Falls are a leading cause of morbidity and mortality in the aging population yet only a small percentage of older adults report being asked about falls or their risk for falls. The Centers for Disease Control and Prevention initiated the STopping Elderly Accidents, Deaths and Injuries (STEADI) toolkit more than 10 years ago, but provider uptake has been slow due to provider time limitations. Research has shown that promising outcomes from shared medical appointments (SMAs), particularly related to patient education and screening for fall risk reduction, and ultimately in reducing falls in this population. Researchers at the University of California, San Diego, wanted to establish an SMA workflow to comprehensively screen and evaluate fall risk. Their model included referring patients to the SMA with scheduling per their preference virtually or in-person. Patients then attended a nurse visit for appropriate fall risk related screening, followed by the SMA with 2 physicians for review of medical history, fall screening results, and implementation of fall reduction strategies.
Overall, 52 patients were seen/assessed between November 2021 and February 2023 with SMAs ranging from 3 to 5 patients with an average age of 77 (=/− 6.7). Questionnaire self-reported risk factors (from CDC’s Stay Independent brochure, Table, page 17), self-reported strength, and polypharmacy were associated with objective markers of increased fall risk. Follow up survey results found the clinically integrated model was well accepted by patients. The authors concluded that falls prevention SMAs can be effective.
Source: Moran R, Ramirez M, Wood G, Hofflich H, Wing D, Nichols J. Shared-medical appoint for screening and risk assessment for fall prevention. Gerontol Geriatr Med. 2023;9:1-6. https://doi.org/10.1177/23337214231186460
