Background and importance Fractures are the most common injuries seen after a fall. Falls among the older population are associated with a high morbidity and mortality. The aetiology of falls is usually multifactorial and the use of several types of drugs has been associated with an increased fall risk. As drugs are a modifiable risk factor, periodic drug review and eventual withdrawal of drug related falls could be a possible strategy to prevent falls in older people.
Aim and objectives The aim of the study was to analyse the proportion of patients who were treated for osteoporosis and were taking, concomitantly, any drug that increased the risk of falls.
Material and methods A retrospective observational study was conducted in three primary care centres covering a population of 97 722 people. Study population: patients with a prescription of any drug for osteoporosis. Data collected were age, gender, drugs for osteoporosis treatment and drugs that had a medium or high fall risk.
Results A total of 1594 patients were treated with drugs for osteoporosis: 91.5% were women, median age was 72.4 (SD 10.6) years. Drugs for osteoporosis prescribed were: alendronate (62.7%), denosumab (15.5%), alendronic acid+colecalciferol (6.2%), risedronate (6.2%), ibandronate (3.5%), raloxifene (3.0%), teriparatide (1.8%), bazedoxifene (1.0%) and etidronate (0.1%).
We found that 69.1% of patients had an active prescription of a drug that increased the risk of falls: 38.5% of patients had one drug concomitantly prescribed; 30.5% two; 17.9% three; 8.7% four; and 4.4% five or more.
The most prescribed drugs related to falls were (expressed as per cent of prescriptions): anxiolytics (N05B) (21.2%), antidepressants (N06A) (19.5%), high risk antihypertensives (beta-blockers (C07A) (9.2%) and angiotensin convertor enzyme inhibitors (C09A) (8.9%)), opioid analgesics (N02A) (8.3%), medium risk antihypertensives (calcium antagonists (C08C) (7.4%) and angiotensin II receptor antagonists (C09C) (5.5%)), antihypertensives combined with diuretics (C09C, C09B) (7.3%), hypnotics and sedatives (N05C) (5.4%) and antiepileptics considered as high or medium risk (valproic acid, carbamazepine, clonazepam, phenytoin, phenobarbital and gabapentin) (3.7%).
Conclusion and relevance Concomitant prescription of drugs for osteoporosis and drugs that increase the risk of falls is common. Periodic drug review is required to reassess the necessity of continuing drugs that contribute to the risk of falls in patients treated for osteoporosis.
References and/or acknowledgements No conflict of interest.