An evaluation of injurious falls and Fall-Risk-Increasing-Drug (FRID) prescribing in ambulatory care in older adults

Taylor R. Elliott, Susan Westneat, Shama D. Karanth, Erin L. Abner, Anna M. Kucharska-Newton, Daniela C. Moga

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Falls are a major public health problem affecting millions of older adults each year. Little is known about FRID prescribing behaviors after injurious falls occur. The primary objective of this study was to investigate whether an injurious fall is associated with being prescribed a new FRID. Methods: We conducted a cross-sectional analysis using data from the National Ambulatory Medical Care Survey (2016). We included visits from patients age ≥ 65 years and classified visits based on presence of an injurious fall. The outcome of interest was prescription of new FRID between those with and without an injurious fall. Multivariable logistic regression weighted for sampling and adjusted for demographics, health history and other medications was used. Age and Alzheimer’s disease were examined as potential effect measure modifiers. Odds ratios and 95% confidence intervals were reported. Bayes factor upper bounds were also reported to quantify whether the data were better predicted by the null hypothesis or the alternative hypothesis. Results: The sample included 239,016,482 ambulatory care visits. 5,095,734 (2.1%) of the visits were related to an injurious fall. An injurious fall was associated with a non-statistically significant increase in odds of at least one new FRID prescription: adjusted OR = 1.6 (95% CI 0.6, 4.0). However, there was non-statistically significant evidence that the association depended on patient age, with OR = 2.6 (95% CI 0.9, 7.4) for ages 65–74 versus OR = 0.4 (95% CI 0.1, 1.6) for ages ≥ 75. In addition to age, Alzheimer’s disease was also identified as a statistically significant effect measure modifier, but stratum specific estimates were not determined due to small sample sizes. Conclusions: Ambulatory care visits involving an injurious fall showed a non-statistically significant increase in odds of generating a new FRID prescription, but this association may depend on age.

Original languageEnglish
Article number190
JournalBMC Geriatrics
Volume22
Issue number1
DOIs
StatePublished - Dec 2022

Bibliographical note

Funding Information:
This work was supported by the National Institute on Aging [R01AG054130]. This research did not receive any specific grant from funding agencies in the commercial or not-for-profit sectors.

Publisher Copyright:
© 2022, The Author(s).

Keywords

  • Fall-risk-increasing-drugs (FRIDs)
  • Injurious falls
  • Older adults
  • Prescribing behaviors

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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