Falls in older patients treated for cancer in French outpatient departments: screening and prevention—a prospective observational study

PURPOSE: International guidelines published in 2022 recommend annual fall risk (FR) screening in adults aged ≥ 65 years. Older cancer patients are at increased risk of falls due to cancer-related symptoms, treatment toxicities, and concomitant medications. Falls may negatively impact cancer care and outcomes. METHODS: This exploratory multicenter cross-sectional and prospective study included patients aged ≥ 65 years treated for cancer in ten oncology ambulatory care units. Patients were recruited during World Patient Safety Day in September 2024. FR screening and preventive recommendations followed international guidelines. A 3-month follow-up assessed implementation in patients at high FR. The primary objective was to describe the prevalence of fallers and the distribution in the three FR levels in older adults with cancer. The secondary objectives were to identify factors associated with being at high FR and assess the feasibility of fall prevention recommendations. RESULTS: Among 328 patients, 21% reported at least one fall in the previous year and 15% were classified as high FR. High FR was independently associated with older age (OR 1.33 per 5-year increase), taxane treatment (OR 3.74), and exposure to ≥ 2 fall-risk-increasing drugs (FRIDs) (OR 2.19). Polypharmacy was frequent (61%) but not associated with high FR. At 3 months, only 24% of high FR patients had fully implemented preventive recommendations, mainly biological assessments (60%), medication review (48%), and cardiovascular evaluation (43%). CONCLUSION: High FR in older cancer patients is associated with potentially reversible pharmaceutical factors. Fall prevention recommendations remain poorly implemented, highlighting the need for structured multidisciplinary approaches. TRIAL REGISTRATION NUMBER: NCT06504628, registered on 2024-07-10.