Falls risk increasing drugs in older people hospitalised with a fall
Research type
Research Study
Full title
Use of falls-risk increasing drugs in older people before and after hospitalisation with a fall
IRAS ID
314782
Contact name
Carole Parsons
Contact email
Sponsor organisation
Queen's University Belfast
Duration of Study in the UK
1 years, 7 months, 1 days
Research summary
Summary of Research
Falls are listed as the number one reason for trauma in older people at emergency departments. The older person who falls and loses mobility, can lose confidence, become depressed, more socially isolated and their health and wellbeing can be affected. There are many causes for falls, including the use of certain medicines or Falls Risk Increasing Drugs (FRIDs) and taking 4 or more medicines (also known as polypharmacy). Although Belfast Health & Social Care Trust (BHSCT) currently have a community falls pharmacist who visits patients in their own home to review their medicines, patients who have been admitted to hospital with a fall are not within the current pathway for this service.
The study will focus on older patients (65 years plus) admitted to BHSCT as an inpatient following a fall, to see what medicines they are on which may contribute to falls. We will include patients admitted to routine care of the elderly wards, and orthopaedic wards in Belfast HSC Trust. We will explore what medicines they are on which may increase risk of falls at the time of hospital admission, and if changes are made to any medicines carrying a falls risk, up to 3 months after discharge from hospital. The researcher, who is an employee of BHSCT, will request access to electronic health records for this patient cohort to enable their medication history to be checked in relation to medicines and falls. Written, informed consent will be sought from patients who must have capacity to consent, by the clinical pharmacists caring for these patients on the wards. Once consent is granted, the researcher will not need to contact the patient again as a list of medicines is available on the electronic health record. Patient consent will be collected over 6-12 months until 200 patients consented.Summary of Results
Introduction
Nearly five thousand older people aged 65 years or older attended a large Health and Social Care Trust Emergency Departments from April 2021 to March 2022, and 780 of these people who presented with a fall were admitted to hospital (Trust Business Services Activity Statistics May 2022). While information is growing on the effect of polypharmacy (taking many medicines) and Falls Risk Increasing Drugs (FRIDs) on falls risk in older people (Zia et al., 2015; Ganz and Latham, 2020; Zaninotto et al., 2020., Montero Odasso et al., 2021; Montero Odasso et al., 2022; Saeed et al., 2024; de Godoi Rezende Costa Molino et al., 2024), there is a lack of research exploring what happens to these medicines once a patient has had a hospital admission with a fall and is then discharged.
Falls Risk Increasing Drugs increase the risk of having a fall and include medicines used to treat low mood or depression, some pain-killers especially those known as opioids, and medicines to help sleep and anxiety.
One study in Europe involving adults aged 70 years or over living in the community, found that taking at least one Falls Risk Increasing Drug increased the risk of total falls, injurious falls and recurrent falls (de Godoi Rezende Costa Molino et al., 2024), especially in those taking many Falls Risk Increasing Drugs. Older adults often fall after discharge from hospital, with studies reporting that nearly half of older people fall in the six months after hospital discharge (Hill et al., 2011, Sherrington et al., 2014). There isn’t a lot of data looking at medicines associated with falls in the immediate post-hospitalisation period for an older adult who has been admitted with a fall. A detailed review of the evidence (systematic review) exploring use of Falls Risk Increasing Drugs found that their use at the time of a fall-related injury ranged from 65% to 93%, and medicines to treat depression or low mood, and to help sleep and anxiety (hypnotics) were the most commonly prescribed Falls Risk Increasing Drugs (Hart et al., 2020). Another study in a Spanish hospital found that the use of Falls Risk Increasing Drugs among older people admitted with a fall-related fracture was very high (91% received at least one Falls Risk Increasing Drug on admission), with an increase in use of medicines to treat depression and anxiety (hypnotics) one month after the fracture (Beunza-Sola et al., 2018).
Inappropriate prescribing and polypharmacy (taking many medicines) are found frequently in older people at hospital admission following a fall.
Older people make up a significant proportion of the post-hospital discharge population with one American study describing the increased incidence of falls, falls-related injuries including hip fracture, and medication complications following discharge (Mahoney et al., 2000). Thus it is important that older people admitted to hospital with a fall have a timely review of their medicines in relation to falls risk.
This might include stopping or slowly withdrawing medicines, also known as ‘deprescribing’, particularly around transitions of care such as hospital discharge.
