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Keywords:

  • fall risk increasing drugs;
  • Priscus-list;
  • frail elderly;
  • multivariate regression;
  • count data models;
  • pharmacoepidemiology

ABSTRACT

Background

Society benefits on a large scale from improved medical care and pharmaceuticals. The prescription of pharmaceuticals, however, also carries risks such as the possibility of an increased hazard of falls, which may lead to severe injuries and increased health expenditures associated with these injuries. This study investigates the relationship of several fall risk increasing drugs (FRIDs) and injuries of elderly persons using multivariate regression models.

Method

Routine data from the Techniker Krankenkasse of frail elderly persons aged ≥ 65 years is analysed for the year 2009 by estimating count data models, in order to take the data generating process of the number of injuries into account. The results of this model are compared to those from logistic regressions, which is the default regression model in this field of research.

Results

The empirical results suggest that the incidence of injuries strongly increases with doses of antidepressants, anxiolytics, hypnotics and sedatives, antiarrhythmics and drugs from the Priscus-list. However, antihypertensives and antiparkinsonian agents show no significant association and neuroleptics indicate a significant negative association.

Conclusion

As recurrent injuries are common, the analysis of the number of injuries rather than just the probability of having an injury provides a more informative analysis of FRIDs. According to the empirical results, antidepressants, anxiolytics, hypnotics and sedatives, antiarrhythmics as well as drugs from the Priscus-list should be prescribed carefully, because these drugs are positively correlated with the incidence of injuries. Copyright © 2012 John Wiley & Sons, Ltd.