Background The increase in life expectancy increases the risk of falls, leading to dependence and death. Some studies have shown a link between inappropriate prescriptions and falls.
Purpose The main objective of this study was to evaluate if we could reduce falls and potentially readmissions by optimising the prescription of drugs in elderly people.
Materials and Methods From May to December 2011, we enrolled patients admitted for falls in a geriatric post-acute care unit. For each patient, we detected potentially inappropriate medication (overuse, misuse and underuse) depending on the chronic conditions and suggested drug modifications to the general practitioner (GP). Three months after discharge, we phoned the GPs to find out if the pharmaceutical interventions had been accepted or not, and if patients had fallen again.
Results 96 patients (65% of women; median age 85 years) were admitted for falls due to medicines. 86% of the patients were living at home. Medicines involved with the risk of falling were essentially diuretics, benzodiazepines, calcium inhibitors, antiarrhythmics, sartans, anticholinesterases. The modifications usually suggested related to diuretics, benzodiazepines, anticholinergics, vitamin-calcium supplements, osteoporosis treatment and the use of stockings. Among patients called three months later, 75% of the suggestions were still respected, but 29% of the patients had fallen again. There was no difference in the number of falls for patients for whom the modifications had been respected and those for whom they had not been.
Conclusions This study suggested that falls were more frequent among patients living at home; work needs to be done to secure elderly people’s houses. The importance of inappropriate prescriptions on fall events was also underlined. Falls occurred because of multifactorial mechanisms: inappropriate home fittings, sarcopenia, neurodegenerative diseases and inappropriate medicines. One way of reducing the risk of falling in elderly people is to improve the medication.
No conflict of interest.
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