268A Review of Medication in Inpatient Fallers in the Acute Hospital

Abstract

Background: Falls are among the most frequent and most significant incidents affecting inpatient safety, with medication being identified as a significant risk factor. Polypharmacy and potentially inappropriate prescribing (PIP) are areas of growing importance and concern. Medications used to treat cardiovascular conditions are the most common medications contributing to polypharmacy. The objective of this study was to identify the burden of medication in patients with falls in an acute tertiary referral hospital. 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 patients' records were reviewed. Mean age of 71.6 years. 43 (15.8%) patients did not have a completed discharge summary (either died or not available). 25% of patients had a documented history of cognitive impairment and dementia on their discharge summary. 86.3% of patients had >5 medications prescribed at discharge. 55.8% of patients were on anti-hypertensives, and was associated with an increased risk of readmission (p = 0.2). Anti-depressants (47.8%), anti-psychotics (21.1%) and sedatives (20.4%). 33.3% of patients were on secondary bone protection at discharge. Conclusions: Given that up to 40% of falls are preventable, it is vital to identify and address further risk factors for falls. Regular medication review for those taking five or more medications. The NICE guidelines re-iterates the importance of medication review, as part of a multifactorial approach to falls prevention. There are challenges changing or stopping medications as the clinical benefit may outweigh the falls risk to the patient.