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EuGMS Task and Finish group on Fall-Risk-Increasing Drugs (FRIDs): Position on Knowledge Dissemination, Management, and Future Research

. 2019 Apr ; 36 (4) : 299-307.

Language English Country New Zealand Media print

Document type Journal Article, Research Support, Non-U.S. Gov't

Links

PubMed 30741371
PubMed Central PMC6435622
DOI 10.1007/s40266-018-0622-7
PII: 10.1007/s40266-018-0622-7
Knihovny.cz E-resources

Falls are a major public health concern in the older population, and certain medication classes are a significant risk factor for falls. However, knowledge is lacking among both physicians and older people, including caregivers, concerning the role of medication as a risk factor. In the present statement, the European Geriatric Medicine Society (EuGMS) Task and Finish group on fall-risk-increasing drugs (FRIDs), in collaboration with the EuGMS Special Interest group on Pharmacology and the European Union of Medical Specialists (UEMS) Geriatric Medicine Section, outlines its position regarding knowledge dissemination on medication-related falls in older people across Europe. The EuGMS Task and Finish group is developing educational materials to facilitate knowledge dissemination for healthcare professionals and older people. In addition, steps in primary prevention through judicious prescribing, deprescribing of FRIDs (withdrawal and dose reduction), and gaps in current research are outlined in this position paper.

Academic Department of Geriatric Medicine Brighton and Sussex Medical School Brighton Sussex UK

AZ Alma Eeklo Belgium

Department of Clinical and Experimental Science University of Brescia Brescia Italy

Department of Clinical Epidemiology Leibniz Institute for Prevention Research and Epidemiology BIPS Bremen Germany

Department of Computing Science Umeå University Umeå Sweden

Department of Elderly Medicine Brighton and Sussex University Hospitals NHS Trust Sussex UK

Department of Epidemiology Erasmus MC University Medical Centre Rotterdam Rotterdam The Netherlands

Department of Geriatric Medicine Cork University Hospital Cork Ireland

Department of Geriatric Medicine Odense University Hospital Odense Denmark

Department of Geriatrics and Gerontology 1st Faculty of Medicine Charles University Prague Czech Republic

Department of Geriatrics University Medical Center Utrecht Utrecht University Utrecht The Netherlands

Department of Gerontology Neuroscience and Orthopedics Catholic University of the Sacred Heart Rome Italy

Department of Health Sciences Public University of Navarra Avda Barañain s n 31008 Pamplona Spain

Department of Internal Medicine and Geriatrics University Hospital of Montpellier Montpellier University Euromov France

Department of Internal Medicine Erasmus MC University Medical Centre Rotterdam Rotterdam The Netherlands

Department of Internal Medicine Ghent University Ghent Belgium

Department of Internal Medicine Section of Geriatric Medicine Amsterdam Public Health Research Institute Amsterdam UMC University of Amsterdam Meibergdreef 9 1105AZ Amsterdam The Netherlands

Department of Medical Gerontology School of Medicine Trinity College Dublin Dublin 2 Ireland

Department of Medicine University College Cork Cork Ireland

Department of Public Health Sciences Karolinska Institutet Tomtebodavägen 18A Widerströmska huset 17177 Stockholm Sweden

Effective Prescribing and Therapeutics Health and Social Care Directorate Scottish Government Edinburgh Scotland UK

Faculty of Health and Social Sciences South Bohemian University Česke Budějovice Czech Republic

Faculty of Industrial Design Engineering Delft University of Technology Delft The Netherlands

Faculty of Medicine University of Iceland Reykjavik Iceland

Falls and Syncope Unit Mercer's Institute for Successful Ageing St James's Hospital Dublin 8 Ireland

Geriatria Accettazione geriatrica e Centro di ricerca per l'Invecchiamento Italian National Research Center on Aging Ancona Italy

Geriatric Research Unit Department of Clinical Research University of Southern Denmark Odense Denmark

Institute of Clinical Pharmacology Mannheim University of Heidelberg Heidelberg Germany

