SAFE Medication Review Framework

SAFE Medication Review Framework
A Team-based Approach

Use this framework to conduct a medication review
to help prevent older adult falls.
Adapted from existing medication therapy management tools developed
and used by pharmacists, this review framework uses the SAFE process:
Screen, Assess, Formulate, and Educate.
Consider working with pharmacists, who are trained specifically in
medication review and are a valuable resource available to your healthcare team.

S

Screen for medications that may increase fall risk.

A

Assess the patient to best manage health conditions.

F

Formulate the patient’s medication action plan.

E

Educate the patient and caregiver about medication
changes and fall prevention strategies.

Centers for Disease
Control and Prevention
National Center for Injury
Prevention and Control

2016

Screen for medications that may increase fall risk.
■

Obtain and reconcile the medication list1

■

Group medications based on medical conditions

■

Identify medications that may increase fall risk or have potential interactions

■

Consider adjusting medications based on age, kidney, and liver function

■

Use labs, health and prescription history, and prescription monitoring data

Assess the patient to best manage health conditions.
Discuss the following:
■

Treatment goals

■

Current medication regimen

■

Side effects experienced

■

Non-pharmacologic options

■

Patient values and preferences

■

Barriers to care2

S
A
F
E

Formulate the patient’s medication action plan.
■

Stop medications when possible3

■

S
 witch to safer alternatives

■

Reduce medications to the lowest effective dose

■

Simplify the dosing regimen

■

Develop a monitoring plan for medication side effects

■

Explore non-pharmacologic options to manage medical conditions

■

Incorporate patient preferences and solutions to identified barriers

Educate the patient and caregiver about medication changes
and fall prevention strategies. Discuss the following:
■

Reasons for medication changes

■

Steps for implementing action plan

■

Other approaches to reduce fall risk

■

Importance of referrals to specialists

1 Include information about prescription drugs, over-the-counter medications, supplements, allergies,
alcohol use, and recreational drug use.
2 Examples include low health literacy, physical or cognitive impairment, and socioeconomic barriers
that may affect medication adherence.
3 In some instances, gradual dose reduction (tapering) may be advisable.

Additional resources available at www.cdc.gov/steadi/patient.html.

CS262175A