This study aimed to analyze the effect of fall risk-increasing drugs (FRIDs) and drug-related factors relative to falls through clinical pharmacy service in hospitalized patients, focusing on the relevance of clinical pharmacist evaluation in the context of physician assessment. A prospective study of inpatient falls was conducted in 2017 retrieving data from 4 hospitals in South Bohemia, Czech Republic. An online database was developed to collect patient and fall-related data, and fall evaluation records. Healthcare professionals classified the overall effect of drugs on falls using Likert scale. Univariate and multivariate correlations were performed with a significance level of p < 0.05. Out of the total 280 falls (mean age of patients 77.0 years), a mean of 2.8 diagnoses with fall-related risk, 8.8 drugs, and 4.1 FRIDs per fall were identified. Incidence of falls decreased quarterly (p < 0.001). Use of FRIDs were positively associated with increasing age (p = 0.007). Clinical pharmacists were more likely to identify pharmacotherapy as the relevant fall-related risk, compared to physicians evaluation (p < 0.001). An increasing total number of prescribed drugs as well as higher number of FRIDs increased the suspicion in both professionals in the context of drug-related causes of falls.

Rationale, aims, and objectives: Falls are among the major problems occurring in hospital setting, when drugs are viewed as important modifiable risk factor of falling.The aim was to analyse the effect of pharmacotherapy on the risk of falls in hospitalized patients.Methods: A multicentre prospective case-control study was conducted in 2017 retrieving data from four hospitals in South Bohemia, Czech Republic. An online database was constructed to collect patient and fall-related data. Each fall that occurred during hospitalization was assigned to appropriate controls (no fall during hospitalization) based on gender, age, length of hospitalization, and the number of drugs. Univariate and multivariate correlations were performed with a significance level of P < .05.Results: A total of 222 fall cases (107 males; median age, 81 y) and 1076 controls (516 males; median age, 80 y) were included. According to the first ATC level classification, drugs from groups S, N, and P were significantly associated with fall-related risk compared with controls (P < .05); further analysis of ATC levels showed that only psycholeptics (N05), antipsychotics (N05A), and tiapride were significantly associated with falls. Regression analysis revealed use of psycholeptics N05 (OR = 2.06; 95% CI, 1.56-2.76), or ophthalmologicals S01 (OR = 2.72; 95% CI, 1.37-5.41), as factors with the highest fall-related risk.Conclusions: Apart from the commonly considered fall-risk increasing drugs, other groups, such as ophthalmologicals, should also be considered; however, regarding clinical practice, it is difficult to evaluate the effects of individual drugs in the context of other risk factors of falls, due to the multifactorial nature of falls.

MiniMalizace rizik a teorie tří pilířů u léčiv zvyšujících riziko pádů

Background: Underreporting of advers drug reactions (ADRs) by physicians is a common problem. The purpose of this study was to assess the impact of an educational intervention on physicians' knowledges and attitudes related to spontanaeus ADRs reporting. Methods: A cross-sectional, questionnaire-based study was conducted. Sixty minutes training about pharmacovigilance (PV) and ADRs reporting was given in total 203 physicians, in an university hospital. Before the training, a questionnaire consisting of 19 items was administered to determine the baseline knowledge level of the physicians about PV and the same questionnaire was repeated one year after the training. Results: In total 91 physicians participated to second survey, participation rate was 44.8%. Seventy nine physicians of 91, who completed all item in the survey, were included in the study and their responses were compared with their previous responses. Thirty one of the 79 physicians had academic degrees. In the responses to the post-training questionnaire, it was observed that the level of knowledge of participants significantly increased in the sections on what to report and how to report the ADRs. However, there were no significant differences between the academicians and the non-academicians in terms of the responses given to the survey before and after the training. In the first survey, 12 of 79 participants reported that they had previously reported ADRs, while 14 participants reported ADRs after training. Additionally, training increased physicians' awareness about the national PV center and PV liaison of their institution. Conclusions: Training increased clinicians' knowledge levels of PV, but not their reporting rate of ADRs. One hour training may not be enough to make a change on physicians' ADR reporting attitudes and it may be repeated during their professional practice regularly.

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