Medications and the risk of falls among older people in a geriatric centre in Nigeria: a cross-sectional study
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RESEARCH ARTICLE
Medications and the risk of falls among older people in a geriatric centre in Nigeria: a cross‑sectional study Wuraola Akande‑Sholabi1 · Francis. S. Ogundipe1 · Lawrence. A. Adebusoye2 Received: 3 March 2020 / Accepted: 25 August 2020 © Springer Nature Switzerland AG 2020
Abstract Background Falls are a major cause of morbidity and hospitalization in older people. Many drugs have been shown to increase the risk of falls in this population. Few empirical data exist on the use of fall-risk-increasing drugs among older people of sub-Saharan Africa countries. Objective This study aimed to assess the prevalence and predictors of falls, and the association between FRIDs, drugs causing orthostatic hypotension and falls. Setting Geriatric center, University College Hospital, Ibadan, Nigeria. Methods A cross-sectional study of 400 older patients aged ≥ 60 years selected consecutively at the geriatric centre, between September and November 2019, were interviewed using a semi-structured questionnaire. Socio-demographic information, medication utilization, and history of falls were obtained. Bivariate and multivariate analyses were carried out using SPSS 23. Alpha was set at 0.05. Main outcome measure Prevalence and predictors of falls among ambulatory older patients. Results The mean age of the older patients was 72.4 ± 7.3 years and 255 (63.7%) were females. The total number of FRIDs and ODs used by older patients was 578 (35.2%). The prevalence of fall was 181 (45.3%) which was significantly higher among the females compared with the males (51.8% vs 33.8%) p = 0.01. Classes of medications such as anti-Parkinson’s (p = 0.027), sedatives (p = 0.033), antipsychotics (p = 0.011) and anticholinergic (p = 0.027) were significantly associated with fall. Predictive factors for falls on logistic regression were female [OR = 2.375; 95% CI 0.274–3.704, p = 0.001] and use of antipsychotics [OR = 5.132; 95% CI 1.352–19.480, p = 0.016]. Conclusion The prevalence of falls was high and being a woman ≥ 60 years is a major risk factor for falling. Interventions to decrease falls in older patients by drug modification and deprescribing of FRIDs and ODs might reduce fall-related injuries. Thus, a multidisciplinary approach is essential for intervention to reduce the risk of falls and improve therapeutic outcomes among older patients. Keywords Falls · Fall-risk-increasing drugs · Geriatrics · Medications · Nigeria · Orthostatic drugs
Impacts on practice • The use of antipsychotics is a significant risk factor for
falls; therefore, patients using these medications should be given special consideration during medication therapy management and counselling by clinical pharmacists. • Female (≥ 60 years) is a major risk factor for falls among ambulatory patients. * Wuraola Akande‑Sholabi [email protected] 1
Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
Chief Tony Anenih Geriatric Centre, University College Hospital, Ibadan, Nigeria
2
• Awarenes
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