A retrospective analysis of prescription medications as it correlates to falls for older adults

Abstract

Objectives::To determine the correlation between falls and two medication factors: the class of medications and potentially inappropriate medications (PIMs) prescribed to community-dwelling older adults aged 55 and older.Methods:Retrospective, cross-sectional study. Home health patients residing in a Texas/Mexico border community and reporting at least one fall within the past month. Medication use, medication classification, and potentially inappropriate medications (PIM) recorded by level of falls; non-fallers and recurrent fallers.Results:Of 99 participants, 13.1% reported falling once and 86.9% reported two or more falls. Participant’s average number of medications used was 10.51 (SD 5.75) with 93.9% having four or more prescribed medications. Average number of PIMs prescribed per participant was 1.42 (SD 1.51) with at least one PIM prescribed to 65.6% of participants. Twenty three out of 83 identified classes of prescribed medications met criteria for the study’s analyses but resulted in no significant association to falls when comparing NF to RF. Agents acting on the renin-angiotensin system and lipid modifying agents were the most frequently prescribed medication classes (N=55, 55.6%). Ibuprofen was the PIM most frequently prescribed (n=13, 13.1%). The correlation between use of a prescribed PIM and number of falls was not statistically significant (p=0.128).Conclusions:There was no correlation between classes of medication and level of falls. Recurrent fallers were more likely to have been prescribed a PIM than non-fallers (not significant). Although the analyses conducted for this study did not result in statistical significance, the high prevalence of polypharmacy and prescribed PIMs observed in these participants warrants a thorough review of medications to reduce fall risks among older adults.

Polypharmacy and Falls Risk-increasing Drugs: Their Relation to Fall Recurrence

“…In our research, having low HGS increases the risk of falling, and older age and ACE-I usage increases the risk of recurrent falling. The fall rate in this study (32%) is lower than in several other studies of older adults, which reported fall rates of 13.1 to 41.8% and recurrent fall rates of 13.1 to 86.9% (4,6,24). These studies were carried out with either unhealthy (e.g., people with chronic stroke) or different populations (e.g., home health patients).…”

“…In research, there was no difference in terms of falls between patients using PIMs, which increased the risk of falling and those who did not (31) In a study involving 99 people, 11 types of drugs (ibuprofen, gabapentin, sertraline, alprazolam, ranitidine, zolpidem) were determined as PIMs. At the same time, there was no relationship between PIMs use and falling and recurrent falling, and there was no relationship between recurrent falls and either polypharmacy or PIM (24). In the present study, although polypharmacy was high, the PIM rate was found in only 29.2% of the patients.…”

“…In the literature, the prevalence of polypharmacy ranges from 25-90% (1,3,5,24 ). In our study, the polypharmacy prevalence was 55.6%.…”

“…In our study, the polypharmacy prevalence was 55.6%. Different types of drugs have been reported as the most used in previous studies (5,24). In this study, the most widely used drugs were diuretics, ARB, biguanides, PPI, and ASA.…”

Assessment for the Risk Factors of Polypharmacy in Elderly Patients

“…We found that lipid modifying agents and angiotensin II receptor antagonist were the most frequently reported drug in PP and EPP groups in reference to NPP group. According to a retrospective cross-sectional analysis of prescription medications in older adults in Texas/ Mexico 15 agents acting on the renin-angiotensin system and lipid modifying agents were the most frequently prescribed medication by 55.6% (n=55) for both classes of the whole sample.…”