Year of Publication

2021

College

Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Daniela C. Moga

Committee Member

Erin Abner

Committee Member

Anna Kucharska-Newton

Abstract

Background: Falls are a major public health problem affecting millions of older adults each year. Little is known about FRID prescribing behaviors after injurious falls occur.

Objective(s): The primary objective of this study was to investigate whether an injurious fall impacts the odds of being prescribed a new FRID.

Methods: We conducted a cross-sectional analysis using data from the 2016 National Ambulatory Medical Care Survey to investigate whether an injurious fall impacts the odds of being prescribed a new FRID. We included patients age >/= 65 years and classified visits based on presence of an injurious fall. The outcome of interest was prescription of a new FRID between those with and without an injurious fall. Multivariable logistic regression accounting for sampling and adjusted for demographics, health history and other medications was used. Age and Alzheimer’s disease (AD) were examined as potential effect modifiers. Odds ratios and 95% confidence intervals were reported.

Results: The subset of adults age >/= 65 years included 239,016,482 ambulatory care visits. 5,095,734 (2.1%) of the visits were related to an injurious fall. In the adjusted logistic regression model, an injurious fall increased the odds of being prescribed at least one new FRID by 1.6 times (95% CI 0.6, 4.0). Age was an effect modifier, with an OR of 2.6 (0.9, 7.4) for ages 65-74 versus 0.4 (0.1, 1.6) for ages >/=75. In addition to age, AD was also identified as a statistically significant effect modifier, but stratum specific estimates were not determined due to small sample sizes.

Conclusions: An injurious fall impacts the odds of being prescribed a new FRID with age being an effect modifier. Adults age 65-74 presenting with an injurious fall were more likely to be prescribed any new FRID in comparison to adults age >/= 75 years, who were less likely.

Available for download on Friday, April 21, 2023

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