@article{ref1,
title="The Association Between the Number of Prescription Medications and Incident Falls in a Multi-ethnic Population of Adult Type-2 Diabetes Patients: The Diabetes and Aging Study",
journal="Journal of general internal medicine",
year="2010",
author="Huang, Elbert S. and Karter, Andrew J. and Danielson, Kirstie K. and Warton, E. Margaret and Ahmed, Ameena T.",
volume="25",
number="2",
pages="141-146",
abstract="BACKGROUND: Use of four or more prescription medications is considered a risk factor for falls in older people. It is unclear whether this polypharmacy-fall relationship differs for adults with diabetes. OBJECTIVE: We evaluated the association between number of prescription medications and incident falls in a multi-ethnic population of type-2 diabetes patients in order to establish an evidence-based medication threshold for fall risk in diabetes. DESIGN: Baseline survey (1994-1997) with 5 years of longitudinal follow-up. PARTICIPANTS: Eligible subjects (N = 46,946) had type-2 diabetes, were >/=18 years old, and enrolled in the Kaiser Permanente Northern California Diabetes Registry. MEASUREMENTS AND MAIN RESULTS: We identified clinically recognized incident falls based on diagnostic codes (ICD-9 codes: E880-E888). Relative to regimens of 0-1 medications, regimens including 4 or more prescription medications were significantly associated with an increased risk of falls 4-5 medications adjusted HR 1.22 (1.04, 1.43), 6-7 medications 1.33 (1.12, 1.58), >7 medications 1.59 (1.34, 1.89). None of the individual glucose-lowering medications was found to be significantly associated with a higher risk of falls in predictive models. CONCLUSIONS: The prescription of four or more medications was associated with an increased risk of falls among adult diabetes patients, while no specific glucose-lowering agent was linked to increased risk. Baseline risk of falls and number of baseline medications are additional factors to consider when deciding whether to intensify diabetes treatments.<p /><p>Language: en</p>",
language="en",
issn="0884-8734",
doi="10.1007/s11606-009-1179-2",
url="http://dx.doi.org/10.1007/s11606-009-1179-2"
}