Drug Burden and its Association with Falls Among Older Adults in New Zealand: A National Population Cross-Sectional Study

Jamieson, Hamish A.; Nishtala, Prasad S.; Scrase, Richard; Deely, John; Abey-Nesbit, Rebecca; Connolly, Martin J.; Hilmer, Sarah N.; Abernethy, Darrell R.; Schlüter, Philip J.

doi:10.1007/s40266-017-0511-5

Cited by 25 publications

(25 citation statements)

References 28 publications

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“…Some studies have reported that polypharmacy is associated with an increased risk of adverse drug reactions (ADRs), increased drug interactions, reduced adherence to medication and increased medical expenses . Recently, falls and flails, which are serious problems in elderly patients, have been reported to be associated with polypharmacy. Since most elderly people have multi‐morbidity and commonly have two or more chronic health conditions, they tend to be treated with polypharmacy .…”

Section: What Is Known and Objectivementioning

confidence: 99%

Polypharmacy in elderly patients in Japan: Analysis of Japanese real‐world databases

et al. 2020

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What is known and objective Polypharmacy is associated with an increased risk of adverse drug reactions (ADRs) and drug interactions, decreased adherence to medication and increased medical cost. Recently, polypharmacy has become a major problem in medical care in Japan as a result of the increase in the ageing population. The purpose of this study was to investigate the current situation of polypharmacy and the association between polypharmacy and adverse events. Methods A retrospective data analysis was performed using two different real‐world data from 2007 to 2015 in Japan. The Japanese Adverse Drug Event Report (JADER), a public spontaneous adverse drug reaction database constructed by the Pharmaceuticals and Medical Devices Agency (PMDA), and a large prescription database constructed by a database vendor (Japan Medical Information Research Institute, Inc Japan [JMIRI]) were analysed. Trends of polypharmacy during the study period were investigated. Results and discussion The mean number of drugs per report in the JADER database and per prescription in the JMIRI databases during the study period ranged from 4.8 to 5.6 and 3.5 to 3.7, respectively. The mean number of drugs increased with age in both the JADER and JMIRI databases, and the peak of the mean number of drugs was at 80‐89 years (5.74 drugs) in the JADER database and at 90‐99 years (4.97 drugs) in the JMIRI database. What is new and conclusions The number of drugs increased until age 90 years or more, even though adverse events are more likely to occur after the age of 80 in Japan. Therefore, polypharmacy in the elderly should be focused on the patients aged ≥80 years rather than patients aged ≥65 years from the viewpoint of the prevention of adverse events.

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Section: What Is Known and Objectivementioning

confidence: 99%

Polypharmacy in elderly patients in Japan: Analysis of Japanese real‐world databases

et al. 2020

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“…), environmental assessment, and health service utilization [13]. The RAI-HC assessment is a valid and reliable instrument, has strong test/re-test reliability, and has been used in other studies investigating falls among home care clients [12,14].…”

Section: Data Sourcementioning

confidence: 99%

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

2020

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Background: Accidental falls among older adults are a leading cause of injury-related hospitalizations. Reducing falls is an ongoing quality improvement priority for home care, given that many home care clients experience falls. In this study, we identify factors associated with the rate of falls among home care clients. Methods: We conducted a population-based, cross-sectional study using secondary data from the Hamilton, Niagara, Haldimand, and Brant health region of Ontario, Canada from January 1-March 31, 2018. We captured person-level characteristics with falls from the Resident Assessment Instrument-Home Care (RAI-HC). Negative binomial regression was used to model the rate of falls. Results: Functional characteristics of home care clients had strong, statistically significant associations with the rate of falls. Declines in activities of daily living, assistive device use for locomotion indoors, polypharmacy, and health conditions, such as dizziness or lightheadedness, and parkinsonism, were associated with a higher rate of falls. Males who used assistive devices had a higher rate of falls compared to females; however, males with neurological and cardiovascular health conditions had a decrease in the rate of falls compared to females. Home care clients with parkinsonism who used a cane and took eight or more drugs had stronger associations with an increased rate of falls compared to those who do not have parkinsonism. Conclusions: Functional characteristics, polypharmacy, and health conditions are associated with increased rates of falls among home care clients. Home care clients who are at a greater risk of falls may require environmental adjustments in their home to reduce or eliminate the possibility of falling.

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“…(13) Previous work has highlighted the relationship between a high DBI score and functional decline in older populations, and falls and fractures. (6,9,14,15) Nonetheless, the association of the DBI with hip fractures has not yet been explored at a population level.…”

Section: Abstract Polypharmacy Medications Rai Fallsmentioning

confidence: 99%

Drug Burden Index and Its Association With Hip Fracture Among Older Adults: A National Population-Based Study

Jamieson

Nishtala

Scrase

et al. 2018

The Journals of Gerontology: Series A

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Drug Burden and its Association with Falls Among Older Adults in New Zealand: A National Population Cross-Sectional Study

Abstract: DBI was found to be independently and positively associated with a greater risk of falls in this cohort after adjustment for 18 known confounders. We suggest that the DBI could be a valuable tool for clinicians to use alongside electronic prescribing to help reduce falls in older people.

Cited by 25 publications

References 28 publications

Polypharmacy in elderly patients in Japan: Analysis of Japanese real‐world databases

Polypharmacy in elderly patients in Japan: Analysis of Japanese real‐world databases

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

Drug Burden Index and Its Association With Hip Fracture Among Older Adults: A National Population-Based Study

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