The Polypharmacy Working Group for The World Guidelines for Falls Prevention has made some overarching recommendations about medicines, including:⁵

·      assess the patient for fall history and the risk of falls before prescribing potential fall risk increasing drugs (FRIDs) to older adults;

·      use a validated, structured screening and assessment tool to identify FRIDs when performing a medication review, to optimise FRID deprescribing;

·      medication review and appropriate deprescribing of FRIDs should be part of holistic, multidomain falls prevention interventions, as simply deprescribing a FRID on its own may not necessarily reduce falls;

·      falls prevention strategies for long-term care residents should always include rational FRIDs deprescribing.

Medication reviews for older adults at risk for falls should consider a drug’s necessity. If a medicine is needed and a FRID is normally indicated, then try to find a treatment option that is safer than the FRID, checking for availability and clinically suitability.⁵

Shared decision-making approaches tailored to the individual’s personal circumstances tend to achieve better deprescribing and compliance. Implementation is also more successful by educating the person, family members, carers and other health professionals.