Medication use and risk of falls among nursing home residents: a retrospective cohort study

• Published in: International journal of clinical pharmacy 2017-04, Vol.39 (2), p.408-415
• Main Authors: Bor, Andrea, Matuz, Mária, Csatordai, Márta, Szalai, Gábor, Bálint, András, Benkő, Ria, Soós, Gyöngyvér, Doró, Péter
• Format: Article
• Language: English
• Subjects: Accidental Falls - statistics & numerical data; Aged; Aged, 80 and over; Drug use; Drug-Related Side Effects and Adverse Reactions - epidemiology; Falls; Female; Humans; Hungary - epidemiology; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Nursing homes; Nursing Homes - statistics & numerical data; Older people; Pharmacy; Polypharmacy; Potentially Inappropriate Medication List - statistics & numerical data; Research Article; Retrospective Studies; Risk Factors
• ISSN: 2210-7703; 2210-7711
• DOI: 10.1007/s11096-017-0426-6

Background Geriatric falls are leading causes of hospital trauma admissions and injury-related deaths. Medication use is a crucial element among extrinsic risk factors for falls. To reduce fall risk and the prevalence of adverse drug reactions, potentially inappropriate medication (PIM) lists are widely used. Objective Our aim was to investigate the possible predictors of geriatric falls annualized over a 5-year-long period, as well as to evaluate the medication use of nursing home residents. Setting Nursing home residents were recruited from the same institution between 2010 and 2015 in Szeged, Hungary. Method A retrospective epidemiological study was performed. Patient data were analysed for the first 12 months of residency. Chi-squared test and Fisher’s-test were applied to compare the categorical variables, Student’s t test to compare the continuous variables between groups. Binary logistic regression analysis was carried out to determine the association of falls with other variables found significant in univariate analysis. Microsoft Excel, IBM SPSS Statistics (version 23) and R (3.2.2) programs were used for data analysis. Main outcome measure Falls affected by age, gender, number of chronic medications, polypharmacy, PIM meds. Results A total of 197 nursing home residents were included, 150 (76.2%) women and 47 (23.8%) men, 55 fallers (annual fall prevalence rate was 27.9%) and 142 non-fallers. Gender was not a predisposing factor for falls (prevalence in males: 23.4 vs 29.3% in females, p  > 0.05). Fallers were older (mean years ± SD; 84.0 ± 7.0) than non-fallers (80.1 ± 9.3, p