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

• Published in: Geriatrics & gerontology international Vol. 22; no. 10; pp. 857 - 864
• Main Authors: Li, Shan‐Jen, Hwang, Hei‐Fen, Yu, Wen‐Yu, Lin, Mau‐Roung
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01.10.2022; Blackwell Publishing Ltd
• Subjects: falls; hospital; Hospitalization; older patients; Polypharmacy; potentially inappropriate medications; risk factor
• ISSN: 1444-1586; 1447-0594
• DOI: 10.1111/ggi.14473

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.