Psychotropic drug-related fall incidents in nursing home residents living in the eastern part of the Netherlands
Open accessAbstract
BACKGROUND: Older people are more susceptible to falls than younger people. Therefore, as the Dutch population ages, the total number of falls and costs associated with them will rise. The use of psychotropic drugs is associated with an increased risk of falling. To create tailored fall-prevention programmes, information on the magnitude of the association between fall incidents and specific psychotropic drugs or drug classes is needed. OBJECTIVE: The goal of this study was to delineate the associations between fall incidents and specific psychotropic drugs or drug classes. METHODS: In this retrospective cohort study, electronic patient records, medication records and fall incident reports were collected for 1415 residents receiving somatic or psychogeriatric care in 22 nursing homes in the eastern part of the Netherlands from May 2012 until March 2015. Using a Cox proportional hazards model, we analysed the magnitude of the association between psychotropic drugs and the risk of falling for users and non-users of the psychotropic drugs or drug classes. RESULTS: Antipsychotics (adjusted hazard ratio [aHR] 1.49; 95% confidence interval [CI] 1.12-2.00) and hypnotics and sedatives (aHR 1.51; 95% CI 1.13-2.02) increase the risk of falling. There was no difference between the risk incurred by typical and atypical antipsychotics. However, within these groups, there were differences between the most commonly prescribed drugs: haloperidol and quetiapine were seen to have an association with falls, whereas pipamperone and risperidone were not. CONCLUSIONS: The results suggest falls may be associated with individual drugs rather than drug classes. Within the drug classes, clear differences are evident between individual drugs. Future fall-prevention programmes should highlight the differential risks involved with the use of specific psychotropic drugs, and doctors should take the fall risk into account when choosing specific drugs.
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In older adults, psychotropic use has been associated with risk of severe adverse effects such as falls, stroke and mortality.
“In older adults, psychotropic use has been associated with the risk of severe adverse effects such as falls [13–18], stroke [17, 19–22] and mortality [13, 23–25].”
From Stakeholders' views on the use of psychotropic medication in older people: a systematic review (2022) · cites this paper as [16]
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Izza, M. A. D., Lunt, E., Gordon, A. L., Gladman, J. R. F., Armstrong, S., & Logan, P. (2020) · European Geriatric Medicine · doi:10.1007/s41999-020-00376-1 · Cited by 48 · see citing works
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Bednarczyk, E., Cook, S., Brauer, R., & Garfield, S. (2022) · Age and Ageing · doi:10.1093/ageing/afac060 · Cited by 22 · see citing works
- Authors
- Janus, S. I. M., Reinders, G. H., van Manen, J. G., Zuidema, S. U., & IJzerman, M. J.
- Affiliations
- University of Twente (NL)
- University Medical Center Groningen (NL)
- Corresponding author
- Janus, Sarah I. M.
- Venue
- Drugs in R&D
- Published
- 2017-04-08
- Volume
- 17
- Issue
- 2
- Pages
- 321-328
- ISSN
- 1174-5886 (ISSN-L)
- 1179-6901
- PMC
- PMC5427052
- OpenAlex
- W2604369955
- Cited by
- 26
- References
- 39
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 5 · 2022: 4 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 2
- FWCI
- 5.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Drugs in R&D (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- University of Twente Research Information (publishedVersion, other-oa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc)
- University of Twente Research Information (submittedVersion, other-oa)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- psychotropic drugs, falls, nursing home residents, antipsychotic drugs, sedative-hypnotic drugs, fall risk, fall prevention, older adults, haloperidol, quetiapine, typical and atypical antipsychotics, drug safety
- MeSH terms
- Accidental Falls, Aged, 80 and over, Female, Humans, Hypnotics and Sedatives, Male, Netherlands, Nursing Homes, Psychotropic Drugs, Retrospective Studies, Incidence, Proportional Hazards Models
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