A Study of Psychoactive Medicines and Risk of Falls Among Indonesian Elderly Patients

Fita Rahmawati, Nasikhatul Mustafidah, I Dewa Putu Pramantara, Izyan Abdul Wahab

Abstract


One of the causes of injury to the elderly is due to falls. Falling can be prevented by identifying and controlling risk factors. One risk factor that can be controlled is the use of fall risk medicines including psychoactive. This study aims to identify the association between the use of psychoactive medicine and its characteristic with the risk of falls among the elderly in Indonesia.  The study utilized a case-control study design for a total number of 414 elderly patients. Cases were elderly aged 60 years or more with a high risk of falling assessed using the Morse Fall Scale (MFS). Each case was matched with up to two randomly selected controls of the same age who are classified as low to moderate risk of falling. Psychoactive medicine-fall risk associations were estimated via logistic regression. There were 138 cases and 276 controls. The median age of subjects was 66 years old and 54.83% was a woman. Elderly with a high risk of falling had higher psychoactive medicines use when compare with controls (31.16 % vs 21.38 %, p< 0.05). After adjusting for potential confounders, the use of psychoactive medicines was significantly associated with higher fall risk in elderly patients (OR 1.79 95% CI 1.10-2.90). Only the duration of psychoactive medication use over 90 days was significantly associated with a high risk of falling (AOR 3.65 95% CI 1.46-9.14). In elderly patients, the continued use of psychoactive medicines increased the risk of fall. Prescribers need to weigh risk and benefit from the use of psychoactive medicines in the elderly to prevent future fall.

Keywords


Psychoactive medicine, Fall risk, Elderly

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References


Alshammari, S. A., Alhassan, A. M., Aldawsari, M. A., Bazuhair, F. O., & Alotaibi, F. K. (2018). Falls among elderly and its relation with their health problems and surrounding environmental factors in Riyadh. Journal of Family & Community Medicine, 25(1), 29–34. https://doi.org/10.4103/jfcm.JFCM

Andersson, K., Melander, A., Svensson, C., Lind, O., & Nilsson, J. L. G. (2005). Repeat prescriptions : refill adherence in relation to patient and prescriber characteristics , reimbursement level and type of medication. European Journal of Public Health, 15(6), 621–626. https://doi.org/10.1093/eurpub/cki053

Anto, W. S. (2015). Pengaruh Penambahan Latihan Keseimbangan Pada Latihan Core Stability Lebih Baik Terhadap Resiko Jatuh Pada Lansia. STIKES Aisyiyah Yogyakarta. Retrieved from http://digilib.unisayogya.ac.id/1921/1/NASKAH PULIKASI SKRIPSI WIBOWO.pdf

Badan Pusat Statistik. (2018). Statistik Penduduk Lanjut Usia 2017. Jakarta: Badan Pusat Statistik.

Berlie, H. D., & Garwood, C. L. (2010). Diabetes Medications Related to an Increased Risk of Falls and Fall-Related Morbidity in the Elderly, 44, 712–717. https://doi.org/10.1345/aph.1M551

Blalock, D. (2016). An Evidenced-Based Approach to Fall Risk Assessment and Management in an Outpatient Imaging Center: Morse Fall Scale. In 43rd Biennial Convention 2015 Theme: Serve Locally, Transform Regionally, Lead Globally.`. Las Vegas, Nevada, USA.

Bloch, F., Thibaud, M., Dugué, B., Brèque, C., & Kemoun, G. (2011). Psychotropic Drugs and Falls in the Elderly People: Updated Literature Review and Meta-Analysis. Journal of Aging and Health, 23(2), 329–346. https://doi.org/10.1177/0898264310381277

Cabrera, M. A. S., Dellaroza, M. S. G., Trelha, C. S., Paccola, L. B. B., Perdiga˜o, S. da C. D., Pinto, M. E. de B., … Oliveira, D. G. de. (2010). Psychoactive Drugs as Risk Factors for Functional Decline Among Noninstitutionalized Dependent Elderly People. American Medical Directors Association, 11, 519–522. https://doi.org/10.1016/j.jamda.2009.12.001

CDC. (2017). Risk Factors for Falls.

Chan, T.-C., Luk, J. K.-H., Chu, L.-W., & Chan, F. (2014). Validation study of Charlson Comorbidity Index. Geriatrics & Gerontology International, 14(2), 452–457. https://doi.org/10.1111_ggi.12129

Costa-Dias, M. J. M. da, Martins, T., & Araújo, F. (2014). Study of the cut-off point of the Morse Fall Scale (MFS). Revista de Enfermagem ReferÃancia, 4(1), 63–72. https://doi.org/10.12707/RIII13101

Dessy, V. A., Harmayetty, & Widyawati, I. Y. (2013). Penilaian Risiko Jatuh Lanjut Usia (Lansia) Menggunakan Pendekatan Hendrich Falls Scale And Morse Falls Scale. Jurnal Ners, 8(1), 107–117.

Du, Y., Wolf, I. K., & Knopf, H. (2017). Association of psychotropic drug use with falls among older adults in Germany. Results of the German Health Interview and Examination Survey for Adults 2008-2011 (DEGS1). PLoS ONE, 12(8), 1–15. https://doi.org/10.1371/journal.pone.0182432

Ganz DA, Huang, C., Saliba, D., Berlowitz, D., & Lukas, C. V. (2013). Preventing Falls in Hospitals A Toolkit for Improving Quality of Care. Agency for Healthcare Research and Quality, 13–0015–EF.

Grundstrom, A. C., Guse, C. E., & Layde, P. M. (2013). Risk Factors for Falls and Fall-Related Injuries in Adults 85 Years of Age and Older. Arch Gerontol Geriatr, 54(3), 421–428. https://doi.org/10.1016/j.archger.2011.06.008.Risk

Hanlon, J. T., Boudreau, R. M., Roumani, Y. F., Newman, A. B., Ruby, C. M., Wright, R. M., … Studenski, S. A. (2009). Number and dosage of central nervous system medications on recurrent falls in community elders: The health, aging and body composition study. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 64(4), 492–498. https://doi.org/10.1093/gerona/gln043

Lee, J. K., Mendoza, D. M., Mohler, M. J., & Lee, E. M. (2016). Geriatrics. In M. A. Chisholm-Burns, T. L. Schwinghammer, B. G. Wells, P. M. Malone, J. M. Kolesar, & J. T. DiPiro (Eds.), Pharmacotherapy Principle and Practice (4th ed., pp. 7–18). United State: McGraw-Hill Education.

Lestari, L. D. (2015). Hubungan Tingkat Kemandirian Dengan Risiko Jatuh Pada Lansia Di Panti Sosial Tresna Werdha Unit Abiyoso Pakem Sleman Yogyakarta. STIKES Jenderal Achmad Yani Yogyakarta. Retrieved from http://repository.unjaya.ac.id/2711/

Mangoni, A. A., & Jackson, S. H. D. (2003). Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications: Age-related changes in pharmacokinetics and pharmacodynamics. British Journal of Clinical Pharmacology, 57(1), 6–14. https://doi.org/10.1046/j.1365-2125.2003.02007.x

Ministry of Health Republic of Indonesia. (2014). Situasi dan Analisa Lanjut Usia. Jakarta.

Ministry of Health Republic of Indonesia. (2016). PMK no 52 Tahun 2016 : Standar Tarif Pelayanan Kesehatan Dalam Penyelenggaraan Program Jaminan Kesehatan.

National Health Council. (2016). About Chronic Conditions.

Pasa, T. S., Angela, M., Baratto, M., Morais, B. X., & Carollo, J. B. (2017). Risk assessment and incidence of falls in adult hospitalized patients. Rev. Latino-Am. Enfermagem, 25(e2862), 1–8. https://doi.org/10.1590/1518-8345.1551.2862

Pratt, N. L., & Ramsay, E. N. (2014). Association Between Use of Multiple Psychoactive Medicines and Hospitalization for Falls : Retrospective Analysis of a Large Healthcare Claim Database. Drug Saf, 37, 529–535. https://doi.org/10.1007/s40264-014-0179-2

Psychoactive Drug. (n.d.).

Ruscin, J. M., & Linnebur, S. A. (2018). Drug-Related Problems in Older Adults.

Shuto, H., Imakyure, O., Matsumoto, J., Egawa, T., Jiang, Y., Hirakawa, M., … Yanagawa, T. (2010). Medication use as a risk factor for inpatient falls in an acute care hospital: A case-crossover study. British Journal of Clinical Pharmacology, 69(5), 535–542. https://doi.org/10.1111/j.1365-2125.2010.03613.x

WHO. (n.d.). Psychoactive Substances.

WHO. (2007). A Global Report on Falls Prevention- Epidemiology of Falls. WHO Report, 1–40. https://doi.org/10.1007/BF02365631

WHO. (2018a). Global Database on Body Mass Index “BMI Classification.”

WHO. (2018b). Guideline for ATC classification and DDD assignment 2018. Retrieved from ttps://www.whocc.no/atc_ddd_index/

Wilhite, S. (n.d.). The Evolutionary Significance of Psychoactive Drugs.

Yoshida, S. (2007). A Global Report on Falls Prevention- Epidemiology of Falls. Ageing and Life Course, Family and Community Health, WHO, 1–40. https://doi.org/10.1007/BF02365631




DOI: http://dx.doi.org/10.14499/indonesianjpharm30iss3pp%25p

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