International Journal of Clinical Pharmacy

, Volume 38, Issue 2, pp 243–251 | Cite as

Exploring the relationship between fall risk-increasing drugs and fall-related fractures

  • Sabrina De WinterEmail author
  • Sarah Vanwynsberghe
  • Veerle Foulon
  • Eddy Dejaeger
  • Johan Flamaing
  • An Sermon
  • Lorenz Van der Linden
  • Isabel Spriet
Research Article



Hospital admissions due to fall-related fractures are a major problem in the aging population. Several risk factors have been identified, including drug use. Most studies often retrieved prescription-only drugs from national databases. These are associated with some limitations as they do not always reliably reproduce the complete patient’s active drug list.


To evaluate the association between the number of FRIDs intake identified by a standardised medication reconciliation process and a fall-related fracture leading to a hospital admission in older adults.


The first cohort has been recruited from one traumatology ward of a tertiary teaching hospital in Belgium and the second cohort has been recruited from 11 community pharmacies in Belgium.


A prospective study with two individually matched cohorts was performed. Adult patients (≥75 years) admitted with an injury due to a fall were included in the first cohort (faller group). The second cohort consisted of patients who did not suffer from a fall within the last 6 months (non-faller group). Matching was performed for age, gender, place of residence and use of a walking aid. In both groups, clinical pharmacists and undergraduate pharmacy students obtained the medication history, using a standardised approach. A list of drugs considered to increase the risk of falling was created. It included cardiovascular drugs and drugs acting on the nervous system. A linear mixed model was used to compare the number of fall risk-increasing drugs between fallers and non-fallers.

Main outcome measure

The number of fall risk-increasing drugs in a faller versus a non-faller group.


Sixty-one patients were matched with 121 non-fallers. Patients received on average 3.1 ± 2.1 and 3.2 ± 1.8 fall risk-increasing drugs in the faller and in the non-faller group, respectively. The mean number of fall risk-increasing drugs was comparable in both groups (p = 0.844), even after adjusting for alcohol consumption, fear of falling, vision and foot problems (p = 0.721).


In a sample of hospitalised patients admitted for a fall-related injury, no significant difference in the number of fall risk-increasing drugs versus that of an outpatient group of non-fallers was found.


Belgium Falls Fall risk-increasing drugs Fractures Hospitalisation Older adults 



We would like to express our special thanks to Prof. Dr. Apr. Gert Laekeman, Clinical Pharmacology and Pharmacotherapy, Dpt Pharmaceutical and Pharmacological Sciences, KU Leuven, for his contribution to this study, to keep this project on track in the community pharmacies and for carefully reading this manuscript. We would like to thank all the collaborating undergraduate pharmacy students and the community pharmacies. Finally, we also want to thank Annouschka Laenen, Leuven Biostatistics and Statistical Bioinformatics Centre, Dpt of Public Health and Primary Care, KU Leuven for the statistical assistance.



Conflicts of interest


Supplementary material

11096_2015_230_MOESM1_ESM.docx (16 kb)
Supplementary material 1 (DOCX 16 kb)


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Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2016

Authors and Affiliations

  • Sabrina De Winter
    • 1
    Email author
  • Sarah Vanwynsberghe
    • 1
  • Veerle Foulon
    • 2
  • Eddy Dejaeger
    • 3
  • Johan Flamaing
    • 3
  • An Sermon
    • 4
  • Lorenz Van der Linden
    • 1
  • Isabel Spriet
    • 1
  1. 1.Clinical Pharmacology and PharmacotherapyUniversity Hospitals LeuvenLouvainBelgium
  2. 2.Clinical Pharmacology and PharmacotherapyCatholic University LeuvenLouvainBelgium
  3. 3.Gerontology and GeriatricsUniversity Hospitals LeuvenLouvainBelgium
  4. 4.TraumatologyUniversity Hospitals LeuvenLouvainBelgium

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