Kawakami Chad, Taira Deborah, Prudencio Jarred
Daniel K. Inouye College of Pharmacy, University of Hawai'i at Hilo, Hilo HI.
Board Certified Ambulatory Care Pharmacy Specialist with experience in outpatient family medicine and specialty clinics.
Hawaii J Health Soc Welf. 2019 Jul;78(7):240-244.
Falls are among the leading causes of morbidity and mortality in older adults in Hawai'i. According to a recent report, 101 older adults in Hawai'i died from falls from 2011 to 2015, while another 9,158 had fall injuries resulting in hospitalizations or emergency department visits. Because certain medications can increase the risk of falls, medication reviews should be a component of any fall treatment plan. The purpose of this column is to examine medication interventions attempted before hospital discharge in patients taking psychotropic medications upon admission after a fall. A retrospective review of electronic medical records was conducted for the year 2016. All older adults admitted to a large hospital in Hawai'i after a fall-related injury who were taking a psychotropic medication were included. During the study period, 19 patients were admitted to the hospital on a psychotropic medication after a fall. Of the 19 patients, 18 (95%) had no change in their psychotropic medication during hospitalization. In 15 patients (79%), EMR documentation did not demonstrate an attempt to review psychotropic medications. The study confirms the need for medication reviews to address potentially inappropriate medications in older adults who are admitted to the hospital after a fall.
跌倒位列夏威夷老年人发病和死亡的主要原因之中。根据最近一份报告，2011年至2015年期间，夏威夷有101名老年人死于跌倒，另有9158人因跌倒受伤而住院或前往急诊室就诊。由于某些药物会增加跌倒风险，因此药物审查应成为任何跌倒治疗计划的一部分。本专栏的目的是研究在跌倒后入院时服用精神药物的患者在出院前尝试的药物干预措施。对2016年的电子病历进行了回顾性审查。纳入了所有在夏威夷一家大型医院因跌倒相关损伤入院且正在服用精神药物的老年人。在研究期间，有19名患者在跌倒后因服用精神药物而入院。在这19名患者中，18名（95%）在住院期间精神药物没有变化。在15名患者（79%）中，电子病历记录未显示有尝试审查精神药物的情况。该研究证实了对跌倒后入院的老年人进行药物审查以处理潜在不适当药物的必要性。
