Fall Incidence and the Use of Psychotropic, Opioid or Cardiovascular Medications
Journal Title: Annals of Physiotherapy & Occupational Therapy - Year 2018, Vol 1, Issue 1
Abstract
Background: Medications are one identifiable risk factor for falls. In addition to polypharmacy, certain medications have been associated with an increased risk for falls. The purpose of this study is to assess if the most frequently prescribed medication categories: psychotropic, opioid and cardiovascular are associated with an increased incidence of falls in community dwelling adults 65 years and older. Methods: This retrospective observational study used data collected from subjects who participated in the Senior Awareness and Fall Education Balance Screening Program throughout Fresno County from 2007-2014. A review was completed by one person to identify psychotropic, opioid, and cardiovascular medications. Due to the abundance of cardiovascular medications, this group was classified into 12 subcategories. Participants were identified as a faller if they had experienced ≥2 falls in the last year and ≤1 fall served as the comparison group. Results: A total of 509 participants were included. A stepwise logistic regression analysis was used to examine the predictor of falls. The overall model was statistically significant (P<.001). Furthermore, 70.3% of fallers and non-fallers were categorized correctly when subjects were taking psychotropic and opioid medications. Chi-square test analysis detected a statistically significant association between reported incidence of falls and use of either psychotropic or opioid but not cardiovascular medication category. When cardiovascular drug classes were subcategorized, the use of antiarrhythmic medication was statically significant. The strongest predictor for falls, however, was use of psychotropic and opioid medications combined. Subjects taking at least one medication from psychotropic drug class were 2.4 times (OR 2.4, CI 1.56-3.64) more likely to have reported a fall. Those taking opioid medications were only 2.1 times (OR 2.1, CI 1.17-2.23) more likely to have reported a fall. But, if the subjects were taking medications from both psychotropic and opioid classifications, they were 4.3 times (OR 4.3, CI 1.96-9.64) more likely to report a fall. Conclusion: Identification of older adults who consume anti-arrhythmic, opioids, or psychotropic medications could allow for patient education on adverse drug reactions, early intervention of fall prevention, or referral to physician/pharmacist for medication consolidation, in line with new national initiative for decreased opioid use.
Authors and Affiliations
Trueblood PR
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