270Sedatives Usage in Inpatient Fallers in an Acute Hospital

Abstract

Background: Falls are among the most frequent and most significant incidents affecting inpatient safety. These are multifactorial events and falls risk can be modified by addressing many of these factors. One of the most important of these is polypharmacy, and in particular sedative medications. Medication review is a widely advocated risk reduction strategy. Methods: Retrospective review of falls in an Irish acute teaching hospital and tertiary referral centre. Falls on the inpatients was collected over a three-month period using incident report forms. The electronic discharge letter was reviewed. Information on demographics, length of stay, and medications prescribed on discharge was collected. Fall risk medications were identified and reviewed. Results: 273 patient electronic records were reviewed, with a mean age of 71.6 years. 43 (15.8%) patients did not have a completed discharge summary (either died or not available). Overall median medication was 10. 20.4% were on benzodiazepines/z-drugs on discharge. Antidepressants - 47.8%, Antipsychotics - 23.3%; Opioids - 34.4%. Usage of sedatives was more common in those over 65 (p<0.05) and those with a documented history of cognitive impairment (p<0.05), however, there was no difference in readmissions at 12 months. Conclusion: Medication reviews focused on falls prevention involves balancing minimising medications associated with falls and effectively treating underlying health conditions. Polypharmacy is a common finding in patients being discharged from our institute. Reviewing and discontinuing fall risk medications in older people and/or substituting them with other drugs not associated with the risk of falls in the older will to a large extent prevent these accidents. This information will guide the development of future falls risk medicine reviews initiatives in our hospital, increasing their feasibility in the acute hospital setting.