Association of drug therapy with falls in elderly and senile patients: Subanalysis of the epidemiological study EVKALIPT

Abstract

Aim to evaluate the structure of drug therapy in patients with falls and to identify the associations of falls with drug administration.
 Material and methods. This work is a subanalysis of the epidemiological study EVKALIPT. 4301 patients who had information about presence or absence of falls in the previous year were selected. The patients were divided into 2 groups: 1 group (n = 1307) having falls, 2 group (n = 2994) without falls. We studied the complaints and medical history, conducted general examination and analyzed medical documentation to get the information on drug treatment. A regular intake of 5 or more drugs was considered polypharmacy.
 Results. All patients had chronic diseases. In patients with falls, most diseases were more common, the Charlson Comorbidity Index was higher (5.532.4 versus 4.732.03, p0.001), as well as the proportion of high comorbidity (62.2% versus 47.7%, p0.001). All study participants took medications, on average 5.4 2.6 drugs. The patients with falls received higher number of drugs (5.732.6 versus 5.32.5, p0.001). The frequency of polypharmacy was 64.6% and 56.7% (p0.001) in groups 1 and 2, respectively. The patients with falls were more likely to take sartans, beta-blockers, diuretics, centrally acting antihypertensives, anticoagulants, nitrates, amiodarone, insulin, NSAIDs, proton pump inhibitors, calcium, vitamin D, anti-osteoporrotic therapy. Administration of a number of drugs was associated with falls (OR 1.18-2.15). For some drugs, a trend in favor of falls was revealed. Only statin therapy was associated with a 24% reduction in the odds of falling. The presence of polypharmacy increased the risk of falls by 1.3 times (OR 1.27, 95% CI 1.10-1.46, p=0.001).
 Conclusion. Polypharmacy and drug evaluation are important in assessing the risk of falls. In clinical practice, it is necessary to regularly conduct an audit of medications in elderly patients.