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Geriatr Gerontol Int. 2015 Jul;15(7):856-63. doi: 10.1111/ggi.12359. Epub 2014 Sep 26.

Medication use and fall-risk assessment for falls in an acute care hospital.

Author information

1
Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
2
Department of Chest, Cathay General Hospital, Taipei, Taiwan.
3
Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
4
Department of Nursing, National Taipei University of Nursing and Health Science, Taipei, Taiwan.

Abstract

AIM:

A nested case-control study was carried out to examine relationships of a fall-risk score and the use of single medications and polypharmacy with falls among hospitalized patients aged 50 years and older in Taiwan.

METHODS:

There were 83 patients who experienced a fall during hospitalization in an acute-care hospital. Matched by age and sex, five control patients for each case were randomly selected from all other inpatients who had not experienced any fall at the time of the index fall.

RESULTS:

Patients who took tricyclic antidepressants, diuretics, and narcotics were 3.36-, 1.83- and 2.09-fold, respectively, more likely to experience a fall than their counterparts. Conversely, patients who took beta-blockers were 0.34-fold more likely than those who did not take them to experience a fall. Patients taking ≥6 medications were 3.08-fold more likely than those taking fewer medications to experience a fall, whereas those with anxiety were 4.72-fold more likely to experience a fall than those without. A high fall-risk score was not significantly associated with the occurrence of falls.

CONCLUSIONS:

Among older hospitalized patients, tricyclic antidepressants, diuretics, narcotics, and polypharmacy should be mindfully prescribed and reviewed on a regular basis. A fall-risk scale developed from community-dwelling older people might not accurately predict falls in hospitalized patients. Further research to validate the negative effect of beta-blocker use on falls is required.

KEYWORDS:

falls; hospital; medication use; older patients; psychotropics

PMID:
25258200
DOI:
10.1111/ggi.12359
[Indexed for MEDLINE]

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