Anticholinergic Burden or ACB is the effect some medicines have of blocking chemicals in the brain which may cause unwanted effects such as dry mouth, sleepiness and confusion, especially in older people.
In a previous study conducted within the Hospital Trust (Crawford et al., 2024), the role of a community falls pharmacist in reviewing medicines in older people who have fallen in a community-based setting was studied. However this service is not available to older people who have been admitted to hospital with a fall.
Carollo and colleagues undertook a detailed review of the effect of medication review and deprescribing (stopping or slowly withdrawing medicines) in older people and concluded that ‘integration of thorough medication review and deprescribing protocols in hospital settings may improve post-discharge outcomes and reduce overall healthcare costs’ (Carollo et al., 2024). This study improves our knowledge of which Falls Risk Increasing Drugs healthcare professionals such as doctors, nurses and pharmacists encounter during a patient hospital admission with a fall and in the immediate hospital discharge period to inform medication review and deprescribing protocols This will help us to inform how to ‘optimise’ or ensure these medicines are used in the most suitable way.
Aims and Objectives
The aim of this study was to explore how medicines are used in older people following hospital admission with a fall and up to three months following hospital discharge. The objectives are to find out if there is a change in number of medications prescribed, number of Falls Risk Increasing Drugs, anticholinergic burden and types of Falls Risk Increasing Drugs prescribed in older people coming in to hospital with a fall, during hospitalisation, and up to three months following discharge from hospital.Methods
Study design
This study was a quantitative study exploring how medicines changed during hospital stay, and three months after discharge, using medical records of older people admitted to hospital with a fall. The observational study design enabled us to obtain a thorough understanding of what really happens within the busy healthcare environment (in this case, the management of Falls Risk Increasing Drugs in the hospital setting) where there is limited time to collect data for research.
Study population: Who participated in the study?
All people admitted to Care of the Elderly and Orthopaedic wards across Trust sites were screened by local site collaborators (pharmacists already working on these wards) from March 2023 to November 2023 to determine whether they were eligible for inclusion in the study.
The inclusion criteria for this study were as follows:
• Age 65 years or older
• Taking 4 or more medicines
• Admitted to Care of the Elderly or Orthopaedic wards with a fall
• The person understands and is willing to agree to be included in the study
Exclusion criteria:
• Age under 65 years
• Taking less than 4 medicines
• Not admitted to the hospital wards with a fall
• Patient does not understand or does not want to be included in the study.
People who met the inclusion criteria were approached by the local site collaborator (a pharmacist already working in that ward) and provided with a participant information sheet and consent form. Those who agreed to participate returned the signed consent form to the ward pharmacist.
Personal and public involvement (PPI)
Advice and input from the Age NI consultative forum were obtained in June 2022 on the design and layout of the participant information sheet and consent form. Age NI is a charity supporting older people in Northern Ireland.
Sample size
Approximately 4870 older people aged 65 years or older attended Trust A&E departments between April 2021 and March 2022 (Trust activity statistics, accessed April 2022). Some of these people were then admitted to the Hospital (approximately 780 over the 12 months who had presented with a fall). A sample size of 114 people, based on the population size of 780, gave 95% confidence level and a margin of error of 8.5% (https://eur03.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.qualtrics.com%2F&data=05%7C02%7Capprovals%40hra.nhs.uk%7C12378f7f2bda4f9f9ba908dd36f207c2%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638727135345173114%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=q1orAyPAOduDpZCOPL3ChbIrJ2QiyFBuVXC2eda7%2Fx0%3D&reserved=0). The research team felt this number was the maximum number of people that could be recruited based on the available resources (pharmacists assigned to wards receiving older people with a fall, and the consultant pharmacist) and ensured that good quality data could be collected in a busy clinical environment.
