Medication reviews are effective in preventing fall-related injuries in older adults

Fall-related injuries result in substantial economic burden to an individual and the healthcare system. About 30% of community-dwelling older adults fall each year: 30% to 50% of these falls lead to minor injuries (e.g., bruises, lacerations), while 5% to 10% of falls result in serious injuries (e.g., wrist or hip fractures, traumatic brain injury). Fall-related injuries can have adverse consequences such as disability, reduced independence and mobility, a fear of falling, increased likelihood of admission to long-term care facilities and higher risk of death. Medication side effects, as well as drug-drug and drug-disease interactions, could lead to an increased risk of falls, injuries, hospital admissions and diminished quality of life. A recent systematic review and meta-analysis conducted at Western University in London, Ont. evaluated the role of medication review as a single intervention or combined with other interventions in preventing fall-related injuries in older community-dwelling adults. Read: How to prevent, assess and treat depression among older adults Pooled results from 11 studies produced 714 fall-related injuries in the intervention (medication review) group and 913 in the control group. The meta-analysis showed that the risk difference [RD] of -0.07 (95% CI: -0.11 to -0.02, p = 0.007) was significantly in favour of the intervention group. Results of five studies in which fall-related fractures were outcomes were pooled together. The pooled results favoured the intervention group slightly, with the RD = -0.02 (95% CI: -0.04 to -0.01, p = 0.01). Results of four studies using medication review alone as a single intervention were pooled together. Compared with usual care, medication review alone was found to lower the risk of fall-related injuries in community-dwelling older adults (RD = -0.07, 95% CI: -0.11 to -0.02, p = 0.008). Read: Key issues in managing hypertension in the elderly Pooled results of two studies used hospital admission due to falls as an outcome. Results were inconclusive regarding whether the intervention group had a lower risk of fall-related admissions, compared to the control group (RD = -0.03, 95% CI: -0.09 to 0.02, p = 0.23). In summary, this systematic review and meta-analysis found medication review to be effective in preventing fall-related injuries and fall-related fractures in community-dwelling older adults, when used as a single intervention or as part of a multifactorial fall prevention program. The review was not conclusive as to whether medication review was effective in reducing fall-related hospital admissions in older adults. The authors concluded that their systematic review and meta-analysis demonstrates that medication review is beneficial in preventing fall-related injuries in general, and fractures specifically, in community-dwelling older adults. They recommend future investigations focusing on the process of performing medication reviews to further inform fall-related injury prevention for older adults. Read: Anemia of chronic disease: A contemporary approach Reference 1. Ming Y, Zecevic AA, Hunter SW, et al. Medication review in preventing older adults’ fall-related injury: a systematic review & meta-analysis. Can Geriatr J 2021;24:237-50. https://cgjonline.ca/index.php/cgj/article/view/478/704 (accessed October 26, 2021).

Medication reviews are effective in preventing fall-related injuries in older adults

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