Study of Pharmacogenomic-Guided Medication Prescribing to Prevent Falls and Medication Harm in Older Adults Aged 65 and Above

What this Trial Is About

Researchers are evaluating whether pharmacogenomic testing, which uses participants DNA, can help optimize medication prescribing and reduce side effects in older adults taking five or more medications. This clinical trial focuses on older adults aged 65 and above who have experienced a ground-level fall, aiming to see if DNA-based prescribing can lower medication-related side effects, including falls and fall-related injuries. The study compares two groups one where doctors receive DNA test results to guide prescribing, and one receiving usual care without immediate DNA information. Participants will be randomly assigned to either the DNA Care Pathway, where pharmacogenomic test results are provided to their primary care physician to help adjust medications, or the Emergency Department Care Pathway, where usual care is given and DNA results are shared only after the study ends. All participants provide a one-time cheek swab for DNA analysis and, if blood is drawn for routine care, a small additional blood sample for drug level testing. They will complete monthly calendars to track medication changes, falls, and injuries, and participate in follow-up phone calls for about six months. During the study, researchers will collect data from monthly phone interviews, calendars, and medical record reviews to monitor falls, medication changes, adverse drug effects, and new medical problems. The main outcomes measured are the number of recurrent falls, emergency visits related to adverse drug events, and overall mortality within a 6-7 month follow-up. The study also looks at gene-drug interactions and patient wellbeing. The total participation period is about 6 to 7 months, with ongoing monitoring to assess medication safety and fall prevention in older adults.

The Geriatric Emergency Department Pharmacologic Harm Prevention Project