Polypharmacy and medication related falls risk in orthogeriatric femoral fracture patients

Abstract

Aim: To report polypharmacy rates and identify specific medications that increase falls risk in orthogeriatric femoral fracture patients. Method: A retrospective sub-analysis, using the electronic medical records of patients admitted with a minimal trauma femoral fracture to a tertiary teaching hospital during a 12-monthperiod was undertaken. Specific medications associated with falls risk were classified under three specific groups: benzodiazepines, tricyclic antidepressants (TCAs), and non-benzodiazepine hypnotics. Results: A sample of 131patients was included in the audit. Of these, 99 patients (75.6%) were reported to be taking five or more medications prior to their falls related admission. From this, 49 patients (37.4%) were taking ten or more medications. One in five patients were found to be taking specified falls risk medications prior to admission, primarily benzodiazepines (75.8%). Conclusion: Orthogeriatric patients admitted to hospital with a femoral fracture following a minimal trauma fall were commonly taking five or more medications prior to admission. Over a third of patients that were reported to take ten or more pre-admission medications were taking specified falls risk medications. This highlights the need for medication-reviews and de-prescribing, particularly focusing on falls risk medications, to reduce incidence of falls and minimal trauma fractures in high risk patients

Keywords

• polypharmacy
• falls risk
• femoral fractures
• geriatrics