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Don’t Fall Into Cascade of Medications

When seniors are prescribed more than four medications, their chances of falling significantly increases.

By: Lorrie Ward Jackson | Category: Health & Fitness | Issue: October 2011

Dr. Miki Finnin, Pharm. D., BCPS, CGP, 
owner of Medication Advisors.

Dr. Miki Finnin, Pharm. D., BCPS, CGP, owner of Medication Advisors.

If you have ever discussed concerns about an elderly friend or family member, chances are the discussion has involved the risk of that loved one taking an injurious fall. These fears are not unwarranted, and the statistics necessitate close examination.

Each year, over 30 percent of seniors who live in retirement communities fall. The rate rises in nursing facilities to a possible 55 percent. The chance of falling increases dramatically if an elderly person is on more than four medications; over a third of the geriatric population takes over five medications, sometimes many more. To make matters worse, these medicines are often changed frequently and include medications that actually increase the likelihood of falls due to an adverse effect of the drug itself or its mixture with another drug.

Dr. Miki Finnin, pharmacist and owner of Medication Advisors, sometimes attributes this last to the “prescribing ­cascade.” This happens when a patient is given one medication that causes a particular side effect and then is prescribed another that causes a different side effect, only to be prescribed yet another with the same result. “This creates the cascade,” says Dr. Finnin. “With our knowledge at Medication Advisors, we can go back to the beginning. Perhaps if we choose a different medication than the one that started the cascade, we can eliminate the need for some of those medications downstream.”

Medication Advisors ­provides what is known as Medication Therapy Management or Medication Review Services. This is a fairly new concept in Oklahoma, but Dr. Finnin has years of experience, having provided this ­service when she worked at the University of Minnesota in Duluth. “We started offering these services with St. Luke’s Hospital and their clinics,” she recalls. “In Minnesota, this is not such a new service – it’s more of a known commodity as far as medication reviews.”

When Dr. Finnin came to Oklahoma, she immediately saw the need here and set about to specialize in the geriatric area, furthering her geriatric ­experience at the University of Oklahoma College of Medicine. She founded Medication Advisors, a company designed
to help the elderly and their ­families navigate the maze often created by a myriad of ­different prescriptions.

What can clients expect from a meeting with Dr. Finnin? First, she will meet with them and evaluate their situation, ­gathering medical information, reviewing medications and side effects and interactions with other medications, and discerning whether any of the medications can be replaced with a less costly alternative. Next, she will educate the client, discussing their actual health condition and how their current medications are either working for or against that condition, and presenting a plan of action to reap the most benefits from needed medication, with the least amount of side effects. Finally, she will act as advocate between the client and his or her health providers. “My main question is,” she states, “Why are we putting something into our mouths that is not ­getting us to our goal?”

Follow-up is an integral part of Dr. Finnin’s process, as she understands that with rapidly changing health conditions, ­medications often change quickly as well. She recommends one ­follow-up appointment per ­quarter at least, with more frequent visits for those who have conditions like diabetes. This continual care can reap lasting and rewarding results, and the cost of the service is far less than the cost of a hospital stay and possible transfer to an expensive facility following a medication-related fall. “The goal of our company is to keep patients in their home, aging in place.”


For more information, contact

Medication Advisors, PLLC

P.O. Box 1113
Glenpool, OK 74033
(888) 407-8643

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