Sains Malaysiana 49(6)(2020): 1381-1388

http://dx.doi.org/10.17576/jsm-2020-4906-16

The Use of Fall Risk-Increasing Drugs among Older People in Nursing Homes

(Penggunaan Ubatan yang Meningkatkan Risiko Jatuh dalam Kalangan Warga Tua di Rumah Penjagaan)

LEE SHIOW LING, MARHANIS OMAR*, ADLIAH MHD-ALI & MOHD MAKMOR-BAKRY

Faculty of Pharmacy, National University of Malaysia, Jalan Raja Muda Abdul Aziz, 53000 Kuala Lumpur, Federal Territory, Malaysia

Received: 18 March 2019/Accepted: 14 February 2020

ABSTRACT

Medication use is one of the modifiable risk factors that causes falls. Falls are the leading cause of injury among elderly people. The incidence of falls does significantly impact elderly people‘s independence in carrying out their regular activities. This study aimed to determine the prevalence of drugs that cause falls and the fall risk status among elderly people residing in nursing homes. A cross-sectional study was conducted on residents in 27 long term care facilities in Malaysia from March 2018 until November 2018 using a researcher-assisted questionnaire. A total of 212 residents were recruited in this study. A majority of the residents were taking at least one fall-risk increasing drug (FRIDs) or orthostatic drug (ODs) (n=145, 68.4%), with two-thirds of them presenting high risk of falling (n=95, 65.5%). A significant association was found between the use of beta-blocking agents (p=0.033), renin-angiotensin system inhibitors (p=0.038), length of stay in facilities (p=0.031), frailty status (p<0.001), number of drugs in total (p=0.010) and as needed (p=0.025) with an increased risk of falls. Therefore, a majority of the elderly people residing in nursing homes were proven to be prone to the use of fall-risk medications. Frail elderly people have a higher risk of falling compared to those who were non-frail.

Keywords: Drug use; polypharmacy; side-effect

ABSTRAK

Penggunaan ubatmerupakan salah satu faktor risiko yang terubahsuai yang menyebabkan jatuh. Jatuh adalah penyebab utama kecederaan dalam kalangan warga tua. Ini akan memberi kesan kepada warga tua dalam menjalankan aktiviti lazim mereka. Kajian ini bertujuan untuk menentukan ubat-ubatan yang memberi risiko yang menyebabkan jatuh dalam kalangan warga tua yang berada di rumahpenjagaan. Satu kajian rentas telah dijalankan dalam kalanganpenghuni di 27 rumahpenjagaan di Malaysia bermula dari bulan Mac 2018 hingga November 2018 menggunakan borang soal selidik. Seramai 212 penghuni terlibat dalam kajian ini. Majoritipenghuni didapati mengambil sekurang-kurangnya satu ubat yang mempunyai risiko untuk jatuh (FRID) atau ubat ortostatik (OD) (n = 145, 68.4%), dengan dua pertiga daripada mereka mempunyai risiko jatuh yang tinggi (n = 95, 65.5%). Satu kaitan yang penting antara penggunaan agen penghalang beta (p = 0