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PS-116 Exposure to anticholinergic and sedative drugs: relationship between drug burden index (DBI), anticholinergic risk scales (ARS) and falls in elderly hospitalised patients
  1. E Jean-Bart,
  2. C Tetu,
  3. C Mouchoux
  1. Charpennes Hospital Center Hospices Civils de Lyon, Pharmacy, Villeurbanne, France

Abstract

Background Falls have a major impact on public health for elderly. Some scores and scales assess the risk of falls or iatrogenic risk. Few are specific to assess the impact or relationship between drug exposure and falls in elderly.

Purpose Our objective was to evaluate relationship between iatrogenic scores, DBI, ARS and fall risk.

Material and methods A multicenter retrospective study was performed in 5 geriatric hospitals. For faller and nonfaller hospitalised elderly, characteristics, comorbidities and drugs prescriptions were collected. DBI and ARS scores were calculated. Relationship between scores and falls were assessed. Description of drugs classes involved in scores was performed.

Results A total of 315 patients, with a mean age of 87 years, were included, 117 of them were fallers. History of fall within 12 months (OR = 6.5 [3.9 – 10.1]), orthostatic hypotension (OR = 4.3 [2.3 to 7.9]), blurred vision (OR = 1.8 [1.1–2.8]), Mini Mental State Evaluation <20/30 (OR = 2.1 [1.3 to 3.4]), and antidepressant prescription (OR = 1.7 [1.05 to 2.8]) were significantly associated with a fall risk. Within this population, 61% of patients had DBI > 0 and 21% ARS ≥ 3. The drugs that contributed to DBI were respectively among fallers and non-fallers: benzodiazepines (16.2% (19/117)/20.2% (40/198)) and opioids (6.0% (7/117)/14.1% (28/198)). For ARS, these classes were, benzodiazepines (8.6% (10/117)/6.6% (13/198)) and antidepressants (5.1% (6/117)/7.6% (15/198)). Statistical analysis didn’t show any relationship between DBI > 0 or ARS > 0 and fall risk (p > 0.05).

Conclusion Results showed that because of multifactorial characteristic of fall, predicting its risk should be based on a set of factors, directly related or not with patient, with or without drug prescriptions. A specific iatrogenic score, routinely used to identify prescription and fall risk patients would help clinicians and pharmacists to optimise therapeutic for elderly.

References and/or acknowledgements No conflict of interest.

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