Medication use and falls: Applying Beers criteria to medication review in Parkinson’s disease

Abstract

Objectives:Our goal was to assess the association between potentially inappropriate medication use and risk of falls in the Parkinson’s disease population.Methods:This was a retrospective cohort study conducted at an outpatient Parkinson’s Disease Treatment Center. Individuals 65 years of age or older, diagnosed with Parkinson’s disease who attended at least three visits in 2015 for physical, occupational therapy, or physician’s visits were included in the study. Electronic medical records were utilized to perform chart reviews, and medications were analyzed to identify prescription medications, combination preparations, over-the-counter medications, and dietary supplements. The goal of this study was to test the following hypothesis: elderly individuals with Parkinson’s disease who take multiple potentially inappropriate medications are more likely to experience a fall compared to elderly individuals with Parkinson’s disease who do not take multiple potentially inappropriate medications.Results:A higher mean number of prescription medications were associated with falls in elderly Parkinson’s disease patients (6.53 vs 5.21, p < 0.01). Polypharmacy (taking five or more prescription and nonprescription medications) was not significantly associated with falls. Patients taking potentially inappropriate medications specifically contraindicated for those with a history of falls and fractures were more likely to report falls (p < 0.04). Analysis of the specific therapeutic medication categories demonstrated no significant differences between those who did and did not report falls.Conclusion:A future prospective study at Parkinson’s disease center should include an electronic medical record–based intervention to reduce the total number of medications, as well as to minimize the use of high-risk medications.

American Geriatrics Society-Beers Criteria and adverse drug reactions: a comparative cross-sectional study of Nigerian and South African older inpatients

“… 15 Another study in the United States associated falls among a Parkinson’s disease population with the PIMs that are recommended to be avoided in patients with a history of falls in the 2015 AGS-Beers Criteria. 16 …”

Characterization of potentially inappropriate medications use in Indian elderly population and their impact on quality of life using Beers criteria

“…Zhang et al reported the prescription of benzodiazepines in dementia and ibuprofen in gastric ulceration participants 20 . Another study reported about the use of PIMs in Parkinson’s disease 27 . In our study, no one was prescribed any of the drugs that should be avoided in the disease condition he/she was suffering from.…”

“…20 Another study reported about the use of PIMs in Parkinson's disease. 27 In our study, no one was prescribed any of the drugs that should be avoided in the disease condition he/she was suffering from.…”

Proof of Concept in Artificial-Intelligence-Based Wearable Gait Monitoring for Parkinson’s Disease Management Optimization

“…The changes in gait worsen and motor fluctuations, dyskinesias, and freezing of gait become frequent and are accompanied by reduced balance and postural control, all of these exposing the patient to a severe risk of falling. More than that, the decline in the motor capacity can lead, in advanced stages, to the need of wheelchair use [75][76][77]. We expect to see these changes in the correlation coefficient matrix to facilitate gait pattern interpretation.…”