Over Half of Falls Were Associated with Psychotropic Medication Use in Four Nursing Homes in Japan: A Retrospective Cohort Study

Medication use can increase the risk of falls and injuries in nursing homes, creating a significant risk for residents. We performed a retrospective cohort study over one year to identify the incidence of drug-related falls with and without injury among four Japanese nursing homes with 280 beds. We...

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Bibliographic Details
Published in:International journal of environmental research and public health 2022-03, Vol.19 (5), p.3123
Main Authors: Oya, Nozomu, Ayani, Nobutaka, Kuwahara, Akiko, Kitaoka, Riki, Omichi, Chie, Sakuma, Mio, Morimoto, Takeshi, Narumoto, Jin
Format: Article
Language:English
Subjects:
Accidental Falls
Aged, 80 and over
Aging
Anesthesia
Benzodiazepines
Cohort analysis
Dementia
Drugs
Falls
Fractures
Health risks
Humans
Industrialized nations
Injuries
Japan - epidemiology
Nurses
Nursing Homes
Older people
Physicians
Population
Prescription drugs
Psychotropic drugs
Psychotropic Drugs - adverse effects
Retrospective Studies
Risk analysis
Risk factors
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Summary:Medication use can increase the risk of falls and injuries in nursing homes, creating a significant risk for residents. We performed a retrospective cohort study over one year to identify the incidence of drug-related falls with and without injury among four Japanese nursing homes with 280 beds. We evaluated the relationship between potential risk factors for falls and fall-related injuries while considering well-known risks such as ADLs and chronic comorbidities. By collaboratively reviewing care records, we enrolled 459 residents (mean age, 87) and identified 645 falls, including 146 injurious falls and 16 severe injurious falls requiring inpatient care, incidence: 19.5, 4.4, 0.5 per 100 resident-months, respectively. Medication influenced around three-quarters of all falls, >80% of which were psychotropic drugs. Regularly taking ≥5 medications was a risk factor for the initial falls (HR 1.33: CI 1.00−1.77, p = 0.0048) and injuries after falls (OR 2.41: CI 1.30−4.50, p = 0.006). Our findings on the incidence of falls with and without injury were similar to those in Western countries, where the use of psychotropic medication influenced >50% of falls. Discontinuing unnecessary medication use while simultaneously assessing patient ADLs and comorbidities with physicians and pharmacists may help to avoid falls in nursing homes.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph19053123