Background Various factors, including chronic diseases, multiple morbidity and polypharmacy, but also injuries like falls can put elderly at increased risks for adverse drug events (ADE). Despite numerous studies underlining the significance of healthy ageing, epidemiologic studies on community dwelling populations remain scarce in this field. In our study we determine the subsequent association between injurious falls and ADEs among older people, while recognising the role of number and type of medications, as well as co-morbidity.
Methods We used a matched case-control design for our study among Swedish residents 60 years and older. ADEs by unintentional poisoning resulting in hospitalisation or death were considered as cases. These were extracted from the National Patient Register (NPR) and the Cause of Death Register from January 2006 to December 2009. Cases were matched with four controls by sex, age and residential area. The medication prescribed during the four month period prior to index date, was extracted from the Swedish Prescribed Drug Register (SPDR), while previous episodes of injurious falls were extracted from the NPR. For our analysis we used conditional logistics regression and estimated our effects with odds rations (OR) and 95% confidence intervals (CI). In the analysis, we adjusted for confounders, including comorbidity.
Results Within six-month after an injurious fall, we found a three-fold increased risk for an ADE among older people. Although the risk for an ADE after a fall injury is significantly high over the whole period, it was highest in the one to three weeks period immediately after an injurious fall. Younger older individuals (60–79 year), were at a higher risk than older ones (80+ year). Older people with an ADE up to three weeks following a fall injury had a tendency to have been prescribed a higher number of medications, but were less likely to have a previous medical history involving other fall-related hospitalizations.
Conclusions Older people with an injurious fall are at an increased risk for a subsequent ADE. The period after an injurious fall could serve as potential point for the prevention of ADEs. Falls are common among the older population group, and the medicinal options for treatments after a fall should be carefully regarded by physicians and their patients in consideration of the potential risk for ADEs.
- adverse drug events
- injurious falls
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