falls risks and intervene to reduce the risks identified (2,3). In this CDC-funded study, health care professionals (HCPs) within UNC outpatient clinics will be alerted to patients on high-risk medications and provide team-based interventions to maximize the success of falls education and medication deprescribing.

This deprescribing intervention will focus specifically on opioids and benzodiazepines (BZDs) in patients 65 years of age and older since these medications have high susceptibility to negative cognitive effects in older adults and contribute to a higher risk of falls. This study will identify factors affecting the adoption, effective implementation, and maintenance of a deprescribing program focused on opioids and BZDs with the intent of reducing falls. Watch the video below for more information.

  Study Overview [VIDEO 8:19]

 

Overview of the A-TAPER (Assess then TAPER) Process

The process that will be promoted during this study has been dubbed ‘A-TAPER’ (Assess then TAPER), the steps of which are outlined in the diagram below. A crucial aspect of this process will be the utilization of clinical support services provided by a consultant pharmacist. The consultant pharmacist will provide support for participating medical providers via the steps highlighted in the diagram below*. A more detailed overview of the consultant pharmacist’s contribution to the process can be viewed on page 2 of the downloadable version of the algorithm.

 

For more information about the A-TAPER process and the consultant pharmacists’ contributions, watch these videos:
  Overview of the A-TAPER Process [VIDEO 6:28]
  Meet the Pharmacists [VIDEO 7:11]

 

References
  1. Falls Prevention Facts. National Council on Aging. Available at: https://www.ncoa.org/news/resources-for-reporters/get-the- facts/falls-prevention-facts/. Accessed March 22, 2018.
  2. Florence CS, Bergen G, Atherly A, et al. Medical Costs of Fatal and Nonfatal Falls in Older Adults. J Am Geriatr Soc. 2018; Available ahead of print: https://doi.org/10.1111/jgs.15304
  3. Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;9:CD007146

 

Select a Pathway:   Deprescribing Opioids       Deprescribing Benzodiazepines