Preventing Falls in the Elderly: The Role of the Pharmacist

摘要

Falls are a common and often devastating occurrence for the elderly in home and institutional settings. The physical, psychological, and economic consequences of falls are significant. Elderly patients at highest fall risk usually have a number of predisposing conditions contributing to that risk. Medications are frequently associative factors in falls in the elderly. The overall number of medications prescribed is often as important as the choice of drug in determining potential for falls. The medications most often implicated in falls are antipsychotics, sedative-hypnotics, antidepressants, type I antiarrhythmics, anticonvulsants, narcotics, and other medications with significant anticholinergic side effects. The literature regarding medications and fall risk is conflicting and difficult to interpret and apply. Confounding variables contributing to this ambiguity include pharmacokinetic factors, range of doses administered, coexisting medical problems, differences in patient care settings, study duration, and outcomes measured. Strategies and considerations for pharmacist assessment of medication-related fall risk are presented.