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J Gen Intern Med. 2010 Feb;25(2):141-6. doi: 10.1007/s11606-009-1179-2. Epub 2009 Dec 5.

The association between the number of prescription medications and incident falls in a multi-ethnic population of adult type-2 diabetes patients: the diabetes and aging study.

Author information

1
Department of Medicine, University of Chicago, Chicago, IL 60637, USA. ehuang@medicine.bsd.uchicago.edu

Abstract

BACKGROUND:

Use of four or more prescription medications is considered a risk factor for falls in older people. It is unclear whether this polypharmacy-fall relationship differs for adults with diabetes.

OBJECTIVE:

We evaluated the association between number of prescription medications and incident falls in a multi-ethnic population of type-2 diabetes patients in order to establish an evidence-based medication threshold for fall risk in diabetes.

DESIGN:

Baseline survey (1994-1997) with 5 years of longitudinal follow-up.

PARTICIPANTS:

Eligible subjects (N = 46,946) had type-2 diabetes, were >or=18 years old, and enrolled in the Kaiser Permanente Northern California Diabetes Registry.

MEASUREMENTS AND MAIN RESULTS:

We identified clinically recognized incident falls based on diagnostic codes (ICD-9 codes: E880-E888). Relative to regimens of 0-1 medications, regimens including 4 or more prescription medications were significantly associated with an increased risk of falls [4-5 medications adjusted HR 1.22 (1.04, 1.43), 6-7 medications 1.33 (1.12, 1.58), >7 medications 1.59 (1.34, 1.89)]. None of the individual glucose-lowering medications was found to be significantly associated with a higher risk of falls in predictive models.

CONCLUSIONS:

The prescription of four or more medications was associated with an increased risk of falls among adult diabetes patients, while no specific glucose-lowering agent was linked to increased risk. Baseline risk of falls and number of baseline medications are additional factors to consider when deciding whether to intensify diabetes treatments.

PMID:
19967465
PMCID:
PMC2837501
DOI:
10.1007/s11606-009-1179-2
[Indexed for MEDLINE]
Free PMC Article

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