Risk factors for falling in psychiatric inpatients: A prospective, matched case–control study

Chan, Chia-Hsiang; Gau, Susan Shur‐Fen; Chan, Hung‐Yu; Tsai, Ya-Ju; Chiu, Chun-Chih; Wang, Shumei; Huang, Meiling

doi:10.1016/j.jpsychires.2013.04.002

Cited by 22 publications

(49 citation statements)

References 31 publications

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“…Moreover, in accordance with the results of the study by Chan 2013(Chan et al, 2013, changing dosage of medication is considered influential if it occurs during the 24 hours before risk assessment. This item was included as well.…”

Section: Methodsmentioning

confidence: 54%

Development and Validation of A New Tool for Assessing Risk of Falls in Acute Psychiatric Settings

Morici¹,

Terzoni²,

Ferrara³

et al. 2015

Int J Emerg Ment Health

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Section: Methodsmentioning

confidence: 54%

Development and Validation of A New Tool for Assessing Risk of Falls in Acute Psychiatric Settings

Morici¹,

Terzoni²,

Ferrara³

et al. 2015

Int J Emerg Ment Health

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“…53 Medication change of a psychotropic drug within 24 hours (aOR 10.3, 95% CI 1.37-76.8) was an important variable significantly associated with an increased risk of falling in nursing home residents. 54 Berry et al observed that changes in specifically non-SSRI antidepressant prescriptions increased the risk of falls within 2 days (OR 4.7, 95% CI 1.3-16.2), with a subsequent decreased risk of falls over the next 5 days (OR 1.9, 95% CI 0.9-4.0). 55 Increased staff awareness might help to reduce falls during this time, and surveillance should be strengthened particularly during the first 48 hours.…”

Section: Medication Changementioning

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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“…A causa é multifatorial, com fatores intrínsecos e extrínsecos que atuam sinergicamente (Vu, Weintraub & Rubenstein, 2006) ou, como na classificação da Organização Mundial de Saúde (WHO, 2007), fatores biológicos (idade, sexo, doenças crónicas, declínio nas capacidades física, cognitiva e afetiva), comportamentais (polimedicação, falta de exercício, calçado inadequado e abuso de álcool), ambientais (edifícios em mau estado; pisos e escadas irregulares; falta de varões de apoio, e iluminação deficiente) e socioeconómicos (baixo rendimento, más condições habitacionais, falta de interação social, acesso limitado aos serviços de saúde e sociais, precários recursos da comunidade). A limitação física e o consumo de medicação psicotrópica elevam o risco de queda (Chan et al, 2013) e levam à sua repetição. Ter alterações cognitivas (Laakkonen et al, 2013), de balanço corporal, do equilíbrio e marcha lentificada, acresce o risco (Chan et al, 2013;Robinovitch et al, 2013), que ganha expressão no pior desempenho das AVD's.…”

Section: Introductionunclassified

“…A limitação física e o consumo de medicação psicotrópica elevam o risco de queda (Chan et al, 2013) e levam à sua repetição. Ter alterações cognitivas (Laakkonen et al, 2013), de balanço corporal, do equilíbrio e marcha lentificada, acresce o risco (Chan et al, 2013;Robinovitch et al, 2013), que ganha expressão no pior desempenho das AVD's.…”

Section: Introductionunclassified

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Quedas, idade avançada e doença mental

Reis

Mayor

Pestana

et al. 2016

riase

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As quedas na população mais velha que vive na comunidade são um importante problema de saúde particularmente quando estão em situações de internamento hospitalar. De etiologia multifatorial, pela sua gravidade e custos requerem intervenção preventiva. São reconhecidas as repercussões na funcionalidade e na qualidade de vida e os elevados custos socioeconómicos. Objetivos: identificar a prevalência de queda nas pessoas mais velhas e caracterizar do ponto de vista clínico, funcional e social as pessoas idosas envolvidas num episódio de urgência, num hospital psiquiátrico. Métodos: tratou-se de um estudo quantitativo, correlacional transversal. Estudou-se a prevalência de queda e fatores associados. A amostra foi constituída por 99 pessoas idosas envolvidas num episódio de urgência no biénio 2012/2013, num hospital psiquiátrico da zona norte de Portugal. Resultados: sugerem uma prevalência de 38% de quedas numa população envelhecida. A perturbação mental e a dependência são fatores em realce. Conclusões: uma complexa interação entre múltiplos fatores pessoais, ambientais e sociais na etiologia de queda sugere a importância da prevenção e de programas de monitorização do risco a ela associados.

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Risk factors for falling in psychiatric inpatients: A prospective, matched case–control study

Cited by 22 publications

References 31 publications

Development and Validation of A New Tool for Assessing Risk of Falls in Acute Psychiatric Settings

Development and Validation of A New Tool for Assessing Risk of Falls in Acute Psychiatric Settings

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

Quedas, idade avançada e doença mental

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