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一项关于老年人处方药与跌倒相关性的回顾性分析。

A retrospective analysis of prescription medications as it correlates to falls for older adults.

作者信息

Lawson Katherine, Vinluan Celeste M, Oganesyan Aida, Gonzalez Eugenia C, Loya Amanda, Strate Justin J

机构信息

El Paso Texas VA. El Paso, TX (United States).

West Coast University. Los Angeles, CA (United States).

出版信息

Pharm Pract (Granada). 2018 Oct-Dec;16(4):1283. doi: 10.18549/PharmPract.2018.04.1283. Epub 2018 Nov 13.

Abstract

OBJECTIVES

To determine the correlation between falls and two medication factors: the class of medications and potentially inappropriate medications (PIMs) prescribed to community-dwelling older adults aged 55 and older.

METHODS

Retrospective, cross-sectional study. Home health patients residing in a Texas/Mexico border community and reporting at least one fall within the past month. Medication use, medication classification, and potentially inappropriate medications (PIM) recorded by level of falls; non-fallers and recurrent fallers.

RESULTS

Of 99 participants, 13.1% reported falling once and 86.9% reported two or more falls. Participant's average number of medications used was 10.51 (SD 5.75) with 93.9% having four or more prescribed medications. Average number of PIMs prescribed per participant was 1.42 (SD 1.51) with at least one PIM prescribed to 65.6% of participants. Twenty three out of 83 identified classes of prescribed medications met criteria for the study's analyses but resulted in no significant association to falls when comparing NF to RF. Agents acting on the renin-angiotensin system and lipid modifying agents were the most frequently prescribed medication classes (N=55, 55.6%). Ibuprofen was the PIM most frequently prescribed (n=13, 13.1%). The correlation between use of a prescribed PIM and number of falls was not statistically significant (p=0.128).

CONCLUSIONS

There was no correlation between classes of medication and level of falls. Recurrent fallers were more likely to have been prescribed a PIM than non-fallers (not significant). Although the analyses conducted for this study did not result in statistical significance, the high prevalence of polypharmacy and prescribed PIMs observed in these participants warrants a thorough review of medications to reduce fall risks among older adults.

摘要

目的

确定跌倒与两个药物因素之间的相关性,这两个因素分别是药物类别以及给55岁及以上社区居住老年人开具的潜在不适当药物(PIM)。

方法

回顾性横断面研究。居住在得克萨斯州/墨西哥边境社区且报告在过去一个月内至少跌倒过一次的家庭健康患者。按跌倒程度记录用药情况、药物分类和潜在不适当药物(PIM);未跌倒者和反复跌倒者。

结果

在99名参与者中,13.1%报告跌倒过一次,86.9%报告跌倒过两次或更多次。参与者使用的药物平均数量为10.51(标准差5.75),93.9%的参与者有四种或更多的处方药。每位参与者开具的PIM平均数量为1.42(标准差1.51),65.6%的参与者至少开具了一种PIM。在83种已确定的处方药类别中,有23种符合该研究分析的标准,但在比较未跌倒者与反复跌倒者时,未发现与跌倒有显著关联。作用于肾素 - 血管紧张素系统的药物和调脂药物是最常开具的药物类别(N = 55,55.6%)。布洛芬是最常开具的PIM(n = 13,13.1%)。开具的PIM使用与跌倒次数之间的相关性无统计学意义(p = 0.128)。

结论

药物类别与跌倒程度之间无相关性。反复跌倒者比未跌倒者更有可能开具PIM(无显著性差异)。尽管本研究进行的分析未得出统计学意义,但在这些参与者中观察到的多药联用和开具PIM的高患病率,值得对药物进行全面审查,以降低老年人的跌倒风险。

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本文引用的文献

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Summary of factors contributing to falls in older adults and nursing implications.老年人跌倒相关因素总结及护理启示
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Clinical consequences of polypharmacy in elderly.老年人药物过多的临床后果。
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