Data Collection
The following data were gathered by the researcher (a consultant pharmacist for older people’s service) from the person’s electronic Health and Care record on hospital admission following a fall, on discharge from hospital, and at three months after discharge:
• data relating to hospital stay: date of admission to hospital, date of discharge from hospital, general discharge destination (e.g. care home, own home), age, gender, & whether or not they required surgery following the fall
• number of medications prescribed
• number, names and types of Falls Risk Increasing Drugs prescribed
• the anticholinergic burden score, calculated based on the medicines prescribed on the patient’s electronic Health and Care record using the Ageing Brain Care anticholinergic burden scale (ACBcalc®) and Medichec® calculation tool. ACBcalc® is a webpage used to calculate anticholinergic scores of medicines (how they affect the brain) based on the German Anticholinergic Burden Score (Kiesel et al., 2018) and the Anticholinergic Cognitive Burden Scale (Boustani et al., 2008; Lisibach et al., 2021). Medichec® is a web-based app developed by South London and Maudsley NHS Foundation Trust, that scores medicines according to how they affect chemicals in the brain (anticholinergic safety) using the Anticholinergic Effect on Cognition (AEC) score. This takes into account the anticholinergic effect of a medicine, the extent of this effect, whether it is able to get into the brain or not and whether there are reports of confusion with the medicine to support the score given.Primary outcomes:
Data were collected at baseline on patient admission to hospital, at discharge and at three months following discharge from hospital following a fall as follows:
• % change in number of medication prescribed
• % change in number of Falls Risk Increasing Drugs prescribed
• % change in Anticholinergic Burden measured using ACBcalc® and Medichec®
The hypothesis or speculation was that following a hospital admission with a fall, there would be an improvement in medicines optimisation in relation to falls for an older patient after discharge, as measured by outcomes 1-3 above and indicated by a reduction in number of medicines prescribed, of Falls Risk Increasing Drugs prescribed, and anticholinergic burden up to three months after hospital discharge following a fall, compared to baseline at admission.
The level of significance was set at 5%. (0.05). We tested for normality first to decide whether parametric or non parametric tests were appropriate to determine if the hypothesis was accepted or rejected.
Statistical analysis
Data were entered into a computer programme called IBM SPSS® Statistics software, version 29 (IBM Corp., New York, USA) for final analysis. Data were analysed descriptively through the generation of means, standard deviations, medians and interquartile ranges as appropriate. Inferential statistics were used as appropriate. The level of significance was set at 5% (0.05).
Data protection and security
It is not possible to identify any participants in any publication, presentation or report arising from this research.
Ethical and governance approvals
Approval for the study was granted by the Health and Social Care Research Ethics Committee B (HSC REC B) on 23rd January 2023 via the Integrated Research Application System (IRAS) (ID 314782 Ref 23/NI/001). University Governance approval was also sought and obtained (ref B22/22). Governance approval was obtained from Trust Research and Development Committee on 28th February 2023 (Ref 22082CP-AA). Recruitment commenced once these approvals were in place.Results
Data were collected from March 2023 to May 2024.
Of the 138 older people identified by the local site collaborators who met the eligibility criteria, 117 agreed to be included in the study. Four of these died before discharge from hospital, and the remaining 113 people were included in the study.
Most participants (80%) were female (n=90). Hospital inpatient length of stay ranged from 2 days to 247 days (median 24 days, mean 33 days). Age on admission to hospital ranged from 65 to 96 years (mean 81 years). Most participants (n=97; 86%) had a fracture following the fall.
At discharge from hospital, most participants (n=91; 80%) returned to their own home, 17 (15%) were discharged to a nursing home, 4 (3.5%) were discharged to an interim care home bed for rehabilitation, and one (1%) was discharged to a residential care home.
Polypharmacy (number of medicines prescribed):
There was a statistically significant difference in number of medicines per patient on admission to hospital compared to discharge from hospital (p < .001), from admission to 3 months after discharge (p <.001), and from discharge to 3 months after discharge (p <.001), with the mean number of medicines increasing from admission (8.053±.368(SE)) to discharge (11.788±.347(SE)) by 46.5%, and then reducing 3 months after discharge (10.664±.368(SE)) from hospital with a fall.The mean number of medicines per patient three months after discharge from hospital following a fall, remained higher than admission to hospital, increasing by nearly one third (32.4%) compared to admission.
The mean anticholinergic burden (ACB) score (ACBcalc®) increased by nearly 18% and the mean Anticholinergic Effect on Cognition (AEC) score (Medichec®) increased by nearly 20% from hospital admission with a fall to 3 months after hospital discharge.
Falls Risk Increasing Drugs
Number of Falls Risk Increasing Drugs
The number of Falls Risk Increasing Drugs per patient did not differ statistically significantly between the three time points (F(2, 224) = 2.898, p = .057).At three months following discharge from hospital with a fall, the most common Falls Risk Increasing Drugs were those used to treat high blood pressure, medicines for fluid, pain medicines, and medicines used to treat depression and anxiety, namely: bisoprolol, furosemide, codeine, amlodipine, amitriptyline, and diazepam, Dihydrocodeine, ramipril, mirtazapine and buprenorphine.
Codeine (a medicine to treat pain) was the most common FRID started after discharge from hospital in 13 (11.5%) people.Anticholinergic Burden (ACB) Score (calculated using ACBcalc®)
There were significant differences in anticholinergic burden score at the three time points X2(2, N=113) = 14.560, p<.001, suggesting a higher anticholinergic burden score three months after discharge from hospital with the lowest score occurring at discharge from hospital following a fall. There were no significant differences between the anticholinergic burden score at hospital discharge (2.05±.194(SE)) compared to anticholinergic burden score at hospital admission (2.04±.207(SE)) (Z= -.195, p = .845). However, there was a statistically significant increase in anticholinergic burden score by 17.6% three months after hospital discharge (2.40±.212(SE)) compared to hospital admission following a fall (Z= -2.976, p=.003), and a statistically significant increase in anticholinergic burden score by 17.1% three months after hospital discharge compared to anticholinergic burden score at hospital discharge (Z= -3.075, p=.002).The top 10 medicines associated with anticholinergic burden before and after hospitalisation with a fall include medicines for fluid, medicines to treat pain, low mood or depression, and medicines for anxiety.
Anticholinergic Effect on Cognition (AEC) Score (calculated using Medichec®)
There were significant differences in the Anticholinergic Effect on Cognition score at the three time points X2(2, N=113) = 19.015, p<.001. . Further analysis revealed no statistically significant differences between the mean Anticholinergic Effect on Cognition score at hospital discharge (1.00±.133(SE)) compared to mean Anticholinergic Effect on Cognition score at hospital admission (1.01±.137(SE)) (Z = -.431, p = .666). However there was a statistically significant increase in Anticholinergic Effect on Cognition score by 19.8% three months after hospital discharge (1.21±.145(SE)) compared to hospital admission following a fall (Z = -2.891, p=.004), and a statistically significant increase in Anticholinergic Effect on Cognition score 3 months after hospital discharge by 21% compared to Anticholinergic Effect on Cognition score at hospital discharge (Z= -5.753, p<.001).
The top 10 medicines associated with Anticholinergic Effect on Cognition before and after hospitalisation with a fall included medicines to treat low mood or depression, medicines for anxiety or nervousness, medicines that work on the bladder and those used to help sleep.Despite the recommendation that all individual drugs with anticholinergic effect on cognition score of 2 or above are reviewed (Medichec® South London and Maudsley NHS Trust), the number of medicines prescribed with Anticholinergic Effect on Cognition score 2 or above before and after hospitalisation with a fall increased.
Results Summary:
This study reported an increase in number of medicines prescribed, number of Falls Risk Increasing Drugs prescribed and number of medicines associated with anticholinergic burden prescribed in people aged 65 years or older, from hospital admission up to 3 months after discharge from hospital with a fall, which was statistically significant in relation to number of medicines prescribed, anticholinergic burden and anticholinergic effect on cognition.
Discussion
The World Guidelines for Falls Prevention and Management for older adults describe the prevention and management of falls and related injuries as a ‘critical global challenge’ in relation to reducing adverse impact, morbidity, mortality, and cost (Montero-Odasso et al., 2022). The use of polypharmacy (or many medicines), Falls Risk Increasing Drugs (FRIDs) and anticholinergic burden (ACB) are known to increase risk of falls in older people (Duerden et al., 2013; NICE, 2013, de Godoi Rezende Costa Molino et al., 2024 ). Despite this, we found that the number of medicines and Falls Risk Increasing Drugs prescribed per patient, and anticholinergic burden score including anticholinergic effect on cognition (AEC) all increased in older people following hospitalisation with a fall.
Number of medicines per person (Polypharmacy)Detailed reviews considering all available evidence known as systematic reviews and meta-analyses carried out by the European Geriatric Medicine Society (EuGMS), report consistent associations with falls and polypharmacy which they define as 4 or more medicines (Seppala et al., 2018a; de Vries et al., 2018). The Health, Aging and Body Composition Study undertaken in the USA found a link between persistent polypharmacy (defined as use of six or more prescription medications at both of the two most recent consecutive annual clinic visits) and increased risk for treated fall injuries from inpatient and outpatient settings, especially when combined with FRID use (Xue et al., 2021). However, this present study found that the mean number of medicines per patient increased by nearly one third from eight to nearly 11, from hospital admission with a fall to three months after discharge from hospital. This is an important finding as polypharmacy or the use of many medicines increases the risk of falls in older people; the addition of each medication above four has been reported to increase fall risk by 14% (Freeland et al., 2012).
Falls Risk Increasing Drugs:
The European Geriatric Medicine Society (EuGMS) Task and Finish group on Falls Risk Increasing Drugs (FRIDs) describe the importance of identifying and reducing the use of risk-increasing medications in older people as ‘an essential and effective component of a multifactorial fall-risk-management approach’ (Seppala et al., 2019). Lee and colleagues carried out a detailed review (also known as a systematic review and meta-analysis) of trials involving over 1000 people aged 65 years or older, and found that deprescribing Falls Risk Increasing Drugs did not change the rate of falls, incidence of falls or rate of fall-related injuries over 6-12 months follow–up (Lee et al., 2021). They concluded that there is a lack of good evidence to decide if a Falls Risk Increasing Drug deprescribing strategy alone is enough to prevent falls or fall related injury in older people. However a more recent three year study among community-dwelling adults in Europe aged 70 years or older, found that Falls Risk Increasing Drugs use was associated with increased prospective incidence rates of total, injurious and recurrent falls even among healthy older adults (de Godoi Rezende Costa Molino et al., 2024). Despite these risks of falls with Falls Risk Increasing Drugs use in older people, our study found the mean number of Falls Risk Increasing Drugs prescribed in older people increased by nearly 8% at hospital admission with a fall to three months after hospital discharge. Similarly, a systematic review found high use of Falls Risk Increasing Drugs among older people who had experienced a fall-related injury and no decrease in overall FRID use following the fall related healthcare episode (Hart et al., 2020).
This study found that at three months following discharge from hospital with a fall, the most common Falls Risk Increasing Drugs prescribed were those used to treat high blood pressure, fluid, pain medicines, and medicines used to treat depression and anxiety. Codeine used to treat pain was the most common Falls Risk Increasing Drug or FRID started after discharge from hospital.
Anticholinergic burden:
Individuals with recurrent or injurious falls are more likely to take medications with anticholinergic properties (Zia et al., 2016). Anticholinergic medications are used to block a chemical in our brain also known as a neurotransmitter ‘acetylcholine’ and are prescribed to treat a variety of medical conditions including Parkinson’s disease, allergies, chronic obstructive pulmonary disease (a condition affecting the lungs), depression and urinary or bladder incontinence. Medications with anticholinergic properties can be associated with dry eyes, urinary or bladder retention, dizziness, cognitive impairment (confusion or memory problems) and increased risk of falls (Marcum et al., 2015; Zia et al., 2016). As the body ages, its ability to metabolise or break down medications declines due to an age-associated decline in hepatic or liver and renal or kidney drug metabolism and an increase in blood-brain barrier permeability, and therefore older people are more likely to be affected by anticholinergic effects of their medications (Boustani et al., 2008; Bishara et al., 2017).
In addition to the anticholinergic burden (ACB) effect measured by the ACBcalc® scale, the Anticholinergic Effect on Cognition (AEC) scale measured using Medichec® takes into account the anticholinergic effect of a medicine, the extent of this effect, whether it is able to penetrate the brain or not and whether there are reports of cognitive impairment (confusion or memory loss) with the medicine to support the score given.
Medicines which have an effect on the mind (known as psychotropic medicines) including medicines for depression (eg amitriptyline, mirtazapine), medicines to treat mental health conditions (known as antipsychotics), benzodiazepines (eg diazepam), fluid tablets known as loop diuretics (eg furosemide), medicines for pain known as opioids (eg codeine, dihydrocodeine, buprenorphine), blood pressure medicines (antihypertensives), anticholinergics and polypharmacy (use of four or more medications) are amongst the high risk medications identified by the EuGMS Task and Finish Group on Falls Risk Increasing Drugs as associated with fall risk (Seppala et al., 2018a; Seppala et al., 2018b; de Vries et al., 2018; Seppala et al.,2019).However this present study found that three months after discharge from hospital following a fall, older people were prescribed more medicines, more Falls-Risk Increasing Drugs and more medicines associated with anticholinergic burden compared to at the time of admission to hospital with the fall
Possible explanation for the findings:
The National Institute for Health and Clinical Excellence (NICE) Guidance (2013) recommends that all older people with recurrent falls or who are assessed as being at increased risk of falling should be considered for an individualised multifactorial intervention including a medication review. However, this is challenging due to the difficulty in identifying who is responsible and best placed to undertake medicines optimisation to reduce falls risk in older people, as illustrated by studies highlighting the challenges in deprescribing in the hospital setting (Browne et al., 2014; Bennett et al., 2014., Kalim et al., 2022). Research suggests that deprescribing in the hospital setting is not optimal; one European study reported that over 50% of older hospitalised people were prescribed at least one potentially inappropriate medicine (Gallagher et al., 2011). A study conducted in Ireland in an acute hospital examined fifty inpatients at risk of falls and found that twenty percent of falls-risk medicines were suitable for discontinuation, dose reduction or switching to a safer alternative (Browne et al., 2014). In an Australian prospective cohort study of older adults admitted to hospital following a fall, those with frailty were prescribed a significantly higher number of Falls Risk Increasing Drugs, and the number prescribed on discharge was additionally significantly associated with recurrent falls (Bennett et al., 2014). A United Kingdom (UK) based study reported that only 0.6% percent of all admission medicines were deprescribed during a hospital admission (Scott et al., 2018), and a further study by the same authors concluded that deprescribing is a low hospital priority; the acute nature of a hospital admission requires prioritisation of the patient’s problems for immediate action, and the patient’s artificial lifestyle whilst in hospital, including medications being managed by healthcare staff and immobility, distorts assessments undertaken in hospital to inform long-term deprescribing decisions (Scott et al., 2020).
Deprescribing in primary care settings is also not without challenges; studies exploring primary care physicians’ and patient views on deprescribing, report barriers such as poor information sharing amongst organisations leading to hesitancy of primary care clinicians to deprescribe medicines prescribed by specialists in other care settings, competing demands on time, and patient-reported factors such as fear of withdrawal effects and lack of understanding around the decision to deprescribe (Wallis et al., 2017, Gillespie et al., 2018; Peat et al., 2022).
Conclusion
Given the significant negative impact on morbidity and mortality of falls in the older population and the need for modification/withdrawal of Falls Risk Increasing Drugs, this research highlights the need for prioritisation of medicines optimisation in older people presenting to hospital with a fall.Limitations to the study
This study was observational in nature but will help to inform other larger and more detailed studies such as randomised controlled trials in this area. We used the Northern Ireland Electronic Care Record to identify medicines that participants are taking, however this record does not hold details of any medicines people may be taking that are not supplied on prescription from their General Practitioner, namely ‘Over the Counter’ or ‘OTC’ medicines and herbal remedies bought in a retail chemist or shop.
Benefits of this study to patients and researchers:
In Northern Ireland, society is getting older, and by 2039, the population aged 65 years or older will have increased by seventy-four percent compared to 2014 (Department of Health NI, 2016). This presents a growing challenge in relation to the demands and pressures on health and social care services. In addition, there is a lack of research specific to the Northern Ireland population which has a different demographic and chronic disease burden compared to the rest of the UK with an abundance of mental health conditions and associated anxiety disorders (Steel et al., 2018). Many of the medicines used to treat anxiety disorders and mental health conditions fall into the FRID category.
This research will inform our knowledge of how medicines associated with increased risk of falls are managed after a hospital admission, which will help to channel resources to better deal with the growing challenges of falls in our older population, and ultimately deliver a person-centred approach. The study will potentially lead to improvements in how we optimise management of medicines in older people following a fall, and inform new pathways, policies and current practice. This research highlights the need for prioritisation of medicines optimisation in older people presenting to hospital with a fall and identified an increase in number of medicines prescribed, Falls Risk Increasing Drugs use and anticholinergic burden following hospitalisation of older people following a fall.
Dissemination of results
A one page summary of the study known as an abstract will be submitted to the British Geriatric Society Spring Conference 2025, University postgraduate day, and presented to a consultative forum at AgeNI. The researchers also plan to submit a research paper summarising the study and the results to an international research journal.References:
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HSC REC B
REC reference
23/NI/0001
Date of REC Opinion
23 Jan 2023
REC opinion
Favourable Opinion