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Int J Clin Pharm. 2016 Apr;38(2):243-51. doi: 10.1007/s11096-015-0230-0. Epub 2016 Jan 9.

Exploring the relationship between fall risk-increasing drugs and fall-related fractures.

Author information

1
Clinical Pharmacology and Pharmacotherapy, University Hospitals Leuven, Herestraat 49, 3000, Louvain, Belgium. sabrina.dewinter@uzleuven.be.
2
Clinical Pharmacology and Pharmacotherapy, University Hospitals Leuven, Herestraat 49, 3000, Louvain, Belgium.
3
Clinical Pharmacology and Pharmacotherapy, Catholic University Leuven, Herestraat 49 - Bus 521, 3000, Louvain, Belgium.
4
Gerontology and Geriatrics, University Hospitals Leuven, Herestraat 49, 3000, Louvain, Belgium.
5
Traumatology, University Hospitals Leuven, Herestraat 49, 3000, Louvain, Belgium.

Abstract

BACKGROUND:

Hospital admissions due to fall-related fractures are a major problem in the aging population. Several risk factors have been identified, including drug use. Most studies often retrieved prescription-only drugs from national databases. These are associated with some limitations as they do not always reliably reproduce the complete patient's active drug list.

OBJECTIVE:

To evaluate the association between the number of FRIDs intake identified by a standardised medication reconciliation process and a fall-related fracture leading to a hospital admission in older adults.

SETTING:

The first cohort has been recruited from one traumatology ward of a tertiary teaching hospital in Belgium and the second cohort has been recruited from 11 community pharmacies in Belgium.

METHOD:

A prospective study with two individually matched cohorts was performed. Adult patients (≥75 years) admitted with an injury due to a fall were included in the first cohort (faller group). The second cohort consisted of patients who did not suffer from a fall within the last 6 months (non-faller group). Matching was performed for age, gender, place of residence and use of a walking aid. In both groups, clinical pharmacists and undergraduate pharmacy students obtained the medication history, using a standardised approach. A list of drugs considered to increase the risk of falling was created. It included cardiovascular drugs and drugs acting on the nervous system. A linear mixed model was used to compare the number of fall risk-increasing drugs between fallers and non-fallers.

MAIN OUTCOME MEASURE:

The number of fall risk-increasing drugs in a faller versus a non-faller group.

RESULTS:

Sixty-one patients were matched with 121 non-fallers. Patients received on average 3.1 ± 2.1 and 3.2 ± 1.8 fall risk-increasing drugs in the faller and in the non-faller group, respectively. The mean number of fall risk-increasing drugs was comparable in both groups (p = 0.844), even after adjusting for alcohol consumption, fear of falling, vision and foot problems (p = 0.721).

CONCLUSION:

In a sample of hospitalised patients admitted for a fall-related injury, no significant difference in the number of fall risk-increasing drugs versus that of an outpatient group of non-fallers was found.

KEYWORDS:

Belgium; Fall risk-increasing drugs; Falls; Fractures; Hospitalisation; Older adults

PMID:
26749341
DOI:
10.1007/s11096-015-0230-0
[Indexed for MEDLINE]

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