Polypharmacy as a risk for fall occurrence in geriatric outpatients

Kojima, Takao; Akishita, Masahiro; Nakamura, Tetsurō; Nomura, Kazushi; Ogawa, Sumito; Iijima, Katsuya; Eto, Masato; Ouchi, Yasuyoshi

doi:10.1111/j.1447-0594.2011.00783.x

Cited by 178 publications

(152 citation statements)

References 22 publications

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“…Although it has been previously reported by other authors, factors such as age, gender and polypharmacy, which are often associated with the risk of falls in both healthy elderly and patients with stroke [31][32][33][34][35], were not significant predictors in this study.…”

Section: Discussioncontrasting

confidence: 51%

Association between dual-task performance and balance during gait in community-dwelling elderly people after stroke

2015

Healthy Aging Res

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Section: Discussioncontrasting

confidence: 51%

Association between dual-task performance and balance during gait in community-dwelling elderly people after stroke

2015

Healthy Aging Res

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“…This discrepancy can be explained by differences in sample size and data collection procedures, as the data in the other study were collected by reviewing patient clinical history (2) . Another study also analyzed the association between the number of drugs taken and risk of falls; however, significant associations were found at ≥ 5 drugs per day, regardless of the type of medication (22) . A study conducted with hospitalized individuals investigated the importance of drug-related falls and reported similar findings, with one out of three individuals suffering recurring falls every year.…”

Section: Discussionmentioning

confidence: 99%

Uso de medicamentos asociados al riesgo de caídas en ancianos no institucionalizados

García

González

Muñoz

et al. 2018

Rev. esc. enferm. USP

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RESUMEN Objetivo: Determinar qué número de medicamentos consumidos diariamente es influyente en el riesgo de caídas en ancianos no institucionalizados y con historial de caídas en el último año. Método: Estudio descriptivo mediante muestreo aleatorio con la utilización de los siguientes instrumentos de medida: cuestionario de la OMS para el estudio de caídas en el anciano, escala de marcha y escala depresión geriátrica y escala de marcha y equilibrio. El análisis univariante, bivariante con prueba no paramétrica de Chi-cuadrado y regresión logística binaria se ellevó a cabo con el programa estadístico SPSS versión 21.0. Resultados: Participaron del estudio 213 personas. El consumo ≥ a 4 medicamentos se comportan para el riesgo de caída p=0,010 OR=4,034. Esto mismo no sucede para personas con un consumo ≤ a 3 medicamentos p=0,006 OR=0,335. Conclusión: Un consumo a partir de cuatro o más medicamentos diarios se considera un factor de riesgo para las personas ancianas que se encuentren en riesgo de caídas.

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“…Taking five or more drugs was significantly associated with an increased risk of falls in geriatric outpatients (OR 4.5, 95% CI 1.7-12.2) after adjusting for potential confounders. 33,34 Outpatients would experience a 14% increase in fall risk with the addition of each medication beyond a four-medication regimen (OR 1.14, 95% CI 1.02-1.27; P=0.027). 35 Mizukami et al examined the prevalence of falls among communitydwelling elderly Japanese individuals, and found that taking at least four daily prescription medications (P,0.05) was significantly associated with falls.…”

Section: Effects Of Characteristics Of Medication Use On Fall Risk Numentioning

confidence: 99%

Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients

Zhou¹,

Chen²,

Zhu³

2014

OTT

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Background: Falls among the elderly are an issue internationally and a public health problem that brings substantial economic and quality-of-life burdens to individuals and society. Falls prevention is an important measure of nursing quality and patient safety. Numerous studies have evaluated the association of medication use with fall risk in elderly patients. However, an upto-date review has not been available to summarize the multifaceted pharmaceutical concerns in the prevention of medication-related falls. Materials and methods: Relevant literature was identified by performing searches in PubMed, Web of Science, and the Cochrane Library, covering the period until February 2014. We included studies that described an association between medications and falls, and effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and pharmacological interventions on fall risk in elderly patients. The full text of each included article was critically reviewed, and data interpretation was performed. Results: Fall-risk-increasing drugs (FRIDs) include central nervous system-acting agents, cough preparations, nonsteroidal anti-inflammatory drugs, anti-Alzheimer's agents, antiplatelet agents, calcium antagonists, diuretics, α-blockers, digoxin, hypoglycemic drugs, neurotoxic chemotherapeutic agents, nasal preparations, and antiglaucoma ophthalmic preparations. The degree of medication-related fall risk was dependent on one or some of the following factors: drug pharmacokinetic/pharmacodynamic properties (eg, elimination half-life, metabolic pathway, genetic polymorphism, risk rating of medications despite belonging to the same therapeutic class) and/or characteristics of medication use (eg, number of medications and drug-drug interactions, dose strength, duration of medication use and time since stopping, medication change, prescribing appropriateness, and medication adherence). Pharmacological interventions, including withdrawal of FRIDs, pharmacist-conducted clinical medication review, and computerized drug alerts, were effective in reducing fall risk. Conclusion: Based on the literature review, clear practical recommendations for clinicians to prevent falls in the elderly included making a list of FRIDs, establishing a computerized alert system for when to e-prescribe FRIDs, seeking an alternative drug with lower fall risk, withdrawing FRIDs if clinically indicated, taking pertinent cautions when the use of FRIDs cannot be avoidable, paying attention to prescribing appropriateness, simplifying the medication regimen, strengthening pharmacist-conducted clinical medication review, ensuring the label of each FRID dispensed contains a corresponding warning sign, being careful when medication change occurs, enhancing medication adherence, and mandating for periodic reassessment of potential risk associated with the patient's medication regimen. Further studies should be conducted in this area, such as investigating whether medication reconciliation and improving medication adherence could ...

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Polypharmacy as a risk for fall occurrence in geriatric outpatients

Abstract: In geriatric outpatients, polypharmacy is associated with falls. Intervention studies are needed to clarify the causal relationship between polypharmacy, comorbidity and falls.

Cited by 178 publications

References 22 publications

Association between dual-task performance and balance during gait in community-dwelling elderly people after stroke

Association between dual-task performance and balance during gait in community-dwelling elderly people after stroke

Uso de medicamentos asociados al riesgo de caídas en ancianos no institucionalizados

Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients

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