Pharmacy DailyPharmacy Daily | Wrong meds lead to falls

PSYCHOTROPIC medicines commonly prescribed for older people in aged care homes to treat mental health conditions may cause loss of balance and lead to unnecessary falls and injuries, with researchers saying the medications need to be reviewed.

Using data from 23 residential aged care facilities in Sydney caring for more than 3,000 older people, the team from the Australian Institute of Health Innovation at Macquarie University found 40% of aged care home residents were given "potentially inappropriate" psychotropic medicines such as benzodiazepines, antipsychotics and antiparkinsonian agents over a two-year period.

They found that 70% of the people who had received such medicines experienced at least one fall, compared with 62% who were not taking the medicines.

While the issue of the risk of falls related to psychotropic medicines has been raised in previous research, the latest study examines medicines that were actually administered to aged care home residents - other studies have only looked at drugs that are prescribed, but these are not always administered.

The study also broke down falls by their level of seriousness.

It showed that 70% of aged care home residents who used potentially inappropriate psychotropic medicines had at least one fall, 54% experienced an injury from a fall and 30% required hospitalisation from a fall.

The authors called for regular medication reviews in aged care homes "to reduce the unnecessary use of potentially inappropriate medicines".

"Medication reviews can alert clinicians and other care staff to a resident who may have been on a medication longer than the recommended time," said the paper's first author, Narjis Batool.

Aged care facilities could consider introducing training to help staff recognise people at risk of a fall, she added, and look at implementing prevention strategies, as well as exercise programs to increase the strength and balance of residents, and better lighting to prevent trips.

Pharmacist and senior author Dr Nasir Wabe said falls continue to be one of the leading challenges in aged care, but noted there are opportunities to prevent falls through targeted interventions.

"The Australian government has facilitated access to medication review services through initiatives such as embedded pharmacists and the Residential Medication Management Review programs, and providers are encouraged to make the most of these opportunities," Dr Wabe said.

Read the paper HERE. KB