Study of fall risk-increasing drugs in elderly patients before and after a bone fracture.

Accidental falls have a significant economic and human impact. The use of certain drugs is one of the modifiable risk factors associated with these events. The aim of this study was to determine the prevalence of use and to explore changes in treatment with fall-related drugs in patients over 65 years of age admitted as a result of a fall-related fracture. Observational and prospective study performed in a tertiary level hospital. A list of fall risk-increasing drugs (FRIDs) was drawn up. The main study variables were number and type of FRIDs prescribed at admission and 1 month after the fracture and number, type, treating physician and place where changes in FRIDs were implemented. In total, 252 patients were included. At admission, 91.3% were receiving at least one FRID, mean daily use was 3.1 FRIDs and the most frequently prescribed FRIDs were diuretics (18%), renin-angiotensin system-acting agents (15.8%) and antidepressants (15%). One month later, mean daily use was 3.4 FRIDs (p=0.099) and a significant increase was detected in the use of hypnotics (p=0.003) and antidepressants (p=0.042). A total of 327 changes in treatment were recorded (1.3 changes/patient). Of the changes, 52.6% were new prescriptions, 72.2% occurred at discharge and 56.6% were ordered by a geriatrician. The use of FRIDs among patients with a fall-related fracture is very high. This use rises 1 month after the fracture, significantly in the case of hypnotics and antidepressants.

Beunza-Sola M ，Hidalgo-Ovejero ÁM ，Martí-Ayerdi J ，Sánchez-Hernández JG ，Menéndez-García M ，García-Mata S ... -  《-》

Prevalence and impact of fall-risk-increasing drugs, polypharmacy, and drug-drug interactions in robust versus frail hospitalised falls patients: a prospective cohort study.

Bennett A ，Gnjidic D ，Gillett M ，Carroll P ，Matthews S ，Johnell K ，Fastbom J ，Hilmer S ... -  《-》

Fall-risk increasing drugs and prevalence of polypharmacy in older patients discharged from an Orthogeriatric Unit after a hip fracture.

Correa-Pérez A ，Delgado-Silveira E ，Martín-Aragón S ，Rojo-Sanchís AM ，Cruz-Jentoft AJ ... -  《-》

Exploring the prevalence and types of fall-risk-increasing drugs among older people with upper limb fractures.

Medications and specifically fall-risk-increasing drugs (FRIDs) are associated with increased risk of falls: reducing their prescription may improve this risk. This study explored patient characteristics associated with FRID use, prevalence and type of FRIDs and changes in their prescriptions among older people with arm fractures over 6 months. Observational prospective study in three fracture clinics in England. Patients aged ≥65 years with a single upper limb fragility fracture were recruited. The STOPPFall tool identified the number and type of FRIDs prescribed at baseline, 3- and 6-month follow-ups. Changes in FRID prescription were categorised as discontinued, new or exchanged. 100 patients (median age 73 years; 80% female) were recruited. At baseline, 73% used ≥1 FRID daily (median = 2), reducing to 64% and 59% at 3 and 6 months, respectively. Those with >1 FRID prescription had a significantly higher number of co-morbidities and medications and higher rates of male gender, polypharmacy, frailty and sarcopenia. The most frequently prescribed FRIDs were antihypertensives, opioids and antidepressants. Between 0 and 3 months, 44 (60%) participants had changes to FRID prescription: 20 discontinued (opioids and antihistamines), 13 started (antidepressants) and 11 exchanged for another. Similar trends were observed at 6 months. Use of FRIDs among older people with upper limb fragility fractures was high. Although overall use decreased over time, 59% were still on ≥1 FRID at the 6-month follow-up, with trends to stop opioids and start antidepressants. Older people presenting with upper limb fractures should be offered a structured medication review to identify FRIDs for targeted deprescribing.

Cox N ，Ilyas I ，Roberts HC ，Ibrahim K ... -  《-》

Is use of fall risk-increasing drugs in an elderly population associated with an increased risk of hip fracture, after adjustment for multimorbidity level: a cohort study.

Thorell K ，Ranstad K ，Midlöv P ，Borgquist L ，Halling A ... -  《BMC Geriatrics》