Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units

MICHALCOVÁ, Jana, Karel VAŠUT, M. AIRAKSINEN a K. BIELAKOVA. Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units. BMC GERIATRICS. LONDON: BMC, 2020, roč. 20, č. 1, s. 1-11. ISSN 1471-2318. Dostupné z: https://dx.doi.org/10.1186/s12877-020-01845-9.

Základní údaje

Originální název

Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units

Autoři

MICHALCOVÁ, Jana (203 Česká republika, garant, domácí), Karel VAŠUT (203 Česká republika, domácí), M. AIRAKSINEN a K. BIELAKOVA

Vydání

BMC GERIATRICS, LONDON, BMC, 2020, 1471-2318

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Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30104 Pharmacology and pharmacy

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 3.921

Kód RIV

RIV/00216224:14160/20:00118182

Organizační jednotka

Farmaceutická fakulta

DOI

http://dx.doi.org/10.1186/s12877-020-01845-9

UT WoS

000587115700001

Klíčová slova anglicky

Older adults; Fall risk; Medication; Hospital; Nursing home; Preventive risk management

Štítky

rivok, ÚAF

Příznaky

Mezinárodní význam, Recenzováno

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Anotace

V originále

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.