Medication Management to Reduce Falls—With Particular Focus on Frailty, Polypharmacy and Prescribing

Falls are a common presentation to the acute medical take, particularly with the increasing prevalence of frailty. Polypharmacy is an important risk factor for falls, and also commonly coexists with frailty. Polypharmacy review should be undertaken whenever a patient presents to hospital with a fall in order to address treatable factors and reduce readmission rate. Pharmacokinetics and pharmacodynamics alter with age and may have implications for the suitability of medications in older patients; some drugs may be less effective, whilst others may have more potent side effects, altering the risk/benefit profile considerably when compared to the standard population. A variety of tools are available to aid appropriate deprescribing. We consider some of the real-world barriers to deprescribing and highlight the importance of at least beginning the process in hospital, with a recommendation for robust communication with community services for continuation.