title: Psychotropic Drug Prescription and the Risk of Falls in Nursing Home Residents.
abstract: Falling is a common and serious problem in the elderly. Previous studies suggest that the use of psychotropic drugs increases the risk of falling. However, the contribution of these drugs on fall risk has not been quantified on a daily basis among the general population of nursing homes until now.
  
  
  
  To assess the association between fall incidence and the prescription of psychotropic drugs and different categories of psychotropic drugs (antipsychotics, antidepressants, and benzodiazepines) among a general nursing home population.
  
  
  
  Retrospective observational study, data collection per person-day.
  
  
  
  9 nursing homes in Eindhoven, the Netherlands.
  
  
  
  2368 nursing home residents, resulting in 538,575 person-days.
  
  
  
  Association between the prescription of psychotropic drugs and falls.
  
  
  
  A total of 2368 nursing home residents were included, which resulted in a data set of 538,575 person-days. Prescription of at least 1 psychotropic drug per day occurred during a total of 318,128 person-days (59.1%). Scheduled prescriptions with or without an as-needed prescription were involved in a total of 270,781 person-days (50.3%). The prescription of psychotropic drugs on a scheduled basis was found to be associated with almost a 3-fold increase in fall incidence (OR 2.88; 95% CI 1.52-5.44). An increase in fall incidence was found following the prescription of antipsychotics (OR 1.97; 95% CI 1.51-2.59) and antidepressants (OR 2.26; 95% CI 1.73-2.95). This increased fall risk was found for prescriptions on a scheduled basis as well as for prescriptions on an as-needed basis.
  
  
  
  The prescription of psychotropic drugs is associated with a strongly increased risk of falling among nursing home residents. To our knowledge, this is the first study among the general nursing home population in which the association between daily falls and daily prescriptions of psychotropic drugs and groups of psychotropic drugs was specified.
authors.affiliation: Department of Geriatrics, Catharina Hospital, Eindhoven, the Netherlands; Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Cox
authors.affiliation: Department of Geriatrics, Vlietland Hospital, Schiedam, the Netherlands.
authors.forename: Heike J
authors.initials: HJ
authors.lastname: van Jaarsveld
authors.affiliation: Department of Education and Research, Catharina Hospital, Eindhoven, the Netherlands.
authors.forename: Saskia
authors.initials: S
authors.lastname: Houterman
authors.affiliation: Vitalis WoonZorggroep, Eindhoven, the Netherlands.
authors.forename: John C G H
authors.initials: JC
authors.lastname: van der Stegen
authors.affiliation: Department of Clinical Pharmacy, Catharina Hospital, Eindhoven, the Netherlands.
authors.forename: Arthur T M
authors.initials: AT
authors.lastname: Wasylewicz
authors.affiliation: Department of Clinical Pharmacy, Catharina Hospital, Eindhoven, the Netherlands.
authors.forename: Rene J E
authors.initials: RJ
authors.lastname: Grouls
authors.affiliation: Department of Geriatrics, Catharina Hospital, Eindhoven, the Netherlands. Electronic address: carolien.vd.linden@catharinaziekenhuis.nl.
authors.forename: Carolien M J
authors.initials: CM
authors.lastname: van der Linden
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009735:Nursing Homes; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs
keywords: Psychotropic drug; fall; nursing home; nursing home resident