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Over Half of Falls Were Associated with Psychotropic Medication Use in Four Nursing Homes in Japan: A Retrospective Cohort Study

Author

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  • Nozomu Oya

    (Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan)

  • Nobutaka Ayani

    (Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
    Department of Psychiatry, Maizuru Medical Center, Kyoto 625-8502, Japan)

  • Akiko Kuwahara

    (Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan)

  • Riki Kitaoka

    (Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan)

  • Chie Omichi

    (Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
    Department of Psychiatry, Shiga University of Medical Science, Otsu 520-2192, Japan)

  • Mio Sakuma

    (Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya 663-8501, Japan)

  • Takeshi Morimoto

    (Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya 663-8501, Japan)

  • Jin Narumoto

    (Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan)

Abstract

Medication use can increase the risk of falls and injuries in nursing homes, creating a significant risk for residents. We performed a retrospective cohort study over one year to identify the incidence of drug-related falls with and without injury among four Japanese nursing homes with 280 beds. We evaluated the relationship between potential risk factors for falls and fall-related injuries while considering well-known risks such as ADLs and chronic comorbidities. By collaboratively reviewing care records, we enrolled 459 residents (mean age, 87) and identified 645 falls, including 146 injurious falls and 16 severe injurious falls requiring inpatient care, incidence: 19.5, 4.4, 0.5 per 100 resident-months, respectively. Medication influenced around three-quarters of all falls, >80% of which were psychotropic drugs. Regularly taking ≥5 medications was a risk factor for the initial falls (HR 1.33: CI 1.00–1.77, p = 0.0048) and injuries after falls (OR 2.41: CI 1.30–4.50, p = 0.006). Our findings on the incidence of falls with and without injury were similar to those in Western countries, where the use of psychotropic medication influenced >50% of falls. Discontinuing unnecessary medication use while simultaneously assessing patient ADLs and comorbidities with physicians and pharmacists may help to avoid falls in nursing homes.

Suggested Citation

  • Nozomu Oya & Nobutaka Ayani & Akiko Kuwahara & Riki Kitaoka & Chie Omichi & Mio Sakuma & Takeshi Morimoto & Jin Narumoto, 2022. "Over Half of Falls Were Associated with Psychotropic Medication Use in Four Nursing Homes in Japan: A Retrospective Cohort Study," IJERPH, MDPI, vol. 19(5), pages 1-11, March.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:5:p:3123-:d:765530
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    References listed on IDEAS

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    1. Sue Jordan & Hayley Prout & Neil Carter & John Dicomidis & Jamie Hayes & Jeffrey Round & Andrew Carson-Stevens, 2021. "Nobody ever questions—Polypharmacy in care homes: A mixed methods evaluation of a multidisciplinary medicines optimisation initiative," PLOS ONE, Public Library of Science, vol. 16(1), pages 1-26, January.
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