Study: NCT05390736

Intervention type: BEHAVIORAL
Group type: EXPERIMENTAL
Intervention: Medication review
Description: Patients' medication history in the EHR is assessed for polypharmacy (using 5 or more medications concurrently) and use of medication in the following classes: tricyclic antidepressants, antihistamines, antiemetics, antipsychotics, antispasmotics, muscle relaxants, benzodiazepines, hypnotics, and opioids. The CRN confirms prescriptions with the patient. The CRN reports the medication risk in her provider report and provides medication management educational materials to the patient. At the patient's upcoming primary care visit, providers evaluated whether the medications associated with increased fall risk could be adjusted.

Intervention type: BEHAVIORAL
Group type: EXPERIMENTAL
Intervention: Comorbidity review
Description: The clinical research nurse reviews the patient's EHR problem list for diagnoses of comorbidities associated with increased fall risk including: cognition problems, Parkinson's disease, cardiac issues, depression, or incontinence. Comorbidities are shared with providers in the recommendation statement.

Intervention type: BEHAVIORAL
Group type: EXPERIMENTAL
Intervention: Fall history
Description: The CRN asks how many times the patient had fallen in the past 12 months, whether those with falls sought medical attention, and if they experienced blackouts, loss of consciousness, or a broken/fractured bone(s) resulting from a fall. Fall history information is added to the provider report to increase the salience of fall prevention information.

Intervention type: BEHAVIORAL
Group type: EXPERIMENTAL
Intervention: Assessment of feet/footwear
Description: The CRN observes or asks about the patient's current footwear, asks about foot pain or loss of sensation, and notes a diabetes diagnosis when applicable. Patient reports of foot pain, loss of sensation or diabetes result in a CRN note to the provider to examine the patient's feet and the potential need for a referral to podiatry. The CRN also reviewed a safe footwear handout with all patients regardless of their responses and emailed it to patients with other patient information following the call.

Intervention type: BEHAVIORAL
Group type: EXPERIMENTAL
Intervention: Assessment of visual acuity
Description: The CRN projects a Banner eye chart on Zoom for the patient to read with their contacts or glasses from five feet away for both eyes together and each eye individually. Phone patients are asked to self-report any vision problems. If either the video screening or patient self-report indicated any vision problems, the CRN notes the result and recommendation for eye care referral for the patient's provider to review and order.

Intervention type: BEHAVIORAL
Group type: EXPERIMENTAL
Intervention: Home safety risk assessment
Description: The CRN reviews the CDC brochure Check for Safety: A Home Fall Prevention Checklist for Older Adults with each patient. Check for Safety asks 17 questions about the home's floors, stairs and steps, kitchen, bathrooms, and bedrooms and suggests ideas for removing or reducing fall hazards. The CRN communicates home safety risks and a recommendation for occupational therapy to the provider for indicated patients.

Intervention type: BEHAVIORAL
Group type: EXPERIMENTAL
Intervention: Vitamin D Deficiency
Description: The CRN asks the patient if they usually take a Vitamin D supplement with their other medications. If the patient does not take a Vitamin D supplement, the CRN recommends the provider check Vitamin D levels and consider supplementation if Vitamin D levels are less than 20 ng/mL.