Potentially inappropriate medication use, polypharmacy, and falls among hospitalized patients

Shan Jen Li, Hei Fen Hwang, Wen Yu Yu, Mau Roung Lin

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Aim: This matched case–control study investigated potentially inappropriate medication (PIM) use, polypharmacy, and other potential risk factors for falls among hospitalized older adults in Taiwan. Methods: During an 18-month study period, 131 case patients who experienced a fall during hospitalization in an acute-care hospital were identified and matched by the time of day, hospital ward, and age to controls (five for each case) who were selected through random systematic sampling. Data on demographics, medical characteristics, and all orally and intravascularly administered medications during hospitalization prior to a fall were collected. PIMs were assessed using the 2019 Beers criteria. Results: A conditional logistic regression analysis revealed that admission to the departments of internal medicine (odds ratio [OR] = 2.33; 95% confidence interval [CI] = 1.09–4.91) and neurology and rehabilitation (OR = 4.67; 95% CI = 2.08–10.5), diabetes with end-organ damage (OR = 2.07; 95% CI = 1.11–3.86), PIM use of central nervous system drugs (OR = 1.81; 95% CI = 1.15–2.86), use of colchicine (OR = 5.49; 95% CI = 1.34–22.5) and spironolactone (OR = 4.54; 95% CI = 1.31–15.8) for renal function impairment, and polypharmacy (≥5 medications; OR = 1.81; 95% CI = 1.05–3.10) significantly increased the risk of falls. By contrast, being overweight or obese (OR = 0.47; 95% CI = 0.29–0.78) was associated with a significantly lower risk of falls. Conclusions: PIM use may increase the risk of falls in hospitalized older patients, and PIM identification and evaluation can reduce this risk. Geriatr Gerontol Int 2022; 22: 857–864.

Original languageEnglish
Pages (from-to)857-864
Number of pages8
JournalGeriatrics and Gerontology International
Volume22
Issue number10
DOIs
Publication statusPublished - Oct 2022

Keywords

  • falls
  • hospital
  • older patients
  • potentially inappropriate medications
  • risk factor

ASJC Scopus subject areas

  • Health(social science)
  • Gerontology
  • Geriatrics and Gerontology

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