Arzneimittel und Stürze im Alter

Modreker, Mirja Katrin; Renteln-Kruse, Wolfgang von

doi:10.1007/s00108-009-2355-5

Cited by 20 publications

(10 citation statements)

References 28 publications

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“…The risk of falls is known to be significantly associated with psychotropic medication, especially for benzodiazepines and other hypnotics, as well as for antiepileptics [62]. However, trauma patients with injurious falls were not included in our study.…”

Section: Limitationsmentioning

confidence: 99%

Drug - related emergency department visits by elderly patients presenting with non-specific complaints

Nickel

Ruedinger

Messmer

et al. 2013

Scand J Trauma Resusc Emerg Med

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BackgroundSince drug-related emergency department (ED) visits are common among older adults, the objectives of our study were to identify the frequency of drug-related problems (DRPs) among patients presenting to the ED with non-specific complaints (NSC), such as generalized weakness and to evaluate responsible drug classes.MethodsDelayed type cross-sectional diagnostic study with a prospective 30 day follow-up in the ED of the University Hospital Basel, Switzerland. From May 2007 until April 2009, all non-trauma patients presenting to the ED with an Emergency Severity Index (ESI) of 2 or 3 were screened and included, if they presented with non-specific complaints. After having obtained complete 30-day follow-up, two outcome assessors reviewed all available information, judged whether the initial presentation was a DRP and compared their judgment with the initial ED diagnosis. Acute morbidity (“serious condition”) was allocated to individual cases according to predefined criteria.ResultsThe study population consisted of 633 patients with NSC. Median age was 81 years (IQR 72/87), and the mean Charlson comorbidity index was 2.5 (IQR 1/4). DRPs were identified in 77 of the 633 cases (12.2%). At the initial assessment, only 40% of the DRPs were correctly identified. 64 of the 77 identified DRPs (83%) fulfilled the criteria “serious condition”. Polypharmacy and certain drug classes (thiazides, antidepressants, benzodiazepines, anticonvulsants) were associated with DRPs.ConclusionElderly patients with non-specific complaints need to be screened systematically for drug-related problems.Trial RegistrationClinicalTrials.gov: NCT00920491

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Section: Limitationsmentioning

confidence: 99%

Drug - related emergency department visits by elderly patients presenting with non-specific complaints

Nickel

Ruedinger

Messmer

et al. 2013

Scand J Trauma Resusc Emerg Med

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“…Der hohe Anteil antihypertensiv behandelter Pflegeheimbewohner in unserem Kollektiv kann insgesamt positiv bewertet werden. Unsere Analyse verweist jedoch auch auf Gefahren [15] und potenzielle Verbesserungsmöglichkeiten der antihypertensiven Therapie.…”

Section: Verordnung Von Antihypertensiva Bei Geriatrischen Pflegeheimunclassified

Verordnung von Antihypertensiva bei geriatrischen Pflegeheimbewohnern in Deutschland

Kölzsch

Bolbrinker

Dräger

et al. 2010

Dtsch med Wochenschr

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Antihypertensive drugs account for a notable part (17 %) of all drug prescriptions in elderly residents of nursing homes throughout Germany. These results indicate that only a minority of all residents were treated with potentially inappropriate or potentially harmful drug combinations. However, the relatively high rate of prescriptions for loop diuretics is a matter of potential concern in this vulnerable group of patients.

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“…There is clear evidence that polypharmacy and the use of psychotropic drugs, especially when combined with cardiovascular medications or present as therapeutic duplications, increase the fall risk [16-19]. Medications for night-time sedation, such as lorazepam and zopiclone, have been found to be the most frequently prescribed medications before a fall in general medicine inpatient units in Canada [20].…”

Section: Introductionmentioning

confidence: 99%

Fall risk-increasing drugs and falls: a cross-sectional study among elderly patients in primary care

et al. 2014

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BackgroundFalls are the most common cause of injuries and hospital admissions in the elderly. The Swedish National Board of Health and Welfare has created a list of drugs considered to increase the fall risk (FRIDs) and drugs that might cause/worsen orthostatism (ODs). This cross-sectional study was aimed to assess FRIDs and their correlation with falls in a sample of 369 community-dwelling and nursing home patients aged ≥75 years and who were using a multi-dose drug dispensing system.MethodsData were collected from the patients’ electronic medication lists. Retrospective data on reported falls during the previous three months and severe falls during the previous 12 months were collected. Primary outcome measures were incidence of falls as well as numbers of FRIDs and ODs in fallers and non-fallers.ResultsThe studied sample had a high incidence of both reported falls (29%) and severe falls (17%). Patients were dispensed a mean of 2.2 (SD 1.5) FRIDs and 2.0 (SD 1.6) ODs. Fallers used on average more FRIDs. Severe falls were more common in nursing homes patients. More women than men experienced severe falls. There were positive associations between number of FRIDs and the total number of drugs (p < 0.01), severe falls (p < 0.01) and female sex (p = 0.03). There were also associations between number of ODs and both total number of drugs (p < 0.01) and being community dwelling (p = 0.02). No association was found between number of ODs and severe falls. Antidepressants and anxiolytics were the most frequently dispensed FRIDs.ConclusionsFallers had a higher number of FRIDs. Numbers of FRIDs and ODs were correlated with the total number of drugs dispensed. Interventions to reduce falls in the elderly by focusing on reducing the total number of drugs and withdrawal of psychotropic medications might improve the quality and safety of drug treatment in primary care.

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Arzneimittel und Stürze im Alter

Cited by 20 publications

References 28 publications

Drug - related emergency department visits by elderly patients presenting with non-specific complaints

Drug - related emergency department visits by elderly patients presenting with non-specific complaints

Verordnung von Antihypertensiva bei geriatrischen Pflegeheimbewohnern in Deutschland

Fall risk-increasing drugs and falls: a cross-sectional study among elderly patients in primary care

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