Institute of Hygiene and Clinical Epidemiology University Hospital of Udine Udine Italy

Istanbul Medical School Department of Internal Medicine Division of Geriatrics Istanbul University Capa 34093 Istanbul Turkey

Landspitali University Hospital Reykjavik Iceland

Nottingham University Hospitals NHS Trust Nottingham UK

School of Pharmacy University of Eastern Finland Kuopio Finland

Servicio de Geriatría Hospital Universitario de Getafe and CIBER de Fragilidad y Envejecimiento Saludable Getafe Madrid Spain

Servicio de Geriatría Hospital Universitario Ramón y Cajal Madrid Spain

The Irish Longitudinal Study on Ageing Trinity College Dublin Dublin 2 Ireland

Trauma Center Wien Meidling Kundratstrasse 37 1120 Vienna Austria

Unit for Research on Aging Society Department of Sociology of Medicine Epidemiology and Preventive Medicine Chair Faculty of Medicine Jagiellonian University Medical College Krakow Poland

University of Luxembourg Ezch sur Alzette Luxembourg

See more in PubMed

Hartholt KA, van Beeck EF, Polinder S, van der Velde N, van Lieshout EM, Panneman MJ, et al. Societal consequences of falls in the older population: injuries, healthcare costs, and long-term reduced quality of life. J Trauma. 2011;71:748–753. doi: 10.1097/TA.0b013e3181f6f5e5. PubMed DOI

Centers for Disease Control and Prevention. Home and Recreational Safety. Important facts about falls. 2017. http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html Accessed 1 May 2018.

EuroSafe. EuroSafe. Injuries in the European Union, Summary on injury statistics 2012–2014. 2016. http://www.bridge-health.eu/sites/default/files/EuropeSafe_Master_R4_SinglePage_12102016%20%281%29.pdf. Accessed 1 Mar 2018.

Heinrich S, Rapp K, Rissmann U, Becker C, König H-H. Cost of falls in old age: a systematic review. Osteoporos Int. 2010;21:891–902. doi: 10.1007/s00198-009-1100-1. PubMed DOI

Carroll NV, Slattum PW, Cox FM. The cost of falls among the community-dwelling elderly. J Manag Care Pharm. 2005;11:307–316. PubMed PMC

Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;2012:Cd007146. PubMed PMC

Mair AF-LF, Alonso A, Harrison C, Hurding S, Kempen T, Kinnear M, Michael N, McIntosh J, Wilson M. The Simpathy consortium. Polypharmacy management by 2030: a patient safety challenge. 2017. http://www.simpathy.eu/resources/publications/simpathy-project-reference-book. Accessed 14 Apr 2018.

Laing SS, Silver IF, York S, Phelan EA. Fall prevention knowledge, attitude, and practices of community stakeholders and older adults. J Aging Res. 2011;2011:9. doi: 10.4061/2011/395357. PubMed DOI PMC

Bell HT, Steinsbekk A, Granas AG. Factors influencing prescribing of fall-risk-increasing drugs to the elderly: a qualitative study. Scand J Prim Health Care. 2015;33:107–114. doi: 10.3109/02813432.2015.1041829. PubMed DOI PMC

Bell HT, Steinsbekk A, Granas AG. Elderly users of fall-risk-increasing drug perceptions of fall risk and the relation to their drug use—a qualitative study. Scand J Prim Health Care. 2017;35:247–255. doi: 10.1080/02813432.2017.1358438. PubMed DOI PMC

Gillespie R, Mullan J, Harrison L. Managing medications: the role of informal caregivers of older adults and people living with dementia. A review of the literature. J Clin Nurs. 2014;23:3296–3308. doi: 10.1111/jocn.12519. PubMed DOI

Hoffmann TC, Del Mar C. Clinicians’ expectations of the benefits and harms of treatments, screening, and tests: a systematic review. JAMA Intern Med. 2017;177:407–419. doi: 10.1001/jamainternmed.2016.8254. PubMed DOI

