Withdrawal of Fall Risk-Increasing Drugs

Book chapter (2016)

Authors

N. van der Velde Amsterdam UMC

T.J.M. van der Cammen Applied Ergonomics and Design - , Erasmus MC

Research Group

Applied Ergonomics and Design () (TU Delft)

Standard deviation United States Randomized controlled trial Benzodiazepines or related drug Control group Drug–drug interaction Fall risk-increasing drugs Intervention group Interquartile range Nonsteroidal anti-infl ammatory drugs Timed up and Go

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Published Date

2016

Language

English

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Faculty

Industrial Design Engineering

Department

Human-Centered Design

Research Group

Applied Ergonomics and Design

Abstract

Falls are among the most serious problems faced by older persons and
are associated with considerable morbidity and mortality. Falls are multifactorial in origin. Hence, assessment of falls and fall risk is a
complex task. An important risk factor for falls is the use of certain drugs, i.e., fall risk-increasing drugs (FRIDs). The exact contribution of FRIDs use to fall risk is not known. To date, information about the effects and effectiveness of FRIDs withdrawal on falls in older persons is scarce.
There is evidence that withdrawal of psychotropics reduces rate of falls and that a prescribing modifi cation program for primary care physicians can reduce risk of falling. Withdrawal of all FRIDs, including cardiovascular and psychotropic drugs, appears to be an effective intervention for lowering fall incidence and can lead to improvement of mobility tests and cardiovascular end points. Withdrawal of psychotropics, especially benzodiazepines (BZD), was an important factor in lowering risk of falls requiring medical treatment during the fi rst year after a 12-month multifactorial intervention. BZD withdrawal has also been shown to result in a signifi -
cant improvement in the stability of the body, a recovery of cognitive functions, and improvement of handgrip strength and balance.
Pharmacological interventions, including withdrawal of FRIDs, pharmacistconducted clinical medication review, and computerized drug alerts, are effective in reducing fall risk and should be incorporated in the care of older persons.