Advertisement

Pharmacy World and Science

, Volume 27, Issue 3, pp 220–222 | Cite as

Use of Medicines that Influence Falls or Fractures in a Residential Home Setting

  • Michael WilcockEmail author
  • Doug MacMahon
  • Anthony Woolf
Article

Abstract

Objective: To study the pattern of use of medicines that may contribute to, or protect against, falls and fractures in the setting of a UK residential home population, and to compare the results with a similar study conducted in 2001.

Setting and method: A cross-sectional survey was conducted in 2003 in 18 residential homes. A trained community pharmacist visited the homes to retrieve information about use of medicines whilst demographic details were provided by the residential home staff.

Main outcome measure: The proportion of patients who were prescribed medicines with a potential positive benefit in preventing fractures, and medicines that may cause elderly people to fall.

Results: The study population consisted of 581 residents. Compared to the 2001 study, the use of both calcium and vitamin D had increased significantly (8.3% versus 2.1%). Although, the overall prescribing of psychotropics in 2003 was relatively low, there was a trend for increased prescribing of these medicines which have been identified as risk factors for falling.

Conclusion: In a residential home setting in the UK, the use of psychotropic drugs is not uncommon, whereas there is limited use of drugs that have the potential for preventing morbidity associated with falls.

Keywords

Drug use Elderly patients Epidemiological study Residential homes United Kingdom 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Department of Health. MedicinesOlder, People. 2001Implementing medicines-related aspects of the National Service Framework for older peopleDoHLondonGoogle Scholar
  2. Shelton, PS, Fritsch, MA, Scott, MA. 2000Assessing the medication appropriateness in the elderly. A review of available measuresDrugs Aging1643750PubMedGoogle Scholar
  3. Fahey, T, Montgomery, AM, Barnes, J, Protheroe, J. 2003Quality of care for elderly residents in nursing homes and elderly people living at home: controlled observational studyBMJ3265804CrossRefPubMedGoogle Scholar
  4. Weedle, PB, Poston, JW, Parish, PA. 1990Drug prescribing in residential homes for elderly people in the United KingdomDICP. Ann Pharmacother245336Google Scholar
  5. Lunn, J, Chan, K, Donoghue, J, Riley, B, Walley, T. 1997A study of the appropriateness of prescribing in nursing homesInt J Pharm Pract5610Google Scholar
  6. Burstow, P, Stokoe, R. 2001Keep taking the medicines: antipsychotics and the over medication of older people. Its causes and consequencesThe Liberal DemocratsLondonGoogle Scholar
  7. Royal College of Physicians.1998Enhancing the health of older people in long-term careThe Royal College of PhysiciansLondonISBN 1 86016 076 XGoogle Scholar
  8. Ford, GA, Ballard, C, Thomas, SHL. 2002Anti-psychotic drug use in older peopleAge Ageing3122526CrossRefPubMedGoogle Scholar
  9. Evans, JG. 2003Drugs and falls in later lifeLancet361448CrossRefPubMedGoogle Scholar
  10. Department of Health.2001National Service Framework for Older PeopleDoHLondonGoogle Scholar
  11. Hughes, CM, Patterson, S, Schweizer, A. 2003Information is care: the need for data to assess the quality of care in UK nursing and residential homesExpert Opin Drug Saf252327CrossRefPubMedGoogle Scholar
  12. Wilcock, M, MacMahon, D, Woolf, A. 2002Residential home patients and their medicines – are we heading for a fall?Pharm Pract1215862Google Scholar
  13. Department of Health. Prescription cost analysis England 2003. Department of Health London, 2004. http://www.publications.doh.gov.uk/stats/pca2003.htm (accessed July 2004)Google Scholar
  14. Walley, T. 2004Neuropsychotherapeutics in the UK. What has been the impact of NICE on prescribing?CNS Drugs18112Google Scholar
  15. Mann, AH, Schneider, J, Mozley, CG,  et al. 2000Depression and the response of residential homes to physical health needsInt J Geriatr Psychiat15110512CrossRefGoogle Scholar
  16. Lawlor, DA, Patel, R, Ebrahim, S. 2003Association between falls in elderly women and chronic diseases and drug use: cross sectional studyBMJ3277127CrossRefPubMedGoogle Scholar
  17. Thapa, PB, Gideon, P, Cost, TW, Milam, AB, Ray, WA. 1998Antidepressants and the risk of falls among nursing home residentsN Engl J Med33987582CrossRefPubMedGoogle Scholar
  18. Chen, YF Dewey, ME Avery, J the Analysis Group of the Medical Research Council Cognitive Function and Ageing Study2001Self-reported medication use for older people in England and WalesJ Clin Pharm Ther2612940CrossRefPubMedGoogle Scholar
  19. Oborne, CA, Hooper, R, Li, KC, Swift, CG, Jackson, SHD. 2002An indicator of appropriate neuroleptic prescribing in nursing homesAge Ageing314359CrossRefPubMedGoogle Scholar
  20. Schweizer, A, Curran, M, Hughes, C. 2003Use of psychoactive medication within care homes for the elderlyHealth Service Research & Pharmacy Practice ConferenceBelfastGoogle Scholar
  21. Hanlon, JT, Schmader, KE, Ruby, CM, Weinberger, M. 2001Suboptimal prescribing in older inpatients and outpatientsJ Am Geriatr Soc492009CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  1. 1.Head of Prescribing Support Unit, c/o Pharmacy DepartmentRoyal Cornwall Hospitals NHS TrustTruroUK
  2. 2.Consultant PhysicianCamborne Redruth Community HospitalRedruthUK
  3. 3.Consultant RheumatologistRoyal Cornwall Hospitals NHS TrustTruroUK

Personalised recommendations