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Over Half of Falls Were Associated with Psychotropic Medication Use in Four Nursing Homes in Japan: A Retrospective Cohort Study

Medication use can increase the risk of falls and injuries in nursing homes, creating a significant risk for residents. We performed a retrospective cohort study over one year to identify the incidence of drug-related falls with and without injury among four Japanese nursing homes with 280 beds. We...

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Autores principales: Oya, Nozomu, Ayani, Nobutaka, Kuwahara, Akiko, Kitaoka, Riki, Omichi, Chie, Sakuma, Mio, Morimoto, Takeshi, Narumoto, Jin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910089/
https://www.ncbi.nlm.nih.gov/pubmed/35270813
http://dx.doi.org/10.3390/ijerph19053123
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author Oya, Nozomu
Ayani, Nobutaka
Kuwahara, Akiko
Kitaoka, Riki
Omichi, Chie
Sakuma, Mio
Morimoto, Takeshi
Narumoto, Jin
author_facet Oya, Nozomu
Ayani, Nobutaka
Kuwahara, Akiko
Kitaoka, Riki
Omichi, Chie
Sakuma, Mio
Morimoto, Takeshi
Narumoto, Jin
author_sort Oya, Nozomu
collection PubMed
description Medication use can increase the risk of falls and injuries in nursing homes, creating a significant risk for residents. We performed a retrospective cohort study over one year to identify the incidence of drug-related falls with and without injury among four Japanese nursing homes with 280 beds. We evaluated the relationship between potential risk factors for falls and fall-related injuries while considering well-known risks such as ADLs and chronic comorbidities. By collaboratively reviewing care records, we enrolled 459 residents (mean age, 87) and identified 645 falls, including 146 injurious falls and 16 severe injurious falls requiring inpatient care, incidence: 19.5, 4.4, 0.5 per 100 resident-months, respectively. Medication influenced around three-quarters of all falls, >80% of which were psychotropic drugs. Regularly taking ≥5 medications was a risk factor for the initial falls (HR 1.33: CI 1.00–1.77, p = 0.0048) and injuries after falls (OR 2.41: CI 1.30–4.50, p = 0.006). Our findings on the incidence of falls with and without injury were similar to those in Western countries, where the use of psychotropic medication influenced >50% of falls. Discontinuing unnecessary medication use while simultaneously assessing patient ADLs and comorbidities with physicians and pharmacists may help to avoid falls in nursing homes.
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spelling pubmed-89100892022-03-11 Over Half of Falls Were Associated with Psychotropic Medication Use in Four Nursing Homes in Japan: A Retrospective Cohort Study Oya, Nozomu Ayani, Nobutaka Kuwahara, Akiko Kitaoka, Riki Omichi, Chie Sakuma, Mio Morimoto, Takeshi Narumoto, Jin Int J Environ Res Public Health Article Medication use can increase the risk of falls and injuries in nursing homes, creating a significant risk for residents. We performed a retrospective cohort study over one year to identify the incidence of drug-related falls with and without injury among four Japanese nursing homes with 280 beds. We evaluated the relationship between potential risk factors for falls and fall-related injuries while considering well-known risks such as ADLs and chronic comorbidities. By collaboratively reviewing care records, we enrolled 459 residents (mean age, 87) and identified 645 falls, including 146 injurious falls and 16 severe injurious falls requiring inpatient care, incidence: 19.5, 4.4, 0.5 per 100 resident-months, respectively. Medication influenced around three-quarters of all falls, >80% of which were psychotropic drugs. Regularly taking ≥5 medications was a risk factor for the initial falls (HR 1.33: CI 1.00–1.77, p = 0.0048) and injuries after falls (OR 2.41: CI 1.30–4.50, p = 0.006). Our findings on the incidence of falls with and without injury were similar to those in Western countries, where the use of psychotropic medication influenced >50% of falls. Discontinuing unnecessary medication use while simultaneously assessing patient ADLs and comorbidities with physicians and pharmacists may help to avoid falls in nursing homes. MDPI 2022-03-07 /pmc/articles/PMC8910089/ /pubmed/35270813 http://dx.doi.org/10.3390/ijerph19053123 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Oya, Nozomu
Ayani, Nobutaka
Kuwahara, Akiko
Kitaoka, Riki
Omichi, Chie
Sakuma, Mio
Morimoto, Takeshi
Narumoto, Jin
Over Half of Falls Were Associated with Psychotropic Medication Use in Four Nursing Homes in Japan: A Retrospective Cohort Study
title Over Half of Falls Were Associated with Psychotropic Medication Use in Four Nursing Homes in Japan: A Retrospective Cohort Study
title_full Over Half of Falls Were Associated with Psychotropic Medication Use in Four Nursing Homes in Japan: A Retrospective Cohort Study
title_fullStr Over Half of Falls Were Associated with Psychotropic Medication Use in Four Nursing Homes in Japan: A Retrospective Cohort Study
title_full_unstemmed Over Half of Falls Were Associated with Psychotropic Medication Use in Four Nursing Homes in Japan: A Retrospective Cohort Study
title_short Over Half of Falls Were Associated with Psychotropic Medication Use in Four Nursing Homes in Japan: A Retrospective Cohort Study
title_sort over half of falls were associated with psychotropic medication use in four nursing homes in japan: a retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910089/
https://www.ncbi.nlm.nih.gov/pubmed/35270813
http://dx.doi.org/10.3390/ijerph19053123
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