Development of a Risk Assessment Tool for Falls Prevention in Hospital Inpatients Based on the Medication Appropriateness Index (MAI) and Modified Beer’s Criteria

Abstract

Medication review is an essential component of comprehensive falls assessment. A medication review by pharmacists can assist to identify and notify prescribers of medications that require adjustment or discontinuation. Beers Criteria and the Medication Assessment Index (MAI) are explicit and implicit inappropriate prescribing (IP) tools, respectively. While the Beers Criteria has been applied to falls prevention, the MAI has not. Developing alternative falls prevention tools has been spurned by both the desire to overcome limitations of the Beers Criteria, coupled with the need for implicit criteria which includes consideration for patient –specific clinical judgement. A literature search and review of the Beers Criteria and MAI tools revealed advantages and disadvantages of each. Using combined explicit/implicit falls assessment criteria using both the Beers Criteria and MAI as a framework, a falls specific inappropriate prescribing (FASPIP) tool for use in elderly hospitalized patients was developed. Validation of the FASPIP in the clinical setting is needed.