Reeve E, Low L-F, Hilmer SN. Beliefs and attitudes of older adults and carers about deprescribing of medications: a qualitative focus group study. Br J General Pract. 2016;66:e552–e560. doi: 10.3399/bjgp16X685669. PubMed DOI PMC

Reeve E, To J, Hendrix I, Shakib S, Roberts MS, Wiese MD. Patient barriers to and enablers of deprescribing: a systematic review. Drugs Aging. 2013;30:793–807. doi: 10.1007/s40266-013-0106-8. PubMed DOI

Seppala LJ, Wermelink A, de Vries M, Ploegmakers KJ, van de Glind EMM, Daams JG, et al. Fall-risk-increasing drugs: a systematic review and meta-analysis: II. Psychotropics. J Am Med Dir Assoc. 2018;19(371):e11–e17. PubMed

Seppala LJ, van de Glind EMM, Daams JG, Ploegmakers KJ, de Vries M, Wermelink A, et al. Fall-risk-increasing drugs: a systematic review and meta-analysis: III. Psychotropics. J Am Med Dir Assoc. 2018;19(372):e1–e8. PubMed

de Vries M, Seppala LJ, Daams JG, van de Glind EMM, Masud T, van der Velde N, et al. Fall-risk-Increasing drugs: a systematic review and meta-analysis: I. cardiovascular drugs. J Am Med Dir Assoc. 2018;19:371e1–e9. doi: 10.1016/j.jamda.2017.12.013. PubMed DOI

Stam H, Harting T, van der Sluijs M, van Marum R, van der Horst H, van der Wouden JC, et al. Usual care and management of fall risk increasing drugs in older dizzy patients in Dutch general practice. Scand J Prim Health Care. 2016;34:164–170. doi: 10.3109/02813432.2016.1160634. PubMed DOI PMC

Laflamme L, Monarrez-Espino J, Johnell K, Elling B, Moller J. Type, number or both? A population-based matched case-control study on the risk of fall injuries among older people and number of medications beyond fall-inducing drugs. PLoS One. 2015;10:e0123390. doi: 10.1371/journal.pone.0123390. PubMed DOI PMC

Michalek C, Wehling M, Schlitzer J, Frohnhofen H. Effects of “Fit fOR The Aged” (FORTA) on pharmacotherapy and clinical endpoints–a pilot randomized controlled study. Eur J Clin Pharmacol. 2014;70:1261–1267. doi: 10.1007/s00228-014-1731-9. PubMed DOI

Frankenthal D, Lerman Y, Kalendaryev E, Lerman Y. Intervention with the screening tool of older persons potentially inappropriate prescriptions/screening tool to alert doctors to right treatment criteria in elderly residents of a chronic geriatric facility: a randomized clinical trial. J Am Geriatr Soc. 2014;62:1658–1665. doi: 10.1111/jgs.12993. PubMed DOI

Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society Summary of the updated american geriatrics society/british geriatrics society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011;59:148–157. doi: 10.1111/j.1532-5415.2010.03234.x. PubMed DOI

World health organization. Integrated care for older people: guidelines on community-level interventions to manage declines in intrinsic capacity. 2017. http://www.who.int/ageing/publications/guidelines-icope/en/. Accessed 2 May 2018. PubMed

Mirza F, Canalis E. Management of endocrine disease: secondary osteoporosis: pathophysiology and management. Eur J Endocrinol. 2015;173:R131–R151. doi: 10.1530/EJE-15-0118. PubMed DOI PMC

Nguyen KD, Bagheri B, Bagheri H. Drug-induced bone loss: a major safety concern in Europe. Expert Opin Drug Saf. 2018;17:1005–1014. doi: 10.1080/14740338.2018.1524868. PubMed DOI

van den Brand CL, Tolido T, Rambach AH, Hunink MG, Patka P, Jellema K. Systematic review and meta-analysis: is pre-injury antiplatelet therapy associated with traumatic intracranial hemorrhage? J Neurotrauma. 2017;34:1–7. doi: 10.1089/neu.2015.4393. PubMed DOI

Blain H, Masud T, Dargent-Molina P, Martin FC, Rosendahl E, van der Velde N, et al. A comprehensive fracture prevention strategy in older adults: the European union geriatric medicine society (EUGMS) statement. Eur Geriatr Med. 2016;7:519–525. doi: 10.1016/j.eurger.2016.04.012. PubMed DOI

Hanlon JT, Schmader KE. The medication appropriateness index at 20: where it started, where it has been, and where it may be going. Drugs Aging. 2013;30:893–900. doi: 10.1007/s40266-013-0118-4. PubMed DOI PMC

Parekh N, Page A, Ali K, Davies K, Rajkumar C. A practical approach to the pharmacological management of hypertension in older people. Ther Adv Drug Saf. 2017;8:117–132. doi: 10.1177/2042098616682721. PubMed DOI PMC

Kaufmann CP, Tremp R, Hersberger KE, Lampert ML. Inappropriate prescribing: a systematic overview of published assessment tools. Eur J Clin Pharmacol. 2014;70:1–11. doi: 10.1007/s00228-013-1575-8. PubMed DOI

Wehling M, Burkhardt H, Kuhn-Thiel A, Pazan F, Throm C, Weiss C, et al. VALFORTA: a randomised trial to validate the FORTA (Fit fOR The Aged) classification. Age Ageing. 2016;45:262–267. doi: 10.1093/ageing/afv200. PubMed DOI

O’Connor MN, O’Sullivan D, Gallagher PF, Eustace J, Byrne S, O’Mahony D. Prevention of hospital-acquired adverse drug reactions in older people using screening tool of older persons’ prescriptions and screening tool to alert to right treatment criteria: a cluster randomized controlled trial. J Am Geriatr Soc. 2016;64:1558–1566. doi: 10.1111/jgs.14312. PubMed DOI

Petrovic M, Gnjidic D, Tommelein E, Boussery K. Pharmacotherapy. In: Roller-Wirnsberger R, Singler K, Polidori M, editors. Learning geriatric medicine. Cham: Springer; 2018. pp. 219–235.

Iyer S, Naganathan V, McLachlan AJ, Le Conteur DG. Medication Withdrawal trials in people aged 65 years and older. Drugs Aging. 2008;25:1021–1031. doi: 10.2165/0002512-200825120-00004. PubMed DOI

Joint Formulary Committee. British national formulary. 2018. https://bnf.nice.org. Accessed 14 May 2018.

Scott IA, Hilmer SN, Reeve E, et al. Reducing inappropriate polypharmacy: the process of deprescribing. JAMA Intern Med. 2015;175:827–834. doi: 10.1001/jamainternmed.2015.0324. PubMed DOI

Garfinkel D, Mangin D. Feasibility study of a systematic approach for discontinuation of multiple medications in older adults: addressing polypharmacy. Arch Intern Med. 2010;170:1648–1654. doi: 10.1001/archinternmed.2010.355. PubMed DOI

Karani MV, Haddad Y, Lee R. The role of pharmacists in preventing falls among America’s older adults. Front Public Health. 2016;4:250. doi: 10.3389/fpubh.2016.00250. PubMed DOI PMC

Meredith S, Feldman P, Frey D, Giammarco L, Hall K, Arnold K, et al. Improving medication use in newly admitted home healthcare patients: a randomized controlled trial. J Am Geriatr Soc. 2002;50:1484–1491. doi: 10.1046/j.1532-5415.2002.50402.x. PubMed DOI

Blalock SJ, Casteel C, Roth MT, Ferreri S, Demby KB, Shankar V. Impact of enhanced pharmacologic care on the prevention of falls: a randomized controlled trial. Am J Geriatr Pharmacother. 2010;8:428–440. doi: 10.1016/j.amjopharm.2010.09.002. PubMed DOI

Preventing in-patient falls The nurse’s pivotal role. Nursing. 2018;2017(47):30–31. PubMed

Australian Commission on Safety and Quality in Health Care. Preventing falls and harm from falls in older people: best practice guidelines for Australian residential aged care facilities. 2009. Accessed 26 Oct 2018.

Boyd R, Stevens JA. Falls and fear of falling: burden, beliefs and behaviours. Age Ageing. 2009;38:423–428. doi: 10.1093/ageing/afp053. PubMed DOI

Tinetti ME, Gordon C, Sogolow E, Lapin P, Bradley EH. Fall-risk evaluation and management: challenges in adopting geriatric care practices. Gerontologist. 2006;46:717–725. doi: 10.1093/geront/46.6.717. PubMed DOI

Drickamer MA, Levy B, Irwin KS, Rohrbaugh RM. Perceived needs for geriatric education by medical students, internal medicine residents and faculty. J General Intern Med. 2006;21:1230–1234. doi: 10.1111/j.1525-1497.2006.00585.x. PubMed DOI PMC

Bunn F, Dickinson A, Barnett-Page E, McInnes E, Horton K. A systematic review of older people’s perceptions of facilitators and barriers to participation in falls-prevention interventions. Ageing Soc. 2008;28:449–472. doi: 10.1017/S0144686X07006861. DOI

Braun BL. Knowledge and perception of fall-related risk factors and fall-reduction techniques among community-dwelling elderly individuals. Phys Ther. 1998;78:1262–1276. doi: 10.1093/ptj/78.12.1262. PubMed DOI

Bagge M, Tordoff J, Norris P, Heydon S. Older people’s attitudes towards their regular medicines. J Prim Health Care. 2013;5:234–242. doi: 10.1071/HC13234. PubMed DOI

Masud T, Blundell A, Gordon AL, Mulpeter K, Roller R, Singler K, et al. European undergraduate curriculum in geriatric medicine developed using an international modified Delphi technique. Age Ageing. 2014;43:695–702. doi: 10.1093/ageing/afu019. PubMed DOI PMC

Tinetti ME, Baker DI, King M, Gottschalk M, Murphy TE, Acampora D, et al. Effect of dissemination of evidence in reducing injuries from falls. N Engl J Med. 2008;359:252–261. doi: 10.1056/NEJMoa0801748. PubMed DOI PMC

Parekh N, Ali K, Davies K, Rajkumar C. Can supporting health literacy reduce medication-related harm in older adults? Ther Adv Drug Saf. 2018;9:167–170. doi: 10.1177/2042098618754482. PubMed DOI PMC

Cherubini ABR, Ferrucci L, Marchionni N, Studenski S, Vellas B. Clinical trials in older adults. Oxford: Wiley-Blackwell; 2015.

European Network of Centres for Pharmacoepidemiology and Pharmacovigilance. ENCePP Guide on Methodological Standards in Pharmacoepidemiology. 2017. http://www.encepp.eu/standards_and_guidances/methodologicalGuide.shtml. Accessed 14 May 2018.

International Society for Pharmacoepidemiology. Guidelines for Good Pharmacoepidemiology Practices (GPP). 2015. https://www.pharmacoepi.org/resources/policies/guidelines-08027/. Accessed 14 May 2018.

Lamb SE, Jorstad-Stein EC, Hauer K, Becker C. Development of a common outcome data set for fall injury prevention trials: the prevention of falls network Europe consensus. J Am Geriatr Soc. 2005;53:1618–1622. doi: 10.1111/j.1532-5415.2005.53455.x. PubMed DOI

Lavan A, Eustace J, Dahly D, Flanagan E, Gallagher P, Cullinane S, et al. Incident adverse drug reactions in geriatric inpatients: a multicentred observational study. Ther Adv Drug Saf. 2017;9:13–23. doi: 10.1177/2042098617736191. PubMed DOI PMC

WHO. The use of the WHO-UMC system for standardised case causality assessment. http://www.who.int/medicines/areas/quality_safety/safety_efficacy/WHOcausality_assessment.pdf. Accessed 8 May 2018.

Pit SW, Byles JE, Henry DA, Holt L, Hansen V, Bowman DA. A quality use of medicines program for general practitioners and older people: a cluster randomized controlled trial. Med J Aust. 2007;187:23–30. PubMed

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