TY  - JOUR
PY  - 2016//
TI  - Effectiveness of medication withdrawal in older fallers: results from the Improving Medication Prescribing to reduce Risk Of FALLs (IMPROveFALL) trial
JO  - Age and ageing
A1  - Boyé, Nicole D. A.
A1  - van der Velde, Nathalie
A1  - de Vries, Oscar J.
A1  - van Lieshout, Esther M. M.
A1  - Hartholt, Klaas A.
A1  - Mattace-Raso, Francesco U. S.
A1  - Lips, Paul
A1  - Patka, Peter
A1  - Van Beeck, Ed F.
A1  - van der Cammen, Tischa J. M.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVES: to investigate the effect of withdrawal of fall-risk-increasing-drugs (FRIDs) versus 'care as usual' on reducing falls in community-dwelling older fallers. <br><br>DESIGN: randomised multicentre trial. PARTICIPANTS: six hundred and twelve older adults who visited an Emergency Department (ED) because of a fall. INTERVENTIONS: withdrawal of FRIDs. MAIN OUTCOMES AND MEASURES: primary outcome was time to the first self-reported fall. Secondary outcomes were time to the second self-reported fall and to falls requiring a general practitioner (GP)-consultation or ED-visit. Intention-to-treat (primary) and a per-protocol (secondary) analysis were conducted. The hazard ratios (HRs) for time-to-fall were calculated using a Cox-regression model. Differences in cumulative incidence of falls were analysed using Poisson regression. <br><br>RESULTS: during 12 months follow-up, 91 (34%) control and 115 (37%) intervention participants experienced a fall; 35% of all attempted interventions were unsuccessful, either due to recurrence of the initial indication for prescribing, additional medication for newly diagnosed conditions or non-compliance. Compared to baseline, the overall percentage of users of ≥3 FRIDs at 12 months did not change in either the intervention or the control group. Our intervention did not have a significant effect on time to first fall (HR 1.17; 95% confidence interval 0.89-1.54), time to second fall (1.19; 0.78-1.82), time to first fall-related GP-consultation (0.66; 0.42-1.06) or time to first fall-related ED-visit (0.85; 0.43-1.68). <br><br>CONCLUSION: in this population of complex multimorbid patients visiting an ED because of a fall, our single intervention of FRIDs-withdrawal was not effective in reducing falls. TRIAL REGISTRATION: Netherlands Trial Register NTR1593.<br><br>© The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-0729
UR  - http://dx.doi.org/10.1093/ageing/afw161
ID  - ref1
ER  -