Fall - related injuries in a nursing home setting: is polypharmacy a risk factor?
Polypharmacy is regarded as an important risk factor for falling and several studies and meta-analyses have shown an increased fall risk in users of diuretics, type 1a antiarrhythmics, digoxin and psychotropic agents. In particular, recent evidence has shown that fall risk is associated with the use of polypharmacy regimens that include at least one established fall risk-increasing drug, rather than with polypharmacy per se.
We studied the role of polypharmacy and the role of well-known fall risk-increasing drugs on the incidence of injurious falls.
Methods: A cross-sectional observational study was carried out from 2004 to 2007 in a population of elderly nursing home residents.
An unmatched, post-stratification design for age class, gender and length of stay was adopted. In all, 695 falls were recorded in 293 patients.
Results: 221 patients (75.4%) were female and 72 (24.6%) male, and 133 (45.4%) were recurrent fallers. 152 patients sustained no injuries when they fell, whereas injuries were sustained in 141: minor in 95 (67.4%) and major in 46 (32.6%).
Taking one "risk drug"(an antiarrhythmic or antiparkinson drug) and taking a total of seven or more other medications seems to represent a risk associationfor injuries (p=0.024; OR=4.4; CI 95% 1.21 - 15.36).
Conclusion: This work reaffirms the importance of routine medication reviews, especially in patients exposed to polypharmacy regimens with 7 or more drugs, including antiarrhythmics or antiparkinson drugs), in order to reduce the risk of fall-related injuries during nursing home stays.
Author: Federico BaranziniMarcello DiurniFrancesca CecconNicola PoloniSara CazzamalliChiara CostantiniCristiano ColliLaura GrecoCamilla Callegari
Credits/Source: BMC Health Services Research 2009, 9:228
Published on: 2009-12-11
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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