title: Medication use and fall-risk assessment for falls in an acute care hospital.
abstract: OBJECTIVE
  A nested case-control study was carried out to examine relationships of a fall-risk score and the use of single medications and polypharmacy with falls among hospitalized patients aged 50 years and older in Taiwan.
  
  
  METHODS
  There were 83 patients who experienced a fall during hospitalization in an acute-care hospital. Matched by age and sex, five control patients for each case were randomly selected from all other inpatients who had not experienced any fall at the time of the index fall.
  
  
  RESULTS
  Patients who took tricyclic antidepressants, diuretics, and narcotics were 3.36-, 1.83- and 2.09-fold, respectively, more likely to experience a fall than their counterparts. Conversely, patients who took beta-blockers were 0.34-fold more likely than those who did not take them to experience a fall. Patients taking ≥6 medications were 3.08-fold more likely than those taking fewer medications to experience a fall, whereas those with anxiety were 4.72-fold more likely to experience a fall than those without. A high fall-risk score was not significantly associated with the occurrence of falls.
  
  
  CONCLUSIONS
  Among older hospitalized patients, tricyclic antidepressants, diuretics, narcotics, and polypharmacy should be mindfully prescribed and reviewed on a regular basis. A fall-risk scale developed from community-dwelling older people might not accurately predict falls in hospitalized patients. Further research to validate the negative effect of beta-blocker use on falls is required.
authors.affiliation: Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.|Department of Chest, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Ming-Huang
authors.initials: MH
authors.lastname: Chiu
authors.affiliation: Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.|Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Hsin-Dai
authors.initials: HD
authors.lastname: Lee
authors.affiliation: Department of Nursing, National Taipei University of Nursing and Health Science, Taipei, Taiwan.
authors.forename: Hei-Fen
authors.initials: HF
authors.lastname: Hwang
authors.affiliation: Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
authors.forename: Shih-Chieh
authors.initials: SC
authors.lastname: Wang
authors.affiliation: Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
authors.forename: Mau-Roung
authors.initials: MR
authors.lastname: Lin
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology
keywords: falls; hospital; medication use; older patients; psychotropics