Medication Use and Associated Risk of Falling in a Geriatric Outpatient Population

Freeland, Kathryn N.; Thompson, Aleda; Zhang, Yanru; Leal, Julie Ehret; Mauldin, Patrick D.; Moran, William P.

doi:10.1345/aph.1q689

Cited by 72 publications

(73 citation statements)

References 13 publications

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“…Each year, about one-third of individuals over the age of 65 years living in the community will experience a fall, 5,6 and about half of these will have a subsequent fall in the following year. 6,7 Fall-related complications such as fracture, death, admission to hospital, admission to an institution, and disability increase with age.…”

Section: Discussionmentioning

confidence: 99%

“…5 A PIM is defined as a medication for which the potential risk for ADEs outweighs the possible clinical benefit for the patient. 11,12 The well-known Beers criteria define PIMs with the potential to increase fall risk in elderly individuals, and it is recommended that certain medication classes be avoided for elderly patients with a history of falls (unless safer alternatives are not available).…”

Section: Discussionmentioning

confidence: 99%

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Influence of Admission to a Tertiary Care Hospital after a Fall on Use of Potentially Inappropriate Medications among Older Patients

Francis

Dyks

Kanji

2014

CJHP

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Influence of Admission to a Tertiary Care Hospital after a Fall on Use of Potentially Inappropriate Medications among Older Patients

Francis

Dyks

Kanji

2014

CJHP

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“…33,34 Outpatients would experience a 14% increase in fall risk with the addition of each medication beyond a four-medication regimen (OR 1.14, 95% CI 1.02-1.27; P=0.027). 35 Mizukami et al examined the prevalence of falls among communitydwelling elderly Japanese individuals, and found that taking at least four daily prescription medications (P,0.05) was significantly associated with falls. 36 Multivariate logistic regression analysis revealed that the overall OR of falling among patients using ten or more drugs was 8.42 (95% CI 4.73-15.0) compared with patients who used 0-1 drug per day.…”

Section: Effects Of Characteristics Of Medication Use On Fall Risk Numentioning

confidence: 99%

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

Zhou¹,

Chen²,

Zhu³

2014

OTT

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Background: Falls 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 upto-date review has not been available to summarize the multifaceted pharmaceutical concerns in the prevention of medication-related falls. Materials and methods: Relevant 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. Results: Fall-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. Conclusion: Based 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 ...

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“…Among the elderly, medication use is a crucial element among extrinsic risk factors for falls [6]. It is proven and well known that older people account for the highest proportion of medication costs, as the number of chronic diseases rapidly increases with age [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…It is proven and well known that older people account for the highest proportion of medication costs, as the number of chronic diseases rapidly increases with age [6,7].…”

Section: Introductionmentioning

confidence: 99%

Geriatric falls and risk factors

Andrea¹

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Medication Use and Associated Risk of Falling in a Geriatric Outpatient Population

Abstract: The addition of medications is associated with a significant increase in risk of falls in elderly patients, regardless of drug class. Further studies are needed to assess the possible increased risk of falls with increasing number of medications.

Cited by 72 publications

References 13 publications

Influence of Admission to a Tertiary Care Hospital after a Fall on Use of Potentially Inappropriate Medications among Older Patients

Influence of Admission to a Tertiary Care Hospital after a Fall on Use of Potentially Inappropriate Medications among Older Patients

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

Geriatric falls and risk factors

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