Maly Josef, Dosedel Martin, Vosatka Jan, Mala-Ladova Katerina, Kubena Ales Antonin, Brabcova Iva, Hajduchova Hana, Bartlova Sylva, Tothova Valerie, Vlcek Jiri
Charles University, Faculty of Pharmacy in Hradec Kralove, Department of Social and Clinical Pharmacy, Hradec Kralove, Czech Republic.
University of South Bohemia in Ceske Budejovice, Faculty of Health and Social Sciences, Institute of Nursing, Midwifery and Emergency Care, Ceske Budejovice, Czech Republic.
J Appl Biomed. 2019 Mar;17(1):60. doi: 10.32725/jab.2019.001. Epub 2019 Jan 17.
This study aimed to analyze the effect of fall risk-increasing drugs (FRIDs) and drug-related factors relative to falls through clinical pharmacy service in hospitalized patients, focusing on the relevance of clinical pharmacist evaluation in the context of physician assessment. A prospective study of inpatient falls was conducted in 2017 retrieving data from 4 hospitals in South Bohemia, Czech Republic. An online database was developed to collect patient and fall-related data, and fall evaluation records. Healthcare professionals classified the overall effect of drugs on falls using Likert scale. Univariate and multivariate correlations were performed with a significance level of p < 0.05. Out of the total 280 falls (mean age of patients 77.0 years), a mean of 2.8 diagnoses with fall-related risk, 8.8 drugs, and 4.1 FRIDs per fall were identified. Incidence of falls decreased quarterly (p < 0.001). Use of FRIDs were positively associated with increasing age (p = 0.007). Clinical pharmacists were more likely to identify pharmacotherapy as the relevant fall-related risk, compared to physicians evaluation (p < 0.001). An increasing total number of prescribed drugs as well as higher number of FRIDs increased the suspicion in both professionals in the context of drug-related causes of falls.
本研究旨在通过临床药学服务分析住院患者中增加跌倒风险药物（FRIDs）及与跌倒相关的药物因素的影响，重点关注临床药师评估在医生评估背景下的相关性。2017年在捷克共和国南波希米亚的4家医院进行了一项关于住院患者跌倒的前瞻性研究，检索相关数据。开发了一个在线数据库来收集患者及与跌倒相关的数据和跌倒评估记录。医护人员使用李克特量表对药物对跌倒的总体影响进行分类。进行单因素和多因素相关性分析，显著性水平为p < 0.05。在总共280例跌倒事件中（患者平均年龄77.0岁），每次跌倒平均发现2.8项与跌倒相关的风险诊断、8.8种药物和4.1种FRIDs。跌倒发生率呈季度下降趋势（p < 0.001）。FRIDs的使用与年龄增长呈正相关（p = 0.007）。与医生评估相比，临床药师更有可能将药物治疗确定为与跌倒相关的风险因素（p < 0.001）。在与药物相关的跌倒原因方面，处方药物总数的增加以及FRIDs数量的增加增加了两位专业人员的怀疑。
