Pharmacy, Health Sciences, & Exercise Science
Correlation Between Initiation or Dose Increase of Central Nervous System Medications and Inpatient Falls
Document Type
Oral Presentation
Location
Indianapolis, IN
Start Date
13-4-2018 9:45 AM
End Date
13-4-2018 10:15 AM
Sponsor
Lindsay Saum (Butler University), Brian Skinner (Manchester University)
Description
Introduction: While several studies have examined the association between central nervous system (CNS) medications and falls, none have analyzed whether initiating or intensifying CNS medications in an inpatient setting impacts patient fall risk. The study aims to identify potential risk factors for inpatient falls.
Research Hypothesis: Initiating or increasing the dose of CNS medications increases fall risk in hospitalized patients.
Study Design: Case-cohort, retrospective chart review over two years
Methods: Inclusion criteria were: age greater than 40 years, length of stay greater than 48 hours, and receipt of at least one of the studied CNS medications. Exclusion criteria were: admission for a fall, usage of depot medications, or fall occurring prior to the index date (median time to fall) for the control group. Studied CNS medication classes were antipsychotics, tricyclic antidepressants (TCAs), non-TCA antidepressants, gabapentinoids, and sedative hypnotics. The study compared home and inpatient medications and categorized them according to the presence or absence of dose escalation or initiation. The primary outcome was to measure the relationship between initiation or increase of CNS medications and the occurrence of falls.
Results: The escalation or initiation of individual CNS medication classes were not found to significantly increase the risk of inpatient falls. However, the use of 3 or more CNS medications (p=0.01) and the intensification of 2 or more CNS medications (p=<0.001) significantly increased fall risk.
Conclusions: This study did not correlate starting or increasing a CNS medication with inpatient falls, although changes in multiple medication classes significantly increased fall risk.
Correlation Between Initiation or Dose Increase of Central Nervous System Medications and Inpatient Falls
Indianapolis, IN
Introduction: While several studies have examined the association between central nervous system (CNS) medications and falls, none have analyzed whether initiating or intensifying CNS medications in an inpatient setting impacts patient fall risk. The study aims to identify potential risk factors for inpatient falls.
Research Hypothesis: Initiating or increasing the dose of CNS medications increases fall risk in hospitalized patients.
Study Design: Case-cohort, retrospective chart review over two years
Methods: Inclusion criteria were: age greater than 40 years, length of stay greater than 48 hours, and receipt of at least one of the studied CNS medications. Exclusion criteria were: admission for a fall, usage of depot medications, or fall occurring prior to the index date (median time to fall) for the control group. Studied CNS medication classes were antipsychotics, tricyclic antidepressants (TCAs), non-TCA antidepressants, gabapentinoids, and sedative hypnotics. The study compared home and inpatient medications and categorized them according to the presence or absence of dose escalation or initiation. The primary outcome was to measure the relationship between initiation or increase of CNS medications and the occurrence of falls.
Results: The escalation or initiation of individual CNS medication classes were not found to significantly increase the risk of inpatient falls. However, the use of 3 or more CNS medications (p=0.01) and the intensification of 2 or more CNS medications (p=<0.001) significantly increased fall risk.
Conclusions: This study did not correlate starting or increasing a CNS medication with inpatient falls, although changes in multiple medication classes significantly increased fall risk.