Psych CASC / OSCE · Old age psychiatry — falls polypharmacy frailty
Explain falls risk and deprescribing to family — CASC communication station
MRCPsych/FRANZCP-style communication station: explain frailty, psychotropic fall risk, multifactorial prevention, and supervised deprescribing with a restart threshold.
On this page
Study tools
Target exams
Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar meeting the resident's son after a falls and medication review.[1]
Candidate instructions. Explain frailty and why sedative and antipsychotic medicines increase fall risk in plain language; outline a supervised deprescribing plan that is not abandonment; describe non-drug sleep and behaviour supports and multifactorial falls prevention; agree safety-netting and teach-back. Examiner plays the son.[2][5][6]
References6ShowHide
- [1]Clegg A, Young J, Iliffe S, et al. Frailty in elderly people Lancet, 2013.PMID 23395245
- [2]Seppala LJ, Wermelink AMAT, de Vries M, et al. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: II. Psychotropics J Am Med Dir Assoc, 2018.PMID 29402652
- [3]Glass J, Lanctôt KL, Herrmann N, et al. Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits BMJ, 2005.PMID 16284208
- [4]Schneider LS, Dagerman KS, Insel P Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials JAMA, 2005.PMID 16234500
- [5]Scott IA, Hilmer SN, Reeve E, et al. Reducing inappropriate polypharmacy: the process of deprescribing JAMA Intern Med, 2015.PMID 25798731
- [6]Panel on Prevention of Falls in Older Persons, AGS/BGS Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons J Am Geriatr Soc, 2011.PMID 21226685