Medication side effects such as dizziness are one of the main reasons older people fall. Weaning the drugs could be the answer. But the decision on this is complex. That is why the doctors at UMC Valpoli in Amsterdam were recently supported in that decision by software developed with artificial intelligence. There are more and more initiatives in the Netherlands to reduce the risk of falling. Other good examples, besides this initiative in Amsterdam, are smart beds in St. Anonius Hospital who monitor patients with sensors, including for the risk of falling. Another example is the heupairbag which is used by Aunt Louise for older people who have difficulty walking.
Drastic consequences fall
These are all important developments, because a “fall” can drastically change the life of the elderly in particular. For example, if it leads to a hip fracture, the quality of life is regularly severely compromised and independent living can become impossible. The numbers say it all: in 2020, 103,000 elderly people aged 65 and over went to the hospital emergency room after a private fall accident. This means that in 2020, on average, every 5 minutes one over 65 was the victim of a private fall accident with injuries that required treatment in an emergency department. More than one in three elderly people were hospitalized after visiting the emergency room (36700 elderly people) and 5,012 elderly people died from a fall.
Risk of falling into fire
With the push of a button on the computer screen, a doctor at UMC Valpoli in Amsterdam can show the patient what the chances of someone falling are in the next year. “Then it turns out, for example, that a patient has a 56% chance of falling in the next year,” says geriatric medicine professor Nathalie van der Velde on website from Amsterdam UMC. “Certainly with such a high score it is advisable to start an interview with a patient. What medications does someone use, and are there any side effects that make you more likely to fall out?
Van der Velde is the principal investigator of the so-called ADFICE_IT Study. In this study, the Valpoli doctors use software developed with the help of artificial intelligence. The software not only predicts a patient’s likelihood of falling, but also provides tailored advice that appears directly in the patient’s electronic medical record. Such advice indicates which risk medications a patient is taking, what the side effects are, and whether it is wise to continue. Van der Velde: “The system supports, but the doctor and the patient decide”.
This AI study will officially begin in October 2022. Seniors aren’t always aware that medications can increase their risk of falling. But after reduced mobility in general, this is the second leading cause of falls. “Older people often use different medicines at the same time. Think sleeping pills and sedatives, antidepressants, pain relievers, and water pills for cardiovascular disease to lower blood pressure. People can fall due to the side effects. Like sleepiness, dizziness, slower reaction, muscle laxity and reduced vision ”.
Risk of falling and gradual reduction of drugs
Weaning drugs can be a solution, but talking to people about it is sometimes difficult for doctors. “For example, if a patient is given a drug to prevent a heart attack, a doctor doesn’t just suggest stopping it. The drug is not prescribed at all, is it? Do I know enough to make this decision? Doctors are trained to act. Stopping a drug seems unnatural. ”In short, stopping requires good patient consultation and complex considerations. So it’s nice if intelligent software can provide targeted support for making a decision.
drugs at risk
Joost van den Berg, who has been working with the system as a medical assistant at Valpoli since the beginning of September 2022: “The system is efficient, because you can immediately see which drugs at risk a patient is using with personalized advice. And it is transparent, because it is directly in the patient’s electronic file. All the different medicines with their advantages and disadvantages, all those loose puzzle pieces, are clearly presented. People can watch. That makes it easier to talk and make a decision. ”In practice, there seems to be a lot of national and even international interest in this promising research.
