Reducing Antipsychotic Medications in Elderly Patients is Associated With Fewer Falls

By Thomas S. May

ORLANDO, Florida -- February 24, 2016 -- Reducing the dosages of antipsychotic medications prescribed to geriatric patients may help lower the rate of falls in this patient population, according to a prospective study presented here on February 23 at the 45th Annual Meeting of the Society of Critical Care Medicine (SCCM).

Frederick B. Rogers, MD, MS, Lancaster General Hospital, Lancaster, Pennsylvania, and colleagues instituted a fall-prevention medication-intervention programme to reduce dosages of antipsychotic medications in patients at a local geriatric living facility, beginning in January 2014.

The investigators found that the rate of falls decreased from 9.4% pre-intervention to 7.6% post-intervention (P =.04).

Medication reductions were determined on an individual basis, under the discretion of an in-house pharmacist and medical director, for all residents receiving antipsychotics. Linear-trend tests assessed fall rates (total falls/total residents) from 2013 to 2014 (pre-intervention), and were compared with fall rates from 2014 to 2015 (post-intervention). During the study period (2013–2015), no statistically significant changes in living facility demographics were observed.

While Dr. Rogers feels that “patients should be receiving medication dosages that adequately combat their symptoms,” these results, he noted, indicate that antipsychotic medications place geriatric patients at an increased risk for falls.

Caregiver medication reviews and reductions in antipsychotic medications are crucial to reducing falls, the investigators concluded.

The incidence of falls among individuals 65 years and older is approximately 30%. In all, 20% to 30% of these falls result in moderate to severe injuries.

[Presentation title: A Reduction in Antipsychotic Medications is Associated With a Decrease in Geriatric Fall Trauma. Abstract 1167]
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