Different Risk-Increasing Drugs in Recurrent versus Single Fallers: Are Recurrent Fallers a Distinct Population?

Askari, Marjan; Eslami, Saeed; Scheffer, Alice C.; Medlock, Stephanie; Rooij, Sophia E. de; Velde, Nathalie van der; Abu‐Hanna, Ameen

doi:10.1007/s40266-013-0110-z

Cited by 41 publications

(51 citation statements)

References 32 publications

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“…As fear of falling is a modifiable risk factor, preventive activities need to be introduced early on, and intervention strategies should take this risk factor into account, for example, by increasing knowledge on how to reduce falls (Austin et al, 2007). It is reported that use of certain medication, such as benzodiazepines and sedatives, is a significant risk factor for falls (Askari et al, 2013;Evans, 2003). Surprisingly, in the present study, this risk factor only applies to individuals with no fall history.…”

Section: Discussionmentioning

confidence: 55%

Gender Differences in Risk Factors for Single and Recurrent Falls Among the Community-Dwelling Elderly

Fakiri

2015

Sage Open

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The purpose of this study was to identify gender differences in risk factors of fall accidents among older people, and whether these factors differ between single and recurrent fallers. A total of 4,426 individuals aged ≥65 years from two large-scale health surveys provided data. Logistic regression analyses were used to identify risk factors and to determine the risk model for falling and recurrent falling in men and women separately. Three major risk factors for falling regardless of gender or fall history are fear of falling, limitations in activities of daily living (ADL), and age ≥75 years. Fear of falling remains one of the common modifiable risk factors. Among those without a fall history, the use of sedatives or tranquilizers increases the risk of falling. Regarding gender differences, ADL limitations and fear of falling appear to be stronger fall risk factors for men than for women. Among women, alcohol use and educational level are significant risk factors for falling, while loneliness is associated with recurrent falling. Men with fear of falling or ADL limitations are at higher risk to have a recurrent fall accident than women with these conditions. Having a visual impairment or living with someone is associated with recurrent falling among men. Our findings emphasize the importance of multifactorial fall interventions, taking into account a variety of subgroup characteristics such as gender and fall history.

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Section: Discussionmentioning

confidence: 55%

Gender Differences in Risk Factors for Single and Recurrent Falls Among the Community-Dwelling Elderly

Fakiri

2015

Sage Open

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“…Besides typical FRIDs such as central nervous system (CNS)-acting agents (benzodiazepines, sedatives, hypnotics, antidepressants, and antipsychotic drugs), in recent years relatively new classes (eg, anti-Alzheimer’s agents, neurotoxic chemotherapeutic agents, and nasal preparations) were identified as having significant association with falls 5–7. Meanwhile, results of several sporadic cohort studies showed that the degree of medication-related fall risk was dependent on one or some of the following factors: drug pharmacokinetic and pharmacodynamic (PK/PD) properties (eg, elimination half-life, metabolic pathway, genetic polymorphism, risk rating of medications despite belonging to the same therapeutic class), and/or characteristics of medication use (eg, number of medications and drug–drug interactions [DDIs], dose strength, duration of medication use and time since stopping, medication change, prescribing appropriateness, and medication adherence).…”

Section: Introductionmentioning

confidence: 99%

Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients

Chen¹,

Zhu²,

Zhou³

2014

TCRM

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BackgroundFalls among the elderly are an issue internationally and a public health problem that brings substantial economic and quality-of-life burdens to individuals and society. Falls prevention is an important measure of nursing quality and patient safety. Numerous studies have evaluated the association of medication use with fall risk in elderly patients. However, an up-to-date review has not been available to summarize the multifaceted pharmaceutical concerns in the prevention of medication-related falls.Materials and methodsRelevant literature was identified by performing searches in PubMed, Web of Science, and the Cochrane Library, covering the period until February 2014. We included studies that described an association between medications and falls, and effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and pharmacological interventions on fall risk in elderly patients. The full text of each included article was critically reviewed, and data interpretation was performed.ResultsFall-risk-increasing drugs (FRIDs) include central nervous system-acting agents, cough preparations, nonsteroidal anti-inflammatory drugs, anti-Alzheimer’s agents, antiplatelet agents, calcium antagonists, diuretics, α-blockers, digoxin, hypoglycemic drugs, neurotoxic chemotherapeutic agents, nasal preparations, and antiglaucoma ophthalmic preparations. The degree of medication-related fall risk was dependent on one or some of the following factors: drug pharmacokinetic/pharmacodynamic properties (eg, elimination half-life, metabolic pathway, genetic polymorphism, risk rating of medications despite belonging to the same therapeutic class) and/or characteristics of medication use (eg, number of medications and drug–drug interactions, dose strength, duration of medication use and time since stopping, medication change, prescribing appropriateness, and medication adherence). Pharmacological interventions, including withdrawal of FRIDs, pharmacist-conducted clinical medication review, and computerized drug alerts, were effective in reducing fall risk.ConclusionBased on the literature review, clear practical recommendations for clinicians to prevent falls in the elderly included making a list of FRIDs, establishing a computerized alert system for when to e-prescribe FRIDs, seeking an alternative drug with lower fall risk, withdrawing FRIDs if clinically indicated, taking pertinent cautions when the use of FRIDs cannot be avoidable, paying attention to prescribing appropriateness, simplifying the medication regimen, strengthening pharmacist-conducted clinical medication review, ensuring the label of each FRID dispensed contains a corresponding warning sign, being careful when medication change occurs, enhancing medication adherence, and mandating for periodic reassessment of potential risk associated with the patient’s medication regimen. Further studies should be conducted in this area, such as investigating whether medication reconciliation and improving medication adherence could decrease th...

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“…This occurs mainly due to their side effects; such as sedation, dizziness, postural disturbances, altered gait and balance, or impaired cognition and these drugs are usually called fall-risk-increasing drugs (FRIDs) 9 . Numerous studies have evaluated the association of medication use with the risk of falling in elderly patients [10][11][12] .…”

Section: Jfsf 93mentioning

confidence: 99%

The correlation of specific medication groups and falls risk in elderly. A medication logbook survey

Pyrgeli

Agapiou

Pyrgelis

et al. 2017

JFSF

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Different Risk-Increasing Drugs in Recurrent versus Single Fallers: Are Recurrent Fallers a Distinct Population?

Cited by 41 publications

References 32 publications

Gender Differences in Risk Factors for Single and Recurrent Falls Among the Community-Dwelling Elderly

Gender Differences in Risk Factors for Single and Recurrent Falls Among the Community-Dwelling Elderly

Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients

The correlation of specific medication groups and falls risk in elderly. A medication logbook survey

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