# New medication score helps NHS teams spot older patients at risk of falls

> A scoring tool built into electronic patient records helps pharmacists and doctors find older people whose combined medicines raise their risk of delirium and falls, and it is already in use.

- Published: 2026-11-05 by Tickety-Boo News
- Section: Health
- Location: England, UK
- Web page: https://ticketyboonews.co.uk/stories/new-medication-score-helps-nhs-teams-spot-older-patients-at-risk-of/
- Original report: [New NHS-ready medication risk tool could cut falls and delirium in older people](https://medicalxpress.com/news/2026-11-nhs-ready-medication-tool-falls.html) (Medical Xpress)

## In brief

- Researchers in Leeds, Liverpool and Bradford created a score showing older patients' medicine-related risk of delirium and falls.
- The model drew on records for almost 750,000 people over 65 and was checked against Welsh data.
- A hospital version is live in two NHS trusts, with ward pilots now under way.

A new scoring tool could help NHS pharmacists and doctors pick out older patients whose mix of medicines puts them at greater risk of delirium and serious falls. The Anticholinergic Medication Index, or ACMI, is designed to run inside electronic patient record systems, and a hospital version is already in use at two NHS trusts.

The tool deals with what is called anticholinergic burden. Plenty of medicines have anticholinergic effects as a side issue rather than their main purpose, and when several are taken together those effects stack up. That can raise the chances of delirium, falls and dementia, with older people the most exposed. The work, by teams at the University of Leeds, the University of Liverpool and the Bradford Institute for Health Research, is published in BMJ Medicine.

The researchers trialled the index at GP surgeries in Bradford. It automatically produced a list of patients aged 65 and over, giving each person's score, the medicines behind it and their predicted risk of a fall or delirium over the following year. Before, someone would have had to calculate those figures for each individual before pharmacists could decide who most needed a structured medication review.

To build the model, the team drew on anonymised records for almost 750,000 people over 65, held in a linked set of GP and hospital data called Connected West Yorkshire. They then checked it against a national dataset from Wales. It is an unusually large sample for this kind of work.

Getting a prediction model into everyday use is no mean feat. Dr Aseel Abuzour, of the University of Leeds, said very few ever make it, but the hospital version, known as ACMICS, has. It appears at several points in the record system, and it recalculates whenever an anticholinergic medicine is prescribed or stopped. Her team has also written a technical specification so that other organisations can build their own equivalent.

The researchers are now trying the index on several geriatric medicine wards and orthopaedic hip fracture wards. The aim is to see whether it could be rolled out more widely in hospitals.

Dr Kate Best, the study's first author, noted that about half of older adults in the UK are prescribed at least one anticholinergic medicine in a given year. She suggested that patients with several health conditions may find it reassuring that a tool can flag when a medication review is due.

## Why it matters

The risks of these medicines have been understood for years, but turning that knowledge into routine action has proved harder. Falls and delirium can be devastating for older people and costly for health services. By doing the sums automatically inside systems that clinicians already use, the ACMI could help busy pharmacists and doctors direct their limited time towards the patients most likely to benefit from a review.