1. The Influence of Medications on Falls in Community Dwelling Elderly
Sandra Spoelstra, PhD-c, MSN, RN 1; Charles Given, PhD 2; Barbara Given, PhD, RN, FAAN 1
Affiliations: Michigan State University of Nursing, 1 College of Nursing, 2 College of Human Medicine
Results
Mean age 79.1 years , 68.1% female, 31.6% had >1falls
73.9% Caucasian & 22.2% African American.
56.8% took 9+ medications which included:
-30.0% Anti-depressants % Hypnotics
-18.1% Anti-anxiety % Anti-psychotics
Number of medications positively correlates to the number of falls that occur (p-value 0.33).
Anti-depressants , hypnotics, and psychotics correlate with increased falls (p-value .00).
Problem Statement
Medication use can place older adults at risk for falls & increased health care utilization.
-This study compares and contrasts elderly with & without medications to determine if certain types, or number of medications impacts falls.
-The hypothesis is there is a relationship between patients with more medications or between certain types of drug classes & falls.
Number of Patient Falls by Number of Medications
Number
of Falls
Number
of Patients
Sample
13, 751 Community dwelling elderly age >65.
Using the Minimum Data Set for Home Care admission.
State of Michigan
Home & Community Based Waiver Medicaid Program.
Conclusion
As the number of medications increase, falls increase.
-Elderly (76+) Caucasian Females, are likely to fall when taking >9+ medications.
-Elderly patients taking anti-depressants, anti-psychotics, or hypnotics are likely to fall.
Design, Methodology, & Analysis
Retrospective, cross-sectional, secondary data analysis.
-A multivariate regression model with Maximum Likelihood Estimates with a Wald Chi-square are used to examine interactions among the variables in order to construct the final model .
This research was conducted while a Nurse Corp Fellow in the State of Michigan.
Implications for Nursing Practice
Nurses need to be aware that multiple medications or certain types of medications increase falls.
-Nurses can identify medications that may be contraindicated or unnecessary, then collaborate with the Physician to reduce contraindicated or unnecessary medications; ultimately reducing falls and improving quality of life.
Number of Medications (1 to 9+)