@article{ref1,
title="Medication use and fall-related hospital admissions from long-term care facilities: a hospital-based case-control study",
journal="Drugs and aging",
year="2017",
author="Ryan-Atwood, Taliesin E. and Hutchinson-Kern, Mieke and Ilomäki, Jenni and Dooley, Michael J. and Poole, Susan G. and Kirkpatrick, Carl M. and Manias, Elizabeth and Mitra, Biswadev and Bell, J. Simon",
volume="34",
number="8",
pages="625-633",
abstract="BACKGROUND: Falls are a leading cause of preventable hospitalizations from long-term care facilities (LTCFs). Polypharmacy and falls-risk medications are potentially modifiable risk factors for falling. <br><br>OBJECTIVE: This study investigated whether polypharmacy and falls-risk medications are associated with fall-related hospital admissions from LTCFs compared with hospital admissions for other causes. <br><br>METHODS: This was a hospital-based, case-control study of patients aged ≥65 years hospitalized from LTCFs. Cases were patients with falls and fall-related injuries, and controls were patients admitted for infections. Conditional logistic regression was used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between polypharmacy (defined as the use of nine or more regular pre-admission medications) and falls-risk medications (categorized as psychotropic medications and those that can cause orthostatic hypotension) with fall-related hospital admissions. <br><br>RESULTS: There was no association between polypharmacy and fall-related hospital admissions (adjusted OR 0.97, 95% CI 0.63-1.48); however, the adjusted odds of fall-related hospital admissions increased by 16% (95% CI 3-30%) for each additional falls-risk medication. Medications that can cause orthostatic hypotension (adjusted OR 1.25, 95% CI 1.06-1.46), but not psychotropic falls-risk medications (adjusted OR 1.02, 95% CI 0.88-1.18) were associated with fall-related hospital admissions. The association between medications that can cause orthostatic hypotension and fall-related hospital admissions was strongest among residents with polypharmacy (adjusted OR 1.44, 95% CI 1.08-1.92). <br><br>CONCLUSION: Polypharmacy was not an independent risk factor for fall-related hospital admissions; however, medications that can cause orthostatic hypotension were associated with fall-related hospital admissions, particularly among residents with polypharmacy. Falls-risk should be considered when prescribing medications that can cause orthostatic hypotension.<p /> <p>Language: en</p>",
language="en",
issn="1170-229X",
doi="10.1007/s40266-017-0472-8",
url="http://dx.doi.org/10.1007/s40266-017-0472-8"
}