Psychotropic drug-induced falls in older people: A review of interventions aimed at reducing the problem
MetadataShow full item record
Falls are a common health problem for older people, and psychotropic medications have been identified as an important independent fall risk factor. The objective of this paper was to review the literature relating to the effect of psychotropic medications on falls in older people, with a particular focus on evidence supporting minimization of their use to reduce risk of falls. A literature search identified 18 randomized trials meeting the inclusion criteria for the review of effectiveness of psychotropic medication withdrawal studies, including four with falls outcomes. One of these, which targeted reduced psychotropic medication use in the community, reported a 66% reduction in falls, while the other studies demonstrated some success in reducing psychotropic medication use but with mixed effects on falls. Other randomized trials evaluated various approaches to reducing psychotropic medications generally or specific classes of psychotropic medications (e.g. benzodiazepines), but did not report fall-related outcomes. Overall, these studies reported moderate success in reducing psychotropic medication use, and a number reported no or limited worsening of key outcomes such as sleep quality or behavioural difficulties associated with withdrawal of psychotropic medication use. Reduced prescription of psychotropic medications (e.g. seeking non-pharmacological alternatives to their use in place of prescription in the first place or, for those patients for whom these medications are deemed necessary, regular monitoring and efforts to cease use or wean off use over time) needs to be a strong focus in clinical practice for three reasons.Firstly, psychotropic medications are commonly prescribed for older people, both in the community and especially in the residential care setting, and their effectiveness in a number of clinical groups has been questioned. Secondly, there is strong evidence of an association between substantially increased risk of falls and use of a number of psychotropic medications, including benzodiazepines (particularly, the long-acting agents), antidepressants and antipsychotic drugs. Finally, the largest effect of any randomized trial of falls prevention to date was achieved with a single intervention consisting of weaning psychotropic drug users off their medications.
Showing items related by title, author, creator and subject.
Preventing falls in In-Patient Older Adult Mental Health Services: Different Causative Factors in Mental and Neurocognitive DisordersHeslop, Karen; Wynaden, Dianne; Tohotoa, Jenny (2014)Aims: To compare falls sustained in two groups of patients (one with mental disorders and the other neurocognitive disorders), in two acute inpatient older adult mental health services in Western Australia (WA). Background: ...
Apikomonkon, Hataichanok (2003)Numerous Thai older people fall each year. Although it has been shown that only 3.1% of fallers sustained fractures (Nevitt, Cumming, Kidd, & Black, 1989), injuries in older people are often more serious. For example, ...
Falls After Discharge From Hospital: Is There a Gap Between Older Peoples’ Knowledge About Falls Prevention Strategies and the Research Evidence?Hill, A.; Hoffman, T.; Beer, C.; McPhail, S.; Hill, Keith; Oliver, D.; Brauer, S.; Haines, T. (2011)Purpose: The aim of this study was to examine whether older people are prepared to engage in appropriate falls prevention strategies after discharge from hospital. Design and Methods: We used a semi-structured interview ...