For adults aged 65 years and older, falls are the leading cause of injury-related mortality and hospitalization. Two risk factors for injurious falls are 1) having experienced a previous fall, which stresses the need to prevent and reduce falls; and 2) the use of certain fall-risk-increasing-drugs (FRIDs). Physicians find FRID withdrawal in older adults often difficult, since it requires complex decision-making about dealing with polypharmacy and multi-morbidity.
Digital tools, such as a Clinical Decision Support System (CDSS) and a Patient Portal, can enhance shared-decision making about medication withdrawal between the physician and patient. Guided by the Medical Research Council (MRC) Framework for complex interventions, we develop, implement, and test a CDSS for physicians at fall outpatient clinics and a Patient Portal for patients who have experienced a fall and were referred to a fall clinic. The CDSS/portal will be implemented in the existing EMR and physicians will be trained. In the Evaluation Phase of the project, the effectiveness of the intervention (i.e., CDSS and Patient Portal) on preventing injurious falls among these older adults will be tested in a Randomized Controlled Trial (RCT) among fall clinics of 10 Dutch hospitals. Additionally, a cost-effectiveness analysis and process-evaluation will be carried out to evaluate the several aspects of the intervention. This project is initiated by the Amsterdam UMC hospital, location AMC and is carried out in cooperation with the UvA.
- Kelly de Wildt (PhD student)
- Dr. Annemiek Linn en Dr. Natasja van Schoor (co-promotoren)
- Prof. dr. Julia van Weert en Prof. Dr. Nathalie van der Velde (promotoren)
Status: Ongoing since 1 July 2020
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