The relation between falls and medication use among elderly in assisted living facilities

Hamza, Sarah A.; Adly, Nermien Naim; Abdelrahman, Ekramy Essa; Fouad, Ibrahim Mohamed

doi:10.1002/pds.4775

Cited by 9 publications

(5 citation statements)

References 40 publications

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“…The present results showing the increased fall risk associated with CNS-active medications (antipsychotics, antidepressants, opioids, antiepileptics, and hypnotics) were consistent with those of several previous studies 7 , 12 , 13 . These results suggest that this relationship should be taken into consideration when developing medication management protocols for hospitalized patients.…”

Section: Discussionsupporting

confidence: 93%

Associations between doses of fall-risk-increasing drugs (FRIDs) and falls of hospitalized patients

Yang,

Kor,

Sun

et al. 2023

Sci Rep

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Falls are a serious public health problem in the aging population because of the associated clinical and socioeconomic impact. Although previous studies have investigated fall-risk-increasing drugs (FRIDs), few studies have focused on dosage among adult inpatients. This study aimed to evaluate associations between fall risk and dosage of different FRIDs classes in hospital inpatients. Inpatients who experienced falls at medical or surgical wards of Changhua Christian Hospital from January 2017 to December 2021 were identified and matched by age, sex, and hospital ward to randomly selected controls (four per case). Anonymous patient data were extracted from the hospital medical data repository, including demographic characteristics, comorbidities, fall-risk scores, and drug prescriptions. Medication dosages were computed using the anatomical therapeutic chemical classification and the defined daily dose system of the World Health Organization. A total of 852 cases and 3408 controls were identified as eligible. Reducing the use of CNS-active medications, administering lower doses of sedative-hypnotics, prescribing sufficient dopaminergic anti-Parkinson agents, and using NSAIDs instead of opioids are imperative in preventing falls among hospitalized patients according to the findings in the study.

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Section: Discussionsupporting

confidence: 93%

Associations between doses of fall-risk-increasing drugs (FRIDs) and falls of hospitalized patients

Yang,

Kor,

Sun

et al. 2023

Sci Rep

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“…3 Old age is associated with a higher risk of multimorbidity and polypharmacy, 4 as multiple conditions often require complex medical treatments. 5,6 Treatment with multiple drugs may, however, not always be beneficial, as polypharmacy among the elderly is associated with higher mortality, 7 morbidity, and adverse events such as falls, 8 hospitalizations, adverse drug reactions, 9,10 and drug-drug interactions (DDIs). 4,11 The prevalence of polypharmacy defined as five or more drugs varies between Western countries.…”

Section: Introductionmentioning

confidence: 99%

Polypharmacy and potential drug–drug interactions among Greenland’s care home residents

Albertsen

Sommer

Olsen

et al. 2022

Therapeutic Advances in Drug Safety

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Background: As lifetime expectancy in Greenland is steadily increasing, so is the proportion of elderly Greenlanders. Old age is associated with polypharmacy, and in this study, we aim to describe the prevalence and characteristics of polypharmacy among the care home residents in Greenland. Methods: Eight care homes in Greenland were visited between 2010 and 2016. Questionnaires including information on prescribed medication and comorbidities were collected and analyzed. Drugs were categorized according to Anatomical Therapeutic Chemical (ATC) category, and potential drug–drug interactions (pDDIs) were assessed using the Danish Interaction Database. Polypharmacy was defined as five or more prescribed drugs. Results: All 244 eligible residents were included in the study. The median number of prescribed drugs per resident was six, and women were prescribed more drugs than men (median six versus five). More than 60% of all residents fulfilled the criteria for polypharmacy. The residents in the polypharmacy group had a higher body mass index (26.9 versus 24.3) and more chronic diseases (median two versus one), and more often pulmonary (14% versus 1%) or endocrine disease (22% versus 2%) than in the non-polypharmacy group. The most prescribed drugs belonged to ATC category N (nervous system, 78% of the residents). Finally, pDDIs were found among 61% of the residents and were more common in the capital (77%), which also had the highest proportion of residents with polypharmacy (77%). Conclusion: This is the first study to describe the patterns of polypharmacy and pDDIs among the elderly in care homes in Greenland. Our findings indicate that polypharmacy is as common in Greenland as elsewhere in the Western world, but there are local differences in the prevalence. Plain Language Summary Polypharmacy among the elderly in care homes in Greenland The lifetime expectancy of the Greenlandic population is increasing, and so is the number of elderly Greenlanders. Previous studies have shown that the elderly have a higher risk of being treated with five drugs or more which is called polypharmacy. Polypharmacy can cause unwanted interactions and side effects. In this study, we examine the characteristics of the residents in Greenlandic care homes belonging to this group. Using questionnaires, we gathered information from 244 residents from care homes in eight different towns and settlements in Greenland. Data included types of medication prescribed to the resident, age, gender, cause of stay, and medical history, which allowed us to compare the results between genders and towns. We found that among 244 residents, more than half of all residents were prescribed five or more different drugs, and women were generally prescribed more drugs than men. Those prescribed five or more drugs had a higher body mass index and more diseases than those prescribed fewer drugs. We also found that certain types of medication, mainly painkillers, were the most prescribed. Finally, residents in the care home in Greenland’s capital Nuuk were more often prescribed five or more drugs than elsewhere in Greenland, indicating local differences in Greenland. Our results give an essential insight into the health and medication of the most fragile elderly in Greenland. Polypharmacy seems to be as common here as elsewhere in the Western world and is a point of focus.

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“…S.A. Hamza и соавт. указали, что вазодиляторы, диуретики, альфа-блокаторы и антипсихотики являются значимыми предикторами падений [24]. В других исследованиях показано, что НПВП, инсулин, антигипертензивные препараты, антиаритмики повышают риск падений [25][26][27].…”

Section: Discussionunclassified

Association of drug therapy with falls in elderly and senile patients: Subanalysis of the epidemiological study EVKALIPT

Ховасова

Vorobyeva

Наумов

et al. 2022

Science and Innovations in Medicine

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Aim to evaluate the structure of drug therapy in patients with falls and to identify the associations of falls with drug administration. Material and methods. This work is a subanalysis of the epidemiological study EVKALIPT. 4301 patients who had information about presence or absence of falls in the previous year were selected. The patients were divided into 2 groups: 1 group (n = 1307) having falls, 2 group (n = 2994) without falls. We studied the complaints and medical history, conducted general examination and analyzed medical documentation to get the information on drug treatment. A regular intake of 5 or more drugs was considered polypharmacy. Results. All patients had chronic diseases. In patients with falls, most diseases were more common, the Charlson Comorbidity Index was higher (5.532.4 versus 4.732.03, p0.001), as well as the proportion of high comorbidity (62.2% versus 47.7%, p0.001). All study participants took medications, on average 5.4 2.6 drugs. The patients with falls received higher number of drugs (5.732.6 versus 5.32.5, p0.001). The frequency of polypharmacy was 64.6% and 56.7% (p0.001) in groups 1 and 2, respectively. The patients with falls were more likely to take sartans, beta-blockers, diuretics, centrally acting antihypertensives, anticoagulants, nitrates, amiodarone, insulin, NSAIDs, proton pump inhibitors, calcium, vitamin D, anti-osteoporrotic therapy. Administration of a number of drugs was associated with falls (OR 1.18-2.15). For some drugs, a trend in favor of falls was revealed. Only statin therapy was associated with a 24% reduction in the odds of falling. The presence of polypharmacy increased the risk of falls by 1.3 times (OR 1.27, 95% CI 1.10-1.46, p=0.001). Conclusion. Polypharmacy and drug evaluation are important in assessing the risk of falls. In clinical practice, it is necessary to regularly conduct an audit of medications in elderly patients.

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The relation between falls and medication use among elderly in assisted living facilities

Cited by 9 publications

References 40 publications

Associations between doses of fall-risk-increasing drugs (FRIDs) and falls of hospitalized patients

Associations between doses of fall-risk-increasing drugs (FRIDs) and falls of hospitalized patients

Polypharmacy and potential drug–drug interactions among Greenland’s care home residents

Association of drug therapy with falls in elderly and senile patients: Subanalysis of the epidemiological study EVKALIPT

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