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Fall-risk increasing drugs and prevalence of polypharmacy in older patients discharged from an Orthogeriatric Unit after a hip fracture

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Abstract

Background

Polypharmacy and fall-risk increasing drugs (FRIDS) have been associated with injurious falls. We aimed to estimate the prevalence of polypharmacy and FRIDS in older patients discharged from an Orthogeriatric Unit after a hip fracture surgery.

Methods

This study describes the baseline findings of a 2-year retrospective cohort study. We included patients older than 80 years discharged from an Orthogeriatric Unit who were able to walk before surgery. Patient’s baseline variables, total number of drugs, and FRIDS at hospital discharge were collected.

Results

We included 228 patients. The mean number of drugs and FRIDS prescribed at discharge was 11.6 ± 3.0 and 2.9 ± 1.6, respectively. Polypharmacy was prevalent in all patients except in three: 23.3% (5–9 drugs) and 75.9% (≥ 10 drugs). Only 11 patients had no FRIDS and 35.5% were on > 3 FRIDS. The most prevalent FRIDS were: agents acting on the renin-angiotensin system (43.9%) and anxiolytics (39.9%). The number of FRIDS was higher in patients with extreme polypharmacy (3.4 ± 1.5) than in those on 5–9 drugs (1.5 ± 1.0, p < 0.05). Independent people in performing instrumental activities had lower risk of extreme polypharmacy (≥ 10 drugs) or > 3 FRIDS: OR 0.39 (95% CI 0.18–0.83) and OR 0.41 (95% CI 0.20–0.84), respectively. People living in a nursing home had higher risk of > 3 FRIDS: OR 4.03 (95% CI 1.12–14.53).

Conclusions

Polypharmacy and fall-risk increasing drugs are prevalent in patients discharged from orthogeriatric care after surgery for a hip fracture. Interventions on drug use at hospital discharge could have a potential impact on falls in this high-risk population.

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Funding

Authors did not receive any governmental or private grants.

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Authors and Affiliations

  1. Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Crta. Colmenar Km 9.1, 28034, Madrid, Spain

    Andrea Correa-Pérez & Alfonso J. Cruz-Jentoft

  2. Servicio de Farmacia, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain

    Eva Delgado-Silveira & Aurora M. Rojo-Sanchís

  3. Departamento de Farmacología, Facultad de Farmacia, Universidad Complutense, Madrid, Spain

    Sagrario Martín-Aragón

Authors
  1. Andrea Correa-Pérez
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  2. Eva Delgado-Silveira
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  3. Sagrario Martín-Aragón
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  4. Aurora M. Rojo-Sanchís
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  5. Alfonso J. Cruz-Jentoft
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Corresponding author

Correspondence to Andrea Correa-Pérez.

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Conflict of interest

Authors declare no competing interests. All authors have completed the Conflict of Interest Disclosure form and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.

Statement of human and animal rights

The study was approved by the Ethics Committee on Clinical Research of the Hospital Universitario Ramón y Cajal (Madrid) on May 2016.

Informed consent

No consent forms from patients were requested, as this is a retrospective study and hospital-collected data were analysed. Patients accept such kind of use of data when they are admitted to the hospital.

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Correa-Pérez, A., Delgado-Silveira, E., Martín-Aragón, S. et al. Fall-risk increasing drugs and prevalence of polypharmacy in older patients discharged from an Orthogeriatric Unit after a hip fracture. Aging Clin Exp Res 31, 969–975 (2019). https://doi.org/10.1007/s40520-018-1046-2

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  • DOI: https://doi.org/10.1007/s40520-018-1046-2

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