Risk of Falling and Hypnotic Drugs: Retrospective Study of Inpatients

Abstract

Background Falls and related injuries remain a concern for patient safety in many hospitals and nursing care facilities. In particular, reports examining the relationship between accidents and drugs with a sedative effect have been increasing; however, the analysis of correlation between the background factors of fall accidents and the detailed therapeutic category of drugs is insufficient. Objectives Our objective was to estimate fall risk following the administration of hypnotics in inpatients within an acute hospital. We assessed the relationship between falls and hypnotic drugs compared with other medicines.Study Design and Setting An inpatient population-based study was carried out at Gunma University Hospital, where all inpatients admitted between 1 October and 31 December 2007 were included. Over a 3-month follow-up period, all reports of falling accidents from ward medical staff were investigated. Results and Discussion Falls occurred in 1.8 % of males and 1.3 % of females in the study population (n = 3,683

Analysis of potential cost reductions related to falls in hospitalized elderly patients by correcting high-dose prescriptions of sedative

“…Known side effects of sedative hypnotics include disorientation, listlessness, headache, fatigue, amnesia, and muscle relaxation [24]. Many reports have indicated that sedative hypnotics are related to fall rates [8,12,18]. The use of high-dose sedative hypnotics in the elderly seems to be associated with an increased fall risk due to a carry-over effect caused by the increased half-life of the drug associated with the patients' poor hepatic and renal function.…”

“…Sedative hypnotics [7,8], psychotropic agents [9,10], anti-hypertensive agents [7,11], antiepileptic drugs [12], and anti-Parkinson agents [13,14] are known risk factors for falls. Among these drugs, sedative hypnotics greatly affect the risk of falling [15,16] since they cause depressed levels of consciousness, cognitive impairment, and muscle relaxation [17].…”

Prevention of Malpractice in the Field of Health, as the Other Type of Prevention

“…• Irrational use of hypnotic and confusing drugs, especially in the elderly patients which increases the risk of falling [34].…”

Use of hypnotics in high risk patient groups

“…Loše izabrani hipnotik može negativno uticati na zdravstveno stanje i povećati verovatnoću negtivnog ishoda, kao što je pokazao jedan broj studija -tipičan primer je upotreba BZD i Z-hipnotika koji mogu, u starijoj populaciji, da dovedu do češćih padova i povreda. Novija japanska studija [36] pokazuje da su pojedini hipnotici manje rizični u ovom pogledu (zolpidem, triazolam, flunitrazepam, nitrazepam), dok su u drugoj grupi, sa povećanim rizikom, hipnotici brotizolam, zopiklon i estazolam. Da bi situacija bila komplikovanija, za svaku studiju koja ne nalazi povećani rizik od neželjenih ishoda kod upotrebe pojedinih lekova, postoji druga studija koja pobija ovakav nalaz, kao što je, na primer, slučaj kod zolpidema [37] i drugih Z-hipnotika [38].…”