Background Polypharmacy and fall risk increased drugs (FRIDS) have been associated with injury falls leading to hospital admission. However, at discharge, polypharmacy and FRIDS are not usually assessed in elderly patients admitted to hospital after a fall related hip fracture.
Purpose To quantify the number of FRIDS and total drugs, and to estimate the prevalence of polypharmacy and FRIDS at discharge in elderly patients admitted to hospital after a fall related hip fracture.
Material and methods A 3 month retrospective search of patients was made at the orthogeriatric unit in a third level hospital in Madrid (Spain). Patient demographics, baseline characteristics, FRIDS and total number of drugs were collected from hospital discharge reports. According to the Swedish National Board of Health and Welfare, the FRIDS considered were: opioids, antipsychotics, anxiolytics, hypnotics and sedatives, antidepressants, vasodilators used in cardiac diseases, antihypertensives, diuretics, beta blocking agents, calcium channel blockers, agents acting on the renin–angiotensin system, alpha-adrenoreceptor antagonists (benign prostatic hypertrophy) and dopaminergic agents (anti-Parkinson).
Results 80 patients (77.5% women, mean age 87.3 years, SD 4.5) who had been admitted to the hospital after a fall related hip fracture were discharged. Previous to admission, 39.0% of patients had a recent past history of falls (previous 6 months), a mean Barthel Index of 80.4 (SD 28.6), a FAC scale of 4.2 (SD 1.3) and a Global Deterioration Scale (GDS) of 2.4 (SD 1.7). At discharge, the mean number of drugs per patient was 11 (SD 3.2); 96.2% of patients were polymedicated (≥5 drugs), and 81.2% were highly polymedicated (≥9 drugs). The number of FRIDS per patient was 2.6 (SD 1.6); 91.2% of patients were discharged with at least 1 FRID (89.0% 1–4 FRIDS and 11.0% 5–6 FRIDS). The most frequent FRIDS at discharge were: antipsychotics (41.2% of patients), agents acting on the renin–angiotensin system (38.7%), antidepressants (33.7%), opioids (27.5%), anxiolytics (23.7%) and diuretics (23.7%).
Conclusion At discharge, polypharmacy and FRIDS were highly prevalent after a fall related hip fracture leading to admission in elderly patients. Due to a high risk of falling in these patients, reducing polypharmacy and number of FRIDS at discharge, as far as possible, could be useful.
No conflict of interest
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