Background Falls are a major cause of morbidity in older people. In most cases falls are multifactorial in aetiology, and medications are one of the most easily reversible risk factors.
Purpose To quantify and analyse fall risk increasing drugs (FRIDs) and other non-pharmacological (NP) conditions in elderly people who had ‘falls’ as a cause of hospital admission.
Material and methods 3 month multicentre retrospective study, in patients aged ≥70 years. The cause of hospital admission was ‘falls’. Data collected were chronic medications and past medical conditions. Data were extracted from hospital admission reports and primary care history reports.
Risk factors for falls were classified as FRIDs and NP. FRIDs were: high (antidepressants, antipsychotics, anticholinergics, benzodiazepines, hypnotics and dopaminergics agents), moderate (antiarrhythmics, antiepileptics, opiate analgesics, older antihistamines, alpha blockers, ACEI/ARB, diuretics and beta blockers) or mild risk (calcium channel blockers, nitrates, oral long acting antidiabetics, cimetidine and ranitidine). NP risk factors were: past history of falls, falls associated with syncope, previous fall with injury and chronic conditions.
Primary outcome measures: prevalence of FRIDs and NP risk factors associated with falls.
Results 121 patients (60 and 61 from two academic hospitals) were collected, with an average age of 85 ± 7 years, 66% of whom were women.
No demographic differences were found between the two hospitals.
Mean number of chronic medications per patient: 7 (5–9). 56% of patients were polymedicated (>5 and ≤9 medicines) and 20% were highly polymedicated (>9 medicines).
36% of chronic prescriptions were FRIDs. Among them 19% were high risk, 72% moderate and 9% mild.
Mean number of FRIDs per patient: 2 (1–4). 85% of patients were taking at least one FRID. Diuretics were taken by 53% of patients, ACEI/ACB by 38%, opiate analgesics by 26% and antidepressants by 24%.
Mean number of NP risk factors per patient: 3 (2–4). 94% of patients had at least one NP risk factor. Most frequent were: cognitive impairment (36%) and past history of fall (31%).
Conclusion A high number of fallers are taking FRIDs as chronic medications. It is necessary to reconcile chronic prescriptions to reduce the risk of falls in elderly people.
References and/or Acknowledgements
Polypharmacy Guidance 2015: http://www.sign.ac.uk/pdf/polypharmacy_guidance.pdf
References and/or AcknowledgementsNo conflict of interest.
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