Department of Clinical Pharmacology, Aalborg University Hospital, Mølleparkvej 8, 9000, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
BMC Geriatr. 2020 Mar 30;20(1):121. doi: 10.1186/s12877-020-01532-9.
Hip fractures constitute a major health problem in elderly people and are often fall-related. Several factors can contribute to a fall episode leading to hip fracture, including fall-risk-increasing drugs (FRIDs), which are often used by elderly people. We aimed to investigate the prevalence of medication-related falls and to assess the role of FRIDs and potentially inappropriate medications (PIMs) in a population of elderly patients hospitalized for a hip fracture.
We reviewed the patient records of 200 consecutive patients, aged ≥65 years, who were admitted for a hip fracture and evaluated whether medications were likely to have contributed to the fall episode. PIMs were identified using the Screening Tool of Older Persons' Prescriptions version 2 (STOPP) and by evaluating indications, contra-indications and interactions of the prescribed medications for each patient.
FRIDs were used by 175 patients (87.5%). Medications were considered a likely contributor to the fall in 82 patients (41%). These were most often psychotropic medications alone or in combination with antihypertensives and/or diuretics. The 82 patients with suspected medication-related falls used more medications, FRIDs and PIMs than the rest of the patients, and in 74 (90%) of the 82 patients, at least one medication considered to be a contributor to the fall was also a PIM.
The prevalence of suspected medication-related falls was 41%. It seems likely that a medication review could have reduced, though not eliminated, the risk of falling in this group of patients.
髋部骨折是老年人的一个主要健康问题,通常与跌倒有关。导致髋部骨折的跌倒事件可能涉及多种因素,包括增加跌倒风险的药物(FRIDs),这些药物通常被老年人使用。我们旨在调查与药物相关的跌倒发生率,并评估 FRIDs 和潜在不适当药物(PIMs)在因髋部骨折住院的老年患者人群中的作用。
我们回顾了 200 名连续患者的病历,这些患者年龄均≥65 岁,因髋部骨折入院,并评估药物是否可能导致跌倒事件。使用老年人处方筛选工具 2 版(STOPP)和评估每位患者处方药物的适应证、禁忌证和相互作用来确定 PIMs。
175 名患者(87.5%)使用了 FRIDs。82 名患者(41%)被认为药物是跌倒的可能原因。这些药物通常是单独或与抗高血压药和/或利尿剂联合使用的精神药物。82 名疑似与药物相关的跌倒患者使用了更多的药物、FRIDs 和 PIMs,而在 82 名患者中的 74 名(90%),至少有一种被认为是导致跌倒的药物也是 PIM。
疑似与药物相关的跌倒发生率为 41%。药物审查似乎有可能降低,但不能消除,该组患者跌倒的风险。