title: Use of fall risk increasing drugs in residents of retirement villages: a pilot study of long term care and retirement home residents in Ontario, Canada.
abstract: BACKGROUND
  Falls continue to be a problem for older people in long-term care (LTC) and retirement home (RH) settings and are associated with significant morbidity and health care use. Fall-risk increasing drugs (FRIDs) are known to increase fall risk and represent modifiable risk factors. There are limited data regarding the use of FRIDs in contemporary LTC and RH settings, and it has not been well documented to what extent medication regimens are reviewed and modified for those who have sustained falls. The objective of this study is to characterize medication related fall risk factors in LTC and RH residents and on-going use of medications known to increase fall risk.
  
  
  METHODS
  Retrospective chart review of residents aged >65 who sustained one or more falls living in LTC or RH settings.
  
  
  RESULTS
  105 residents who fell one or more times during 2009-2010 were identified with a mean age of 89 years, a mean of nine scheduled medications and seven diagnoses, and 83% were women. Residents in LTC were ostensibly at higher risk for falls relative to those in RH settings as suggested by higher proportion of residents with multiple falls, multiple comorbidities, comorbidities that increase fall risk and visual impairment. Post fall injuries were sustained by 42% of residents, and residents in RH sustained more injuries relative to LTC residents (47 vs 34%). Use of FRIDs such as benzodiazepines, antipsychotic, antidepressant and various antihypertensive drugs was common in the present sample. No medication regimen changes were noted in the 6-month post fall period.
  
  
  CONCLUSIONS
  The present study documented common use FRIDs by LTC and RH residents with multiple falls. These potentially modifiable falls risk factors are not being adequately addressed in contemporary practice, demonstrating that there is much room for improvement with regards to the safe and appropriate use of medications in LTC and RH residents.
authors.affiliation: Schlegel Research Chair in Geriatric Pharmacotherapy, Schlegel-UW Research Institute for Ageing, School of Pharmacy, University of Waterloo, 10 Victoria St S, Room 7004, Kitchener, ON, N2G 1C5, Canada. crojas-f@uwaterloo.ca.|, . crojas-f@uwaterloo.ca.
authors.forename: Carlos
authors.initials: C
authors.lastname: Rojas-Fernandez
authors.affiliation: University of Waterloo School of Pharmacy, Kitchener, ON, Canada. farzan_d@hotmail.com.
authors.forename: Farzan
authors.initials: F
authors.lastname: Dadfar
authors.affiliation: University of Waterloo School of Pharmacy, Kitchener, ON, Canada. aywong@uwaterloo.ca.
authors.forename: Andrea
authors.initials: A
authors.lastname: Wong
authors.affiliation: Schlegel-University of Waterloo Research Institute for Aging, 325 Max Becker Drive, Suite 202, Kitchener, ON, N2E 4H5, Canada. sgbrown@uwaterloo.ca.
authors.forename: Susan G
authors.initials: SG
authors.lastname: Brown
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000009:adverse effects*; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001569:Benzodiazepines / Q000009:adverse effects*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009735:Nursing Homes; D009864:Ontario; D010865:Pilot Projects; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000928:Antidepressive Agents; D000959:Antihypertensive Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines