Prevalence and Factors of Fall-Risk Increasing Drug Prescribing for Older Patients in Medical Wards

Abstract

INTRODUCTION: Falls represent a major health concern among older adults, frequently compounded by the use of fall-risk-increasing drugs (FRIDs). This study aims to assess the prevalence of FRID prescribing among older patients admitted to medical wards and at discharge in a Malaysian hospital  and  investigates the associations between patient characteristics and the prescribing of FRIDs. MATERIALS AND METHODS: This is a  retrospective cross-sectional study involving 455 older patients aged ≥60 years. FRIDs were identified using the Screening Tool of Older Persons’ Prescriptions in older adults with high falls risk (STOPPFall) criteria. Sociodemographic and clinical data, including polypharmacy and comorbidities, were analyzed for associations with FRID prescribing during admission and discharge. Results: FRIDs were prescribed to 60.7% of patients during admission and 48.4%  at discharge. During admission, FRID prescribing demonstrated significant associations with polypharmacy, prolonged hospitalization, and the presence of multiple chronic conditions. At discharge, FRID prescribing was significantly associated with polypharmacy and multiple chronic conditions. The most prescribed FRIDs during admission  included diuretics (28.4%), opioids (20.7%), and sedative antihistamines (8.1%), with these patterns persisting at discharge. Conclusion: FRID prescribing is prevalent during admission and at discharge, highlighting the need for targeted interventions. Pharmacists can play a critical role in mitigating fall risks through comprehensive medication reviews, deprescribing, and patient education.