Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units
Abstract Background Falls are common undesirable events for older adults in institutions. Even though the patient’s fall risk may be scored on admission, the medication-induced fall risk may be ignored. This study developed a preliminary categorization of fall-risk-increasing drugs (FRIDs) to be add...
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12877-020-01845-9 |
| _version_ | 1819120953981927424 |
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| author | Jana Michalcova Karel Vasut Marja Airaksinen Katarina Bielakova |
| author_facet | Jana Michalcova Karel Vasut Marja Airaksinen Katarina Bielakova |
| author_sort | Jana Michalcova |
| collection | DOAJ |
| description | Abstract Background Falls are common undesirable events for older adults in institutions. Even though the patient’s fall risk may be scored on admission, the medication-induced fall risk may be ignored. This study developed a preliminary categorization of fall-risk-increasing drugs (FRIDs) to be added as a risk factor to the existing fall risk assessment tool routinely used in geriatric care units. Methods Medication use data of older adults who had experienced at least one fall during a hospital ward or a nursing home stay within a 2-year study period were retrospectively collected from patient records. Medicines used were classified into three risk categories (high, moderate and none) according to the fall risk information in statutory summaries of product characteristics (SmPCs). The fall risk categorization incorporated the relative frequency of such adverse drug effects (ADEs) in SmPCs that were known to be connected to fall risk (sedation, orthostatic hypotension, syncope, dizziness, drowsiness, changes in blood pressure or impaired balance). Also, distribution of fall risk scores assessed on admission without considering medications was counted. Results The fall-experienced patients (n = 188, 128 from the hospital and 60 from nursing home records) used altogether 1748 medicaments, including 216 different active substances. Of the active substances, 102 (47%) were categorized as high risk (category A) for increasing fall risk. Fall-experienced patients (n = 188) received a mean of 3.8 category A medicines (n = 710), 53% (n = 375) of which affected the nervous and 40% (n = 281) the cardiovascular system. Without considering medication-related fall risk, 53% (n = 100) of the patients were scored having a high fall risk (3 or 4 risk scores). Conclusion It was possible to develop a preliminary categorization of FRIDs basing on their adverse drug effect profile in SmPCs and frequency of use in older patients who had experienced at least one documented fall in a geriatric care unit. Even though more than half of the fall-experienced study participants had high fall risk scores on admission, their fall risk might have been underestimated as use of high fall risk medicines was common, even concomitant use. Further studies are needed to develop the FRID categorization and assess its impact on fall risk. |
| first_indexed | 2024-12-22T06:28:52Z |
| format | Article |
| id | doaj.art-ccba0301412d40c7ad9433a7b5e63736 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-22T06:28:52Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-ccba0301412d40c7ad9433a7b5e637362022-12-21T18:35:45ZengBMCBMC Geriatrics1471-23182020-11-0120111110.1186/s12877-020-01845-9Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care unitsJana Michalcova0Karel Vasut1Marja Airaksinen2Katarina Bielakova3Faculty of Pharmacy, Department of Applied Pharmacy, Masaryk UniversityFaculty of Pharmacy, Department of Applied Pharmacy, Masaryk UniversityFaculty of Pharmacy, Division of Pharmacology and Pharmacotherapy, Clinical Pharmacy Group, University of HelsinkiClinic of Internal Medicine, Geriatrics and Practical Medicine, University Hospital BrnoAbstract Background Falls are common undesirable events for older adults in institutions. Even though the patient’s fall risk may be scored on admission, the medication-induced fall risk may be ignored. This study developed a preliminary categorization of fall-risk-increasing drugs (FRIDs) to be added as a risk factor to the existing fall risk assessment tool routinely used in geriatric care units. Methods Medication use data of older adults who had experienced at least one fall during a hospital ward or a nursing home stay within a 2-year study period were retrospectively collected from patient records. Medicines used were classified into three risk categories (high, moderate and none) according to the fall risk information in statutory summaries of product characteristics (SmPCs). The fall risk categorization incorporated the relative frequency of such adverse drug effects (ADEs) in SmPCs that were known to be connected to fall risk (sedation, orthostatic hypotension, syncope, dizziness, drowsiness, changes in blood pressure or impaired balance). Also, distribution of fall risk scores assessed on admission without considering medications was counted. Results The fall-experienced patients (n = 188, 128 from the hospital and 60 from nursing home records) used altogether 1748 medicaments, including 216 different active substances. Of the active substances, 102 (47%) were categorized as high risk (category A) for increasing fall risk. Fall-experienced patients (n = 188) received a mean of 3.8 category A medicines (n = 710), 53% (n = 375) of which affected the nervous and 40% (n = 281) the cardiovascular system. Without considering medication-related fall risk, 53% (n = 100) of the patients were scored having a high fall risk (3 or 4 risk scores). Conclusion It was possible to develop a preliminary categorization of FRIDs basing on their adverse drug effect profile in SmPCs and frequency of use in older patients who had experienced at least one documented fall in a geriatric care unit. Even though more than half of the fall-experienced study participants had high fall risk scores on admission, their fall risk might have been underestimated as use of high fall risk medicines was common, even concomitant use. Further studies are needed to develop the FRID categorization and assess its impact on fall risk.http://link.springer.com/article/10.1186/s12877-020-01845-9Older adultsFall riskMedicationHospitalNursing homePreventive risk management |
| spellingShingle | Jana Michalcova Karel Vasut Marja Airaksinen Katarina Bielakova Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units BMC Geriatrics Older adults Fall risk Medication Hospital Nursing home Preventive risk management |
| title | Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units |
| title_full | Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units |
| title_fullStr | Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units |
| title_full_unstemmed | Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units |
| title_short | Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units |
| title_sort | inclusion of medication related fall risk in fall risk assessment tool in geriatric care units |
| topic | Older adults Fall risk Medication Hospital Nursing home Preventive risk management |
| url | http://link.springer.com/article/10.1186/s12877-020-01845-9 |
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