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Medication-Related Fall (MRF) Screening and Scoring tool: Consensus Delphi Validation

  • At: PPR SIG 2021 (2021)
  • Type: Digital
  • By: SAEED, Dima (School of Pharmacy, Queen’s University Belfast, Belfast, UK., United Kingdom)
  • Co-author(s): Dima Saeed1, Ruth Miller2, Carmel Darcy2, Karen Miller3, Kevin Madden3, Hilary McKee4, Jayne Agnew5, Paula Crawford6, Gillian Carter7, Carole Parsons1 1. School of Pharmacy, Queen’s University Belfast, Belfast, UK. 2. Western Health and Social Care Trust, Londonderry, UK. 3. South Eastern Health and Social Care Trust, Belfast, UK. 4. Northern Health and Social Care Trust, Antrim, UK. 5. Southern Health and Social Care Trust, Craigavon, UK. 6. Belfast Health and Social Care Trust, Belfast, UK. 7. School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK.
  • Abstract:


    Falls are associated with negative health outcomes such as injury and mortality, as well as increased healthcare usage and cost. Risk factors for falls are multifactorial and include polypharmacy and the use of certain medications.


    To develop and validate a medication-related fall (MRF) screening and scoring tool.


    The MRF tool was developed from medication classes associated with falling in the Polypharmacy Guidance Realistic Prescribing 2018, and other medications identified by the Northern Ireland Medicines Optimisation in Older People (MOOP) pharmacy team; medication classes were categorised as high, moderate or low-risk in their ‘potential to cause falls’. Using Delphi consensus methodology, three iterative rounds of online surveys will be conducted. A multidisciplinary expert panel (n=22) will determine their agreement with the falls risk associated with each medication on a 5-point Likert scale with accompanying written feedback. Only medications with at least 75% of respondents agreeing or strongly agreeing will be included in the final version.


    Data collection is ongoing. Two rounds have been completed, and the third round distributed. Twenty-seven medications were proposed in the first round; of these, ten were accepted for inclusion such as sedating depressants, sedating antihistamines, muscle relaxants, antipsychotics, anticholinergics and benzodiazepines. Fourteen of the original proposed medications were considered in the second round, with some split into different classes and two new medication classes were added. In the second round, eight medications were accepted including first and second-generation antiepileptics, non-selective alpha-blockers, beta-blockers, opiate analgesics and thiazide diuretics. Eleven medications are being considered in the third round.


    As a result of the first two rounds, 14 medications have been included in the MRF tool. The MRF tool may be used to evaluate and optimise medications as part of a multidisciplinary intervention to reduce falls risk and fall-related negative outcomes.

Last update 4 October 2019

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