Two or more prescription medications doubles fall rate

Taking two or more prescription drugs at any one time seems to double the unintentional fall rate at home for the young and middle aged, similar to the effect seen in elderly people.


The journal Injury Prevention reported that drugs to lower high blood pressure and cholesterol were most commonly involved, the data showed.


The authors, Bridget Kool, Shanthi Ameratunga, Elizabeth Robinson, found a threefold increase in the odds of falls among people on antihypertensive medications, (consistent with previous research among older adults).


While this study did not have sufficient power to examine different groups of antihypertensives, Gribbin et al found thiazide prescription was associated with a threefold increase in risk of falls among older adults, and that the effect was strongest in the first 3 weeks of prescription.


The authors base their findings on a study looking at young and middle aged people of working age who died or required admission to hospital within 48 hours of an unintentional fall at home in Auckland, New Zealand, between 2005 and 2006.


In all, there were 344 such cases during the study period, and these were compared with 352 people randomly selected from the electoral register, matched for age and sex.


Taking prescription medicines emerged as a risk factor for injury associated with an unintentional fall.


Those taking two or more medications were 2.5 times as likely to sustain an injury as a result of an unintentional fall as those on fewer.


The findings held true, even after taking account of personal, social, and lifestyle factors, including hazardous drinking, illicit drug use, and sleep quotient in the previous 24 hours.


Of the six classes of medicines for which there were sufficient numbers for analysis, drugs to lower blood pressure and cholesterol seemed to triple the risk of a fall.


No increased risk was found for asthma inhalers, anti-inflammatories, steroids, or antidepressants.


It was not clear if these effects related to the drugs themselves or to the underlying conditions they were being used to treat.


Falls are a leading cause of injury and death around the world, say the authors, adding that most research on the topic, to date, has focused on children and older adults.


And they conclude that their research has “revealed a largely unrecognised problem among this younger age group.


Notwithstanding the limitations of this study, the findings signal a need for greater awareness of the association between prescription medications and falls in younger adults, whether this is due to the medications, underlying conditions or a combination of both related factors,” they write.


(Source: Injury Prevention – one of more than 35 specialist titles published by BMJ Group.)


16 January 2012.