De Winter Sabrina, Vanwynsberghe Sarah, Foulon Veerle, Dejaeger Eddy, Flamaing Johan, Sermon An, Van der Linden Lorenz, Spriet Isabel
Clinical Pharmacology and Pharmacotherapy, University Hospitals Leuven, Herestraat 49, 3000, Louvain, Belgium.
Clinical Pharmacology and Pharmacotherapy, Catholic University Leuven, Herestraat 49 - Bus 521, 3000, Louvain, Belgium.
Int J Clin Pharm. 2016 Apr;38(2):243-51. doi: 10.1007/s11096-015-0230-0. Epub 2016 Jan 9.
Hospital admissions due to fall-related fractures are a major problem in the aging population. Several risk factors have been identified, including drug use. Most studies often retrieved prescription-only drugs from national databases. These are associated with some limitations as they do not always reliably reproduce the complete patient's active drug list.
To evaluate the association between the number of FRIDs intake identified by a standardised medication reconciliation process and a fall-related fracture leading to a hospital admission in older adults.
The first cohort has been recruited from one traumatology ward of a tertiary teaching hospital in Belgium and the second cohort has been recruited from 11 community pharmacies in Belgium.
A prospective study with two individually matched cohorts was performed. Adult patients (≥75 years) admitted with an injury due to a fall were included in the first cohort (faller group). The second cohort consisted of patients who did not suffer from a fall within the last 6 months (non-faller group). Matching was performed for age, gender, place of residence and use of a walking aid. In both groups, clinical pharmacists and undergraduate pharmacy students obtained the medication history, using a standardised approach. A list of drugs considered to increase the risk of falling was created. It included cardiovascular drugs and drugs acting on the nervous system. A linear mixed model was used to compare the number of fall risk-increasing drugs between fallers and non-fallers.
The number of fall risk-increasing drugs in a faller versus a non-faller group.
Sixty-one patients were matched with 121 non-fallers. Patients received on average 3.1 ± 2.1 and 3.2 ± 1.8 fall risk-increasing drugs in the faller and in the non-faller group, respectively. The mean number of fall risk-increasing drugs was comparable in both groups (p = 0.844), even after adjusting for alcohol consumption, fear of falling, vision and foot problems (p = 0.721).
In a sample of hospitalised patients admitted for a fall-related injury, no significant difference in the number of fall risk-increasing drugs versus that of an outpatient group of non-fallers was found.
因跌倒相关骨折而住院是老年人群中的一个主要问题。已经确定了几个风险因素，包括药物使用。大多数研究通常从国家数据库中检索仅处方药物。这些存在一些局限性，因为它们并不总是能可靠地重现患者完整的活性药物清单。
评估通过标准化药物重整过程确定的跌倒风险增加药物（FRIDs）摄入量与导致老年人因跌倒相关骨折而住院之间的关联。
第一个队列从比利时一家三级教学医院的一个创伤科病房招募，第二个队列从比利时的11家社区药房招募。
进行了一项有两个个体匹配队列的前瞻性研究。因跌倒受伤入院的成年患者（≥75岁）被纳入第一个队列（跌倒者组）。第二个队列由过去6个月内未发生跌倒的患者组成（非跌倒者组）。根据年龄、性别、居住地点和使用助行器进行匹配。在两组中，临床药剂师和本科药学专业学生采用标准化方法获取用药史。创建了一份被认为会增加跌倒风险的药物清单。其中包括心血管药物和作用于神经系统的药物。使用线性混合模型比较跌倒者和非跌倒者之间增加跌倒风险药物的数量。
跌倒者组与非跌倒者组中增加跌倒风险药物的数量。
61名患者与121名非跌倒者匹配。跌倒者组和非跌倒者组患者接受的增加跌倒风险药物平均分别为3.1±2.1种和3.2±1.8种。两组中增加跌倒风险药物的平均数量相当（p = 0.844），即使在调整了饮酒、跌倒恐惧、视力和足部问题后也是如此（p = 0.721）。
在因跌倒相关损伤住院的患者样本中，未发现增加跌倒风险药物数量与非跌倒门诊患者组之间存在显著差异。
