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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Fall-Risk-Increasing Drugs: A Systematic Review and Meta-analysis: III. Others
Journal of the American Medical Directors Association, Volume 19, No. 4, Year 2018
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Description
Background and objective: The use of psychotropic medication and cardiovascular medication has been associated with an increased risk of falling. However, other frequently prescribed medication classes are still under debate as potential risk factors for falls in the older population. The aim of this systematic review and meta-analysis is to evaluate the associations between fall risk and nonpsychotropic and noncardiovascular medications. Methods and design: A systematic review and meta-analysis. A search was conducted in Medline, PsycINFO, and Embase. Key search concepts were “falls,” “aged,” “medication,” and “causality.” Studies were included that investigated nonpsychotropic and noncardiovascular medications as risk factors for falls in participants ≥60 years or participants with a mean age ≥70 years. A meta-analysis was performed using the generic inverse variance method, pooling unadjusted and adjusted odds ratio (OR) estimates separately. Results: In a qualitative synthesis, 281 studies were included. The results of meta-analysis using adjusted data were as follows (a pooled OR [95% confidence interval]): analgesics, 1.42 (0.91-2.23); nonsteroidal anti-inflammatory drugs (NSAIDs), 1.09 (0.96-1.23); opioids, 1.60 (1.35-1.91); anti-Parkinson drugs, 1.54 (0.99-2.39); antiepileptics, 1.55 (1.25-1.92); and polypharmacy, 1.75 (1.27-2.41). Most of the meta-analyses resulted in substantial heterogeneity that did not disappear after stratification for population and setting in most cases. In a descriptive synthesis, consistent associations with falls were observed for long-term proton pump inhibitor use and opioid initiation. Laxatives showed inconsistent associations with falls (7/20 studies showing a positive association). Conclusion: Opioid and antiepileptic use and polypharmacy were significantly associated with increased risk of falling in the meta-analyses. Long-term use of proton pump inhibitors and opioid initiation might increase the fall risk. Future research is necessary because the causal role of some medication classes as fall-risk-increasing drugs remains unclear, and the existing literature contains significant limitations. © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine
Authors & Co-Authors
Daams, Joost G.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
van der Velde, Nathalie V.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Netherlands, Amsterdam
Vrije Universiteit Amsterdam
Blain, Hubert
Unknown Affiliation
Bousquet, Jean J.
Unknown Affiliation
Eklund, Patrik E.
Unknown Affiliation
Hartikainen, Sirpa A.
Unknown Affiliation
Kenny, Rose Anne
Unknown Affiliation
Laflamme, Lucie
Unknown Affiliation
Landi, Francesco L.
Unknown Affiliation
Petrovic, Mirko
Unknown Affiliation
Szczerbińska, Katarzyna E.
Unknown Affiliation
Statistics
Citations: 171
Authors: 11
Affiliations: 2
Identifiers
Doi:
10.1016/j.jamda.2017.12.099
ISSN:
15258610
Research Areas
Genetics And Genomics
Health System And Policy
Noncommunicable Diseases
Study Design
Cross Sectional Study
Case-Control Study
Study Approach
Qualitative
Systematic review