title: Psychotropic Drug-Related Fall Incidents in Nursing Home Residents Living in the Eastern Part of The Netherlands.
abstract: BACKGROUND
  Older people are more susceptible to falls than younger people. Therefore, as the Dutch population ages, the total number of falls and costs associated with them will rise. The use of psychotropic drugs is associated with an increased risk of falling. To create tailored fall-prevention programmes, information on the magnitude of the association between fall incidents and specific psychotropic drugs or drug classes is needed.
  
  
  OBJECTIVE
  The goal of this study was to delineate the associations between fall incidents and specific psychotropic drugs or drug classes.
  
  
  METHODS
  In this retrospective cohort study, electronic patient records, medication records and fall incident reports were collected for 1415 residents receiving somatic or psychogeriatric care in 22 nursing homes in the eastern part of the Netherlands from May 2012 until March 2015. Using a Cox proportional hazards model, we analysed the magnitude of the association between psychotropic drugs and the risk of falling for users and non-users of the psychotropic drugs or drug classes.
  
  
  RESULTS
  Antipsychotics (adjusted hazard ratio [aHR] 1.49; 95% confidence interval [CI] 1.12-2.00) and hypnotics and sedatives (aHR 1.51; 95% CI 1.13-2.02) increase the risk of falling. There was no difference between the risk incurred by typical and atypical antipsychotics. However, within these groups, there were differences between the most commonly prescribed drugs: haloperidol and quetiapine were seen to have an association with falls, whereas pipamperone and risperidone were not.
  
  
  CONCLUSIONS
  The results suggest falls may be associated with individual drugs rather than drug classes. Within the drug classes, clear differences are evident between individual drugs. Future fall-prevention programmes should highlight the differential risks involved with the use of specific psychotropic drugs, and doctors should take the fall risk into account when choosing specific drugs.
authors.affiliation: Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands. s.i.m.janus@utwente.nl.
authors.forename: Sarah I M
authors.initials: SIM
authors.lastname: Janus
authors.affiliation: Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands.
authors.forename: Gezinus H
authors.initials: GH
authors.lastname: Reinders
authors.affiliation: Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands.
authors.forename: Jeannette G
authors.initials: JG
authors.lastname: van Manen
authors.affiliation: Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
authors.forename: Sytse U
authors.initials: SU
authors.lastname: Zuidema
authors.affiliation: Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands.
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: IJzerman
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D015994:Incidence; D008297:Male; D009426:Netherlands; D009735:Nursing Homes / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012189:Retrospective Studies
chemical_list: D006993:Hypnotics and Sedatives; D011619:Psychotropic Drugs