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

J 2020

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

MICHALCOVÁ, Jana, Karel VAŠUT, M. AIRAKSINEN and K. BIELAKOVA

Basic information

Original name

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

Authors

MICHALCOVÁ, Jana (203 Czech Republic, guarantor, belonging to the institution), Karel VAŠUT (203 Czech Republic, belonging to the institution), M. AIRAKSINEN and K. BIELAKOVA

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30104 Pharmacology and pharmacy

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 3.921

RIV identification code

RIV/00216224:14160/20:00118182

Organization unit

Faculty of Pharmacy

DOI

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

UT WoS

000587115700001

Keywords in English

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

Abstract

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.

Citovat

MICHALCOVÁ, Jana, Karel VAŠUT, M. AIRAKSINEN and K. BIELAKOVA. Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units. BMC GERIATRICS. LONDON: BMC, 2020, vol. 20, No 1, p. 1-11. ISSN 1471-2318. Available from: https://dx.doi.org/10.1186/s12877-020-01845-9.

@article{1742739,
   author = {Michalcová, Jana and Vašut, Karel and Airaksinen, M. and Bielakova, K.},
   article_location = {LONDON},
   article_number = {1},
   doi = {http://dx.doi.org/10.1186/s12877-020-01845-9},
   keywords = {Older adults; Fall risk; Medication; Hospital; Nursing home; Preventive risk management},
   language = {eng},
   issn = {1471-2318},
   journal = {BMC GERIATRICS},
   title = {Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units},
   url = {https://bmcgeriatr.biomedcentral.com/track/pdf/10.1186/s12877-020-01845-9.pdf},
   volume = {20},
   year = {2020}
}

TY  - JOUR
ID  - 1742739
AU  - Michalcová, Jana - Vašut, Karel - Airaksinen, M. - Bielakova, K.
PY  - 2020
TI  - Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units
JF  - BMC GERIATRICS
VL  - 20
IS  - 1
SP  - 1-11
EP  - 1-11
PB  - BMC
SN  - 14712318
KW  - Older adults
KW  - Fall risk
KW  - Medication
KW  - Hospital
KW  - Nursing home
KW  - Preventive risk management
UR  - https://bmcgeriatr.biomedcentral.com/track/pdf/10.1186/s12877-020-01845-9.pdf
L2  - https://bmcgeriatr.biomedcentral.com/track/pdf/10.1186/s12877-020-01845-9.pdf
N2  - 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.
ER  -

MICHALCOVÁ, Jana, Karel VAŠUT, M. AIRAKSINEN and K. BIELAKOVA. Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units. \textit{BMC GERIATRICS}. LONDON: BMC, 2020, vol.~20, No~1, p.~1-11. ISSN~1471-2318. Available from: https://dx.doi.org/10.1186/s12877-020-01845-9.

Detailed Information on Publication Record