Farmacéuticos Comunitarios. 2017 Mar 30; 9(1):28-33 DOI: 10.5672/FC.2173-9218.(2017/Vol9).001.04

Psychopharmaceuticals and the risk of falls among elderly people: preliminary results of the nested case-control pilot study in a Portuguese care home

Gimeno Palanca M, Aguiar JP, Costa AM, Alves da Costa F.
Gimeno M, Aguiar JP, Costa AM, Alves F. Psicofármacos y riesgo de caídas en ancianos: resultados preliminares del estudio piloto caso-control anidado en una residencia de ancianos portuguesa. Farmacéuticos Comunitarios. 2017 Mar 30; 9(1):28-33 DOI: 10.5672/FC.2173-9218.(2017/Vol9).001.04
Abstract : 
Introduction: Falls are frequent in the elderly, because they take medication that may increase the risk of falls, including psychotropic drugs.
 
Aims: To explore the relationship between the use of psychotropic drugs and the occurrence of falls in institutionalized patients, and to identify the most used drugs in these patients. In addition, it was studied the risk associated with the psychotropic drugs and the risk of falls that they caused. 
 
Methods: A nested case-control study was performed from a cohort of polypharmacy patients residing in a nursing home. Cases were those having suffered a fall from August 2014 to December 2015, and controls were those without falls recorded. The exposure of psychoactive drugs was explored retrospectively in both groups. Information was collected in the database of the nursing home. Analysis focused on the odds ratio of falling per pharmacotherapy group, using confidence intervals set at 95%.
 
Results: A sample of 22 patients, 9 cases and 13 controls, was analyzed: most patients were women, and the mean age was 82.3 years (SD=6.45). Residents used a mean of 11 medicines (SD=4.64). The most used pharmaceutical group and drug respectively were antipsychotics and quetiapine (59.1%, n=13; 45.5%, n=10). The OR determined in this study did not evidence any statistically significant association between the pharmacotherapeutic subgroups and/or drugs and increased risk of falling (quetiapine: OR=4.5; IC=0.730-27.739; atypical antipsychotics: OR=3.2; IC=0.540-18.980).
 
Conclusion: Results were obtained in a restricted sample, leading to the incapacity of demonstrating significant associations. However, a trend between the use of psychotropic drugs and the risk of falls in the elderly was shown, identifying the most influential pharmacotherapeutic groups in falls.
 
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