Medication management lowers fall risks primarily by identifying, adjusting, or stopping medications that increase the likelihood of falls, especially in older adults. Many medications can cause side effects such as dizziness, drowsiness, impaired balance, or confusion, all of which contribute to falls. By carefully reviewing and optimizing medication regimens, healthcare providers can reduce these side effects and thus decrease fall risk.
Older adults often take multiple medications simultaneously, a situation known as polypharmacy, which raises the risk of adverse drug interactions and side effects that impair mobility and cognition. Medication review and deprescribing—systematically reducing or stopping unnecessary or harmful medications—are key strategies to address this. Successful medication management involves using specific tools or algorithms to evaluate each drug’s appropriateness, involving prescribers familiar with the patient’s overall health, and conducting reviews regularly, at least every six months. This collaborative and structured approach ensures that medications contributing to falls are minimized while maintaining treatment for necessary conditions.
Certain classes of drugs are particularly associated with increased fall risk. Psychoactive medications, such as sedatives, antidepressants, and antipsychotics, can cause sedation, impaired coordination, and cognitive changes. Other medications like blood pressure drugs (e.g., beta-blockers), anticholinergics, and proton pump inhibitors may also increase fall risk by causing dizziness, low blood pressure, or other side effects. Adjusting doses to the lowest effective amount or substituting safer alternatives can reduce these risks.
Moreover, medication management includes balancing the benefits and risks of drugs that affect injury severity after falls. For example, anticoagulants increase bleeding risk, so their use requires careful consideration in patients prone to falling. Educating patients on fall-related first aid and closely monitoring their medication regimens can mitigate injury severity.
Medication optimization is often part of a broader fall prevention strategy that includes physical activity, home safety modifications, and treatment of underlying conditions like osteoporosis or Parkinson’s disease. For instance, medications that improve bone density reduce fracture risk if a fall occurs. Regular bone density monitoring helps guide these treatments.
In summary, medication management lowers fall risks by:
– Identifying and reducing use of fall risk–increasing drugs (FRIDs).
– Minimizing polypharmacy and avoiding inappropriate medications.
– Adjusting dosages to reduce side effects like dizziness and sedation.
– Involving healthcare providers familiar with the patient’s overall health in medication decisions.
– Conducting regular, structured medication reviews.
– Educating patients about medication effects and fall-related injury prevention.
– Integrating medication management with other fall prevention measures such as exercise and home safety.
This comprehensive approach helps maintain older adults’ physical and cognitive function, reducing the likelihood of falls and their potentially serious consequences.
