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More than 11 million seniors — one of every three — will fall this year
(Sattin 1992; Tinetti, Speechley, and Ginter 1988), and approximately one in
10 of those falls will result in a serious injury such as hip fracture or
head injury (Tinnetti 2003). More than 500,000 seniors will suffer hip
fractures annually by 2040 (Cummings, Rubin, and Black 1990).
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Each year, 35% to 40% of generally healthy seniors living in the community
fall (Campbell, Spears, and Borrie 1990). Because nursing facility residents
are older, more frail, and more cognitively impaired, approximately 50% fall
each year (Rubinstein, Josephson, and Robbins 1994).
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About 20% of hip fracture patients will die within five years of the
fracture (Cooper 1997), yet thousands of those deaths are PREVENTABLE.
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Most people do not realize that falls can be a medication-related problem.
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Risk factors for falls include medication use, advanced age, decreased
mobility and strength, balance impairment, neurological disease,
cardiovascular disease, incontinence, visual impairment, and cognitive
impairment.
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Certain medications — such as high blood pressure medications,
antidepressants, sleep aids, antiseizure medications, and heart
antiarrhythmic medications — can contribute to falls in the elderly for a
variety of different reasons. Perhaps a drug causes dizziness in an elderly patient,
and that patient has not been properly instructed on how to rise and walk
while on the medication. Standing up too quickly could result in a fall. Or,
perhaps a drug causes frequent urination, and a patient constantly gets up
during the night. One of those bathroom trips could cause a fall, and
possibly a hip fracture.
Medication-related falls and hip fractures are preventable.
Consultant pharmacists can assess seniors’ drug regimens for exposure to
risks that may contribute to falls, recommend drug therapy changes, and
educate the patient and caregiver on how to avoid dangerous situations.
Medication management is an effective fall prevention measure (Cooper 1997).
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