A descriptive observational study on ‘medication-related injurious fall’ amongst elderly patients admitted to a tertiary care teaching hospital

Introduction: There is a scarcity of information on the impact of fall-risk-increasing drugs (FRIDs) amongst the elderly in the Indian population. Accidental falls and associated injuries in the elderly population contribute to substantial morbidity, mortality and rising healthcare expenditures. Objectives: There is a scarcity of information on the impact of Fall-risk-increasing drugs (FRIDs) amongst the elderly in the Indian population. Accidental falls and associated injuries in the elderly population contribute to substantial morbidity, mortality and rising health care expenditures. The study was carried out with the aim to evaluate the pharmacotherapeutic aspects of injurious falls in elderly patients and also identifies prabable risk factors for falls. Materials and Methods: A descriptive observational study for a 1-year duration included >65 years of patients, admitted to a tertiary care hospital, with major injuries (fractures and head injuries) due to a fall. The clinical and demographic details, including the consumption of FRIDs, comorbidities, cognitive function and fall-related injuries, were recorded. The literature was reviewed to compile a list of FRIDs, which encompassed cardiovascular medications, psychotropic drugs and other categories such as non-steroidal anti-inflammatory drugs (NSAIDs), opioids and antiepileptics. Results: Amongst the study participants, the mean age was 74.9 ± 7.0 years, with 74.1% females. The femur fractures were 86 (76.78%), the most common consequence of the fall. The probable causes of falls were hypotension (45.5%), diminished vision (37.5%), cognitive impairment (17.0%) and sedation (11.6%). The most common FRIDs consumed were antihypertensives (calcium channel blockers – 28.6% and angiotensin-converting enzyme-I – 15.2%), the other FRIDs received before falls were NSAIDs (8.9%), benzodiazepines (6, 5.4%), antidepressants (17%) and antidiabetic drugs (8.0%). The FRIDs per patient were 0.79 ± 1.02, with at least one FRID consumed by 42% of patients. Conclusion: Femur fracture was the consequence of falls in 76% of elderly people over the age of 70 years. In significant numbers, the consumption of at least 1 FRID was reported. Antihypertensives, analgesics and benzodiazepines were the most common FRID classes, with the probable cause of orthostatic hypotension and drowsiness. The study emphasises the need for a careful pharmacotherapeutic review of the elderly prone to injurious falls.