TY  - JOUR
PY  - 2020//
TI  - Use of fall risk-increasing drugs around a fall-related injury in older adults: a systematic review
JO  - Journal of the American Geriatrics Society
A1  - Hart, Laura A.
A1  - Phelan, Elizabeth A.
A1  - Yi, Julia Y.
A1  - Marcum, Zachary A.
A1  - Gray, Shelly L.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVES: To examine: (1) prevalence of fall risk-increasing drug (FRID) use among older adults with a fall-related injury, (2) which FRIDs were most frequently prescribed, (3) whether FRID use was reduced following the fall-related healthcare episode, and (4) which interventions have reduced falls or FRID use in older adults with a history of falls. <br><br>DESIGN: Systematic review. PARTICIPANTS: Observational and intervention studies that assessed (or intervened on) FRID use in participants aged 60 years or older who had experienced a fall. MEASUREMENTS: PubMed and EMBASE were searched through June 30, 2019. Two reviewers independently extracted data and evaluated studies for bias. Discrepancies were resolved by consensus. <br><br>RESULTS: Fourteen of 638 articles met selection criteria: 10 observational studies and 4 intervention studies. FRID use prevalence at time of fall-related injury ranged from 65% to 93%. Antidepressants and sedatives-hypnotics were the most commonly prescribed FRIDs. Of the 10 observational studies, only 2 used a design adequate to capture changes in FRID use after a fall-related injury, neither finding a reduction in FRID use. Three randomized controlled studies conducted in various settings (hospital, emergency department, and community pharmacy) with 12-month follow-up did not find a reduction in falls with interventions to reduce FRID use, although the study conducted in the community pharmacy setting was effective in reducing FRID use. In a nonrandomized (pre-post) intervention study conducted in an outpatient geriatrics clinic, falls were reduced in the intervention group. <br><br>CONCLUSIONS: Limited evidence indicates high prevalence of FRID use among older adults who have experienced a fall-related injury and no reduction in overall FRID use following the fall-related healthcare encounter. There is a need for well-designed interventions to reduce FRID use and falls in older adults with a history of falls. Reducing FRID use as a stand-alone intervention may not be effective in reducing recurrent falls.<br><br>© 2020 The American Geriatrics Society.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-8614
UR  - http://dx.doi.org/10.1111/jgs.16369
ID  - ref1
ER  -