Background Falls are very frequent health problems in patients hospitalised in healthcare facilities. Regarding prevention of falls, it is essential to analyse all of the factors, including medications which may be potential contributors to falls and consequently efficiently minimise these risk factors.
Purpose The aim of this study was to describe a group of patients who fell during hospitalisation, assess the iatrogenic impact on falls as well as other risk factors, and identify other drug related problems (DRPs) not directly associated with falls.
Material and methods A retrospective observational study was conducted in the rehabilitation care centre from March to November 2014. Patients who had a fall during their hospitalisation were included. Data were collected from medical records containing personal and medication history as well as information concerning the fall. Analysis regarding the relationship between pharmacotherapy and the fall comprised identification of drugs with a potential risk of fall and assessment of the individual risk based on other risk factors presented in each patient. Identification, evaluation and solution of all the DRPs were determined by SAZE (signal analysis measurement elimination) analysis. Data were processed by descriptive analysis.
Results The study sample comprised 150 inpatients (53.3% women). Mean age was 66.2 years (SD=18.4). 12.0% of patients experienced repeated falls. The most frequent diagnosis with risk of fall were arterial hypertension (79.0%), musculoskeletal disorders (59.3%), balance disorders (58.0%) and diabetes mellitus (34.0%). In total, patients used 1286 drugs, of which 55.1% had a potential risk of fall. Based on an assessment of the individual risk of falls, zolpidem, tramadol and benzodiazepines were the most frequent drugs used by patients. Unclear indication, high dose and unsuitable use of drug were the most common DRPs unrelated to the fall.
Conclusion Based on individual assessments, we identified cases in which falls caused by use of drugs could not be omitted. In the case of falls, it is necessary to search for possible causes of the fall and not forget the most commonly used drugs by patients. Clinical pharmacists with such experience in collaboration with other health professionals can contribute to solving this health problem.
No conflict of interest