European position paper on polypharmacy and fall-risk-increasing drugs recommendations in the World Guidelines for Falls Prevention and Management: implications and implementation

Abstract

Falls prevention and management in older adults is a critical global challenge. One of the key risk factors for falls is the use of certain medications. Therefore, to prevent medication-related falls, the following is recommended in the recent World Guidelines for Falls Prevention and Management: (1) assess for fall history and the risk of falls before prescribing potential fall-risk-increasing drugs (FRIDs), (2) use a validated, structured screening and assessment tool to identify FRIDs when performing a medication review, (3) include medication review and appropriate deprescribing of FRIDs as a part of the multifactorial falls prevention intervention, and (4) in long-term care residents, if multifactorial intervention cannot be conducted due to limited resources, the falls prevention strategy should still always include deprescribing of FRIDs.In the present statement paper, the working group on medication-related falls of the World Guidelines for Falls Prevention and Management, in collaboration with the European Geriatric Medicine Society (EuGMS) Task and Finish group on FRIDs, outlines its position on how to implement and execute these recommendations in clinical practice.Preferably, the medication review should be conducted as part of a comprehensive geriatric assessment to produce a personalized and patient-centered assessment. Furthermore, the major pitfall of the published intervention studies so far is the suboptimal implementation of medication review and deprescribing. For the future, it is important to focus on gaining which elements determine successful implementation and apply the concepts of implementation science to decrease the gap between research and practice.

Involuntary Falls in Patients with Chronic Kidney Diseases on Nephrology Wards: Research Advances and Future Perspectives

“…10,14 Furthermore, hospital-specific factors such as physical deterioration and medicationrelated side effects can further heighten the risk of falls. 15,16 Consequently, preventing falls among patients with CKD is a crucial responsibility in nephrology nursing. 17,18 To optimize patient care, a series of studies on this issue were conducted, proposing several preventive measures that have effectively reduced the rate of fall injuries.…”

A Multicomponent Primary-Care Intervention for Preventing Falls in Older Adults Living in the Community: The PREMIO Study

“…Recognized fall risk factors related to the health status of the elderly include poor health [10], conditions due to cardiovascular diseases [11,12], depression [13], dementia [14], arthritis [15], epilepsy [16] and visual impairment [17]. Polypharmacy and the use of certain medications, such as benzodiazepine, psychotropics and some classes of cardiovascular drugs, can also increase the risk of falling [12,[18][19][20].…”