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Clinical Summary

Are antihypertensive medications routinely adjusted post-inpatient fall?

Takeaway

  • The prescriptions of antihypertensive medications are frequently unchanged after an inpatient fall in older adults (≥80 years old) with normal/low blood pressures (< 140 mmHg systolic).
  • In order to reduce the risk of further falls, routine review of medication needs to be part of post-falls assessment in hospitals.

Why this matters

  • Use of antihypertensive medications have been associated with falls in older adults, partly because their use is associated with orthostatic changes in addition to adverse effects such as dizziness and gait disturbance.

Study design

  • Cohort study of 146 older adults with normal/low BP who had documented inpatient falls between 1 January 2014 and 31 August 2014.
  • Funding: None.

Key results

  • Overall, 120 patients were taking the same number of antihypertensive medications before and after the fall, 19 patients had a reduction in the number of medications, and 7 patients had an increase in medications.
  • Only in 26 patients, the antihypertensive medication was either stopped or reduced immediately after fall.
  • During discharge, 73 patients were receiving the same number of antihypertensive medication as before and 51 patients were receiving fewer antihypertensives and 22 were on more.
  • A significant decrease in the dose of antihypertensive medication was seen between pre-fall and discharge period (P<.001).

Limitations

  • Reasons for changes in regimen were not assessed.           

References


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