Musich Shirley, Wang Shaohung S, Ruiz Joann, Hawkins Kevin, Wicker Ellen
Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI, 48108, USA.
Medicare and Retirement, UnitedHealthcare Alliances, PO Box 9472, Minneapolis, MN, 55440, USA.
Drugs Aging. 2017 Jul;34(7):555-565. doi: 10.1007/s40266-017-0470-x.
Approximately one-third of community-dwelling older adults fall each year, and approximately 10% have falls requiring medical services. Among other factors, research studies have linked certain medications with an increased risk of falls.
The aim of this study was to examine the risk of falls relative to use patterns among new and continuing falls-related drug (FRD) users.
A 10% random sample, insured in AARP Medicare Supplement and AARP Medicare Part D Rx plans, was utilized to define new and continuing FRD users. New users had a 12-month pre-period without FRD use, whereas continuing users had at least one FRD in the pre-period. Both groups had 12-month follow-up after initiating or continuing FRD use. Characteristics associated with the risk of falls for new and continuing users were determined using multivariate logistic regression models.
Among insureds, 44% used at least one of the FRD classes. Of these, 29% were new users (N = 35,340) and 71% were continuing users (N = 121,488). Fall rates for the two subgroups were similar at 7 and 8%, respectively. Characteristics associated with the risk of falls were previous injurious fall, use of two or more classes of FRDs, older age, poorer health, and being female. New users were at higher risk than continuing users.
New users of FRDs were at highest risk of falls, and continuing users were at increased risk, especially with higher numbers of FRD classes. Both groups could benefit from falls awareness and prevention programs.
每年约有三分之一居住在社区的老年人跌倒，约10%的跌倒者需要医疗服务。在其他因素中，研究表明某些药物与跌倒风险增加有关。
本研究旨在探讨新的和持续使用与跌倒相关药物（FRD）的使用者的使用模式与跌倒风险之间的关系。
利用美国退休人员协会（AARP）医疗保险补充计划和AARP医疗保险D部分处方药计划中10%的随机样本，确定新的和持续使用FRD的使用者。新使用者在之前12个月内未使用FRD，而持续使用者在之前至少使用过一种FRD。两组在开始或继续使用FRD后均进行12个月的随访。使用多变量逻辑回归模型确定与新使用者和持续使用者跌倒风险相关的特征。
在参保者中，44%的人至少使用过一种FRD类别。其中，29%是新使用者（N = 35340），71%是持续使用者（N = 121488）。两个亚组的跌倒率分别为7%和8%，相似。与跌倒风险相关的特征包括既往有伤害性跌倒、使用两种或更多类别的FRD、年龄较大、健康状况较差以及女性。新使用者比持续使用者的风险更高。
FRD的新使用者跌倒风险最高，持续使用者的风险也增加，尤其是使用的FRD类别较多时。两组都可以从跌倒意识和预防计划中受益。
