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European position paper on polypharmacy and fall-risk-increasing drugs recommendations in the World Guidelines for Falls Prevention and Management : implications and implementation

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Abstract
Falls prevention and management in older adults is a critical global challenge. One of the key risk factors for falls is the use of certain medications. Therefore, to prevent medication-related falls, the following is recommended in the recent World Guidelines for Falls Prevention and Management: 1) assess for fall history and the risk of falls before prescribing potential fall-risk-increasing drugs (FRIDs), 2) use a validated, structured screening and assessment tool to identify FRIDs when performing a medication review, 3) include medication review and appropriate deprescribing of FRIDs as a part of the multifactorial falls prevention intervention, and 4) in long-term care residents, if multifactorial intervention cannot be conducted due to limited resources, the falls prevention strategy should still always include deprescribing of FRIDs. In the present statement paper, the working group on medication-related falls of the World Guidelines for Falls Prevention and Management, in collaboration with the European Geriatric Medicine Society (EuGMS) Task and Finish group on FRIDs, outlines its position on how to implement and execute these recommendations in clinical practice. Preferably, the medication review should be conducted as part of a comprehensive geriatric assessment to produce a personalized and patient-centered assessment. Furthermore, the major pitfall of the published intervention studies so far is the suboptimal implementation of medication review and deprescribing. For the future, it is important to focus on gaining which elements determine successful implementation and apply the concepts of implementation science to decrease the gap between research and practice. Key summary pointsAimThe recent World Guidelines for Falls Prevention and Management provide several recommendations on how to prevent medication-related falls.FindingsMedication review and deprescribing are key interventions in falls prevention and should be structured, personalized, and patient-centered. Preferably, the medication review should be conducted as part of a comprehensive geriatric assessment.MessageImproved information sharing between various prescribers, deprescribing recommendations implemented in guidelines, and increased education and training for health care professionals are warranted to facilitate the deprescribing process.
Keywords
falls prevention, medication review, deprescribing, polypharmacy, adverse drug reactions, fall-risk-increasing drugs, implementation

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MLA
van der Velde, Nathalie, et al. “European Position Paper on Polypharmacy and Fall-Risk-Increasing Drugs Recommendations in the World Guidelines for Falls Prevention and Management : Implications and Implementation.” EUROPEAN GERIATRIC MEDICINE, vol. 14, Springer Science and Business Media LLC, 2023, pp. 649–58, doi:10.1007/s41999-023-00824-8.
APA
van der Velde, N., Seppala, L. J., Hartikainen, S., Kamkar, N., Mallet, L., Masud, T., … Fall risk increasing drugs, F. G. (2023). European position paper on polypharmacy and fall-risk-increasing drugs recommendations in the World Guidelines for Falls Prevention and Management : implications and implementation. EUROPEAN GERIATRIC MEDICINE, 14, 649–658. https://doi.org/10.1007/s41999-023-00824-8
Chicago author-date
Velde, Nathalie van der, Lotta J. Seppala, Sirpa Hartikainen, Nellie Kamkar, Louise Mallet, Tahir Masud, Manuel Montero-Odasso, et al. 2023. “European Position Paper on Polypharmacy and Fall-Risk-Increasing Drugs Recommendations in the World Guidelines for Falls Prevention and Management : Implications and Implementation.” EUROPEAN GERIATRIC MEDICINE 14: 649–58. https://doi.org/10.1007/s41999-023-00824-8.
Chicago author-date (all authors)
van der Velde, Nathalie, Lotta J. Seppala, Sirpa Hartikainen, Nellie Kamkar, Louise Mallet, Tahir Masud, Manuel Montero-Odasso, Eveline P. van Poelgeest, Katja Thomsen, Jesper Ryg, Mirko Petrovic, EuGMS Task, and Finish Grp Fall risk increasing drugs. 2023. “European Position Paper on Polypharmacy and Fall-Risk-Increasing Drugs Recommendations in the World Guidelines for Falls Prevention and Management : Implications and Implementation.” EUROPEAN GERIATRIC MEDICINE 14: 649–658. doi:10.1007/s41999-023-00824-8.
Vancouver
1.
van der Velde N, Seppala LJ, Hartikainen S, Kamkar N, Mallet L, Masud T, et al. European position paper on polypharmacy and fall-risk-increasing drugs recommendations in the World Guidelines for Falls Prevention and Management : implications and implementation. EUROPEAN GERIATRIC MEDICINE. 2023;14:649–58.
IEEE
[1]
N. van der Velde et al., “European position paper on polypharmacy and fall-risk-increasing drugs recommendations in the World Guidelines for Falls Prevention and Management : implications and implementation,” EUROPEAN GERIATRIC MEDICINE, vol. 14, pp. 649–658, 2023.
@article{01H5EYZKKP45MMPGS2QQ24KD92,
  abstract     = {{Falls prevention and management in older adults is a critical global challenge. One of the key risk factors for falls is the use of certain medications. Therefore, to prevent medication-related falls, the following is recommended in the recent World Guidelines for Falls Prevention and Management: 1) assess for fall history and the risk of falls before prescribing potential fall-risk-increasing drugs (FRIDs), 2) use a validated, structured screening and assessment tool to identify FRIDs when performing a medication review, 3) include medication review and appropriate deprescribing of FRIDs as a part of the multifactorial falls prevention intervention, and 4) in long-term care residents, if multifactorial intervention cannot be conducted due to limited resources, the falls prevention strategy should still always include deprescribing of FRIDs. 
In the present statement paper, the working group on medication-related falls of the World Guidelines for Falls Prevention and Management, in collaboration with the European Geriatric Medicine Society (EuGMS) Task and Finish group on FRIDs, outlines its position on how to implement and execute these recommendations in clinical practice. 
Preferably, the medication review should be conducted as part of a comprehensive geriatric assessment to produce a personalized and patient-centered assessment. Furthermore, the major pitfall of the published intervention studies so far is the suboptimal implementation of medication review and deprescribing. For the future, it is important to focus on gaining which elements determine successful implementation and apply the concepts of implementation science to decrease the gap between research and practice.

Key summary pointsAimThe recent World Guidelines for Falls Prevention and Management provide several recommendations on how to prevent medication-related falls.FindingsMedication review and deprescribing are key interventions in falls prevention and should be structured, personalized, and patient-centered. Preferably, the medication review should be conducted as part of a comprehensive geriatric assessment.MessageImproved information sharing between various prescribers, deprescribing recommendations implemented in guidelines, and increased education and training for health care professionals are warranted to facilitate the deprescribing process.}},
  author       = {{van der Velde, Nathalie and Seppala, Lotta J. and Hartikainen, Sirpa and Kamkar, Nellie and Mallet, Louise and Masud, Tahir and Montero-Odasso, Manuel and van Poelgeest, Eveline P. and Thomsen, Katja and Ryg, Jesper and Petrovic, Mirko and Task, EuGMS and Fall risk increasing drugs, Finish Grp}},
  issn         = {{1878-7649}},
  journal      = {{EUROPEAN GERIATRIC MEDICINE}},
  keywords     = {{falls prevention,medication review,deprescribing,polypharmacy,adverse drug reactions,fall-risk-increasing drugs,implementation}},
  language     = {{eng}},
  pages        = {{649--658}},
  publisher    = {{Springer Science and Business Media LLC}},
  title        = {{European position paper on polypharmacy and fall-risk-increasing drugs recommendations in the World Guidelines for Falls Prevention and Management : implications and implementation}},
  url          = {{http://doi.org/10.1007/s41999-023-00824-8}},
  volume       = {{14}},
  year         = {{2023}},
}

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