Reviewing medications is critically important for fall prevention because many medications can increase the risk of falls, especially in older adults. Certain drugs—often called fall risk–increasing drugs (FRIDs)—can cause side effects like dizziness, drowsiness, impaired balance, or slowed reaction times. These effects directly contribute to a higher likelihood of falling. Since older adults frequently take multiple medications (polypharmacy), the combined impact can significantly raise their fall risk.
Medications that commonly increase fall risk include sedatives, antidepressants, antipsychotics, blood pressure medicines such as beta-blockers, anticholinergics, and even some proton pump inhibitors. Many older people are prescribed these drugs either unnecessarily or without regular review to assess ongoing need and safety. When physicians carefully review and adjust these prescriptions—sometimes deprescribing unnecessary or harmful drugs—they can reduce the patient’s vulnerability to falls.
Regular medication reviews help identify potentially inappropriate prescriptions and allow healthcare providers to weigh risks versus benefits more accurately for each individual. This process often involves using specific tools or algorithms designed to flag risky medications and requires collaboration among clinicians familiar with the patient’s overall health status. Reviews conducted at least every six months have been shown to be more effective in reducing falls when they involve prescribers from the patient’s usual care team.
Beyond just stopping risky drugs outright, medication review enables safer prescribing by adjusting doses or switching to alternatives with fewer side effects related to balance and cognition. It also helps address polypharmacy issues where multiple interacting medications may compound fall risks.
While medication review alone may not always drastically reduce falls if done in isolation without other interventions like exercise or environmental modifications, it remains a key modifiable factor within multifactorial strategies proven effective in preventing falls among older adults living in care facilities or at home.
Failing to regularly assess medications after a fall is a missed opportunity since unchanged prescriptions often continue contributing silently to future incidents. Given that nearly all older adults who suffer injurious falls are taking one or more FRIDs at the time of injury highlights how pervasive this problem is—and how crucial ongoing vigilance around medication management becomes for maintaining safety.
In essence:
– Many common prescription drugs impair balance and cognition.
– Older adults often take multiple such meds simultaneously.
– Medication review identifies high-risk meds that could be stopped or adjusted.
– Deprescribing reduces exposure to harmful drug effects linked with falling.
– Regular reviews involving familiar prescribers improve success rates.
– Medication optimization works best as part of broader multifactorial prevention plans including exercise and environment changes.
– Neglecting medication assessment after a fall leaves patients vulnerable unnecessarily.
By systematically reviewing medications with an eye toward minimizing those that elevate fall risk while preserving therapeutic benefit where needed, healthcare providers play an essential role in protecting mobility and independence among aging populations prone to dangerous falls.