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American Journal of Health-System Pharmacy, Vol. 62, Issue 23, 2495-2499
Copyright © 2005 by American Society of Health-System Pharmacists
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Clinical Review

Medication use as a risk factor for falls among hospitalized elderly patients

Paul C. Walker, Ahmad Alrawi, John F. Mitchell, Randolph E. Regal and Ujjaini Khanderia

PAUL C. WALKER, PHARM.D., is Clinical Associate Professor of Pharmacy, College of Pharmacy, University of Michigan (UM), and Manager, Clinical Services, Department of Pharmacy Services, University of Michigan Health System (UMHS), Ann Arbor. AHMAD ALRAWI, PHARM.D., is Pegasys Marketing Fellow, Hoffmann-La Roche Inc., Nutley, NJ; at the time of this study he was a Pharm.D. degree candidate, College of Pharmacy, UM. JOHN F. MITCHELL, PHARM.D., is Medication Safety Coordinator, Department of Pharmacy Services, UMHS, and Clinical Associate Professor, College of Pharmacy, UM. RANDOLPH E. REGAL, PHARM.D., is Clinical Assistant Professor, College of Pharmacy, UM, and Clinical Pharmacist, Department of Pharmacy Services, UMHS. UJJAINI KHANDERIA, PHARM.D., is Clinical Assistant Professor, College of Pharmacy, UM, and Clinical Pharmacist, Department of Pharmacy Services, UMHS.

Address correspondence to Dr. Walker at the Department of Pharmacy Services, B2D301, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0008 (pcwalker{at}umich.edu).


Purpose. The relationship between medication use and falls among hospitalized elderly patients was studied.

Methods. Sixty-two patients 65 years of age or older who fell during hospitalization were randomly selected from incident reports of falls and matched for age, sex, and discharge date with 62 patients who did not fall. Data on demographic characteristics, vital signs, laboratory test variables, drug therapy, and the presence of other known risk factors for falls were collected retrospectively and compared between the groups.

Results. Nonsteroidal antiinflammatory drug (NSAID) use was more frequent in patients who fell than in control patients. NSAID use was a significant predictor of falls and was associated with a 10-fold increase in the likelihood of falling. Opioid analgesics were given more frequently to control patients and were not associated with falls. Dementia, the only non-medication-related independent predicator of falls, was associated with a 21-fold greater risk of falling.

Conclusion. In hospitalized elderly patients, there was a significant association between NSAID use and falls, an effect largely accounted for by low-dose aspirin.

Index terms: Accidental falls; Analgesics and antipyretics; Antiinflammatory agents; Aspirin; Dementia; Geriatrics; Hospitals; Opiates; Toxicity

 






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