An evaluation of injurious falls and Fall-Risk-Increasing-Drug (FRID) prescribing in ambulatory care in older adults

Authors

• Taylor R. Elliott, Durham Veterans Afairs Medical Center
• Susan Westneat, University of Kentucky
• Shama D. Karanth, University of Florida
• Erin L. Abner, Sanders-Brown Center On Aging
• Anna M. Kucharska‑Newton, University of North Carolina at Chapel Hill
• Daniela C. Moga, University of Kentucky

Abstract

Background: Falls are a major public health problem afecting millions of older adults each year. Little is known about FRID prescribing behaviors after injurious falls occur. The primary objective of this study was to investigate whether an injurious fall is associated with being prescribed a new FRID.

Methods: We conducted a cross-sectional analysis using data from the National Ambulatory Medical Care Survey (2016). We included visits from patients age≥65 years and classifed visits based on presence of an injurious fall. The outcome of interest was prescription of new FRID between those with and without an injurious fall. Multivari‑ able logistic regression weighted for sampling and adjusted for demographics, health history and other medications was used. Age and Alzheimer’s disease were examined as potential efect measure modifers. Odds ratios and 95% confdence intervals were reported. Bayes factor upper bounds were also reported to quantify whether the data were better predicted by the null hypothesis or the alternative hypothesis.

Results: The sample included 239,016,482 ambulatory care visits. 5,095,734 (2.1%) of the visits were related to an injurious fall. An injurious fall was associated with a non-statistically signifcant increase in odds of at least one new FRID prescription: adjusted OR=1.6 (95% CI 0.6, 4.0). However, there was non-statistically signifcant evidence that the association depended on patient age, with OR=2.6 (95% CI 0.9, 7.4) for ages 65–74 versus OR=0.4 (95% CI 0.1, 1.6) for ages≥75. In addition to age, Alzheimer’s disease was also identifed as a statistically signifcant efect measure modifer, but stratum specifc estimates were not determined due to small sample sizes.

Conclusions: Ambulatory care visits involving an injurious fall showed a non-statistically signifcant increase in odds of generating a new FRID prescription, but this association may depend on age.

Document Type

Article

Publication Date

12-2022

Digital Object Identifier (DOI)

https://doi.org/10.1186/s12877-022-02877-z

Repository Citation

Elliott, Taylor R.; Westneat, Susan; Karanth, Shama D.; Abner, Erin L.; Kucharska‑Newton, Anna M.; and Moga, Daniela C., "An evaluation of injurious falls and Fall-Risk-Increasing-Drug (FRID) prescribing in ambulatory care in older adults" (2022). Epidemiology and Environmental Health Faculty Publications. 104.
https://uknowledge.uky.edu/epidemiology_facpub/104