Association of potentially inappropriate medications with falls in elderly patients
Received:November 11, 2018  
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DOI:10.11915/j.issn.1671-5403.2019.02.022
Key words:aged; potentially inappropriate medications; fall
Author NameAffiliationE-mail
WANG Peng Departmen of Integration,  
BIAN Meng Department of Pharmacy, Fuxing Hospital of Capital Medical University, Beijing 100038, China  
WANG Qing Departmen of Integration,  
LI Fang Departmen of Integration, lifangwa@sina.com 
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Abstract:
      Objective To investigate the association of the potentially inappropriate medications (PIM) with falls in the elderly patients. Methods A retrospective cross-sectional study was conducted of 280 inpatients aged ≥65 years who were divided into fall group (n=36) and non-fall group (n=244) based on a history of falling six months before admission. Patients′ general data were collected, and their clinical data such as hand-grip strength and walking speed were measured. Patients were assessed using Charlson comorbidity index (CCI) and mini nutritional assessment-short form (MNA-SF) scale. SPSS statistics 23.0 was used for statistical analysis, and t test, non-parametric test or χ2 test was performed, depending on data types. Pearson correlation was used for the normal distribution, and Spearman correlation for the non-normal distribution data. Logistic regression was run to screen for independent risk factors. Results PIM among the enrolled patients were highly prevalent (69.3%,194/280), with psychotropic accounting for 36.1%(101/280), cardiovascular for 22.9%(64/280) and others for 8.9%(25/280). Significantly more patients using psychotropic PIM in the fall group than the non-fall group (58.3% vs 32.8%, P=0.005). Correlation analysis showed that falls were positively associated with osteoporosis (r=0.238, P<0.001), anxiety depression (r=0.170, P<0.004), use of ≥5 oral drugs (r=0.123, P=0.040), psychotropic PIM (r=0.178, P=0.004) and female (r=0.230, P=0.006), and negatively with hand-grip strength (r=-0.146,P=0.015)and walking speed (r=-0.134, P=0.025). Logistic regression showed falls correlated with osteoporosis (OR=3.973, 95%CI 1.759-8.973,P=0.001) and psychotropic PIM (OR=2.415,5%CI 1.141-5.114, P=0.021). Conclusion Psychotropic PIM was associated with falls in the elderly patients. Clinicians should be more mindful of rational prescrip-tions to avoid overuse of psychotropic PIM, particularly drugs of category A (high-alert), thus reducing the risk of fall in the elderly patients.
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