title: Fall risk-increasing drugs and falls: a cross-sectional study among elderly patients in primary care.
abstract: BACKGROUND
  Falls are the most common cause of injuries and hospital admissions in the elderly. The Swedish National Board of Health and Welfare has created a list of drugs considered to increase the fall risk (FRIDs) and drugs that might cause/worsen orthostatism (ODs). This cross-sectional study was aimed to assess FRIDs and their correlation with falls in a sample of 369 community-dwelling and nursing home patients aged ≥75 years and who were using a multi-dose drug dispensing system.
  
  
  METHODS
  Data were collected from the patients' electronic medication lists. Retrospective data on reported falls during the previous three months and severe falls during the previous 12 months were collected. Primary outcome measures were incidence of falls as well as numbers of FRIDs and ODs in fallers and non-fallers.
  
  
  RESULTS
  The studied sample had a high incidence of both reported falls (29%) and severe falls (17%). Patients were dispensed a mean of 2.2 (SD 1.5) FRIDs and 2.0 (SD 1.6) ODs. Fallers used on average more FRIDs. Severe falls were more common in nursing homes patients. More women than men experienced severe falls. There were positive associations between number of FRIDs and the total number of drugs (p < 0.01), severe falls (p < 0.01) and female sex (p = 0.03). There were also associations between number of ODs and both total number of drugs (p < 0.01) and being community dwelling (p = 0.02). No association was found between number of ODs and severe falls. Antidepressants and anxiolytics were the most frequently dispensed FRIDs.
  
  
  CONCLUSIONS
  Fallers had a higher number of FRIDs. Numbers of FRIDs and ODs were correlated with the total number of drugs dispensed. Interventions to reduce falls in the elderly by focusing on reducing the total number of drugs and withdrawal of psychotropic medications might improve the quality and safety of drug treatment in primary care.
authors.affiliation: Center for Primary Health Care Research, Institution of Clinical Sciences, Lund University, Lund, Sweden. veronica.milos@med.lu.se.
authors.forename: Veronica
authors.initials: V
authors.lastname: Milos
authors.forename: Åsa
authors.initials: Å
authors.lastname: Bondesson
authors.forename: Martina
authors.initials: M
authors.lastname: Magnusson
authors.forename: Ulf
authors.initials: U
authors.lastname: Jakobsson
authors.forename: Tommy
authors.initials: T
authors.lastname: Westerlund
authors.forename: Patrik
authors.initials: P
authors.lastname: Midlöv
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects; D014151:Anti-Anxiety Agents / Q000009:adverse effects*; D000928:Antidepressive Agents / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D006707:Homes for the Aged / Q000639:trends; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000639:trends; D011320:Primary Health Care / Q000379:methods* / Q000639:trends; D011619:Psychotropic Drugs / Q000009:adverse effects; D013548:Sweden / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D011619:Psychotropic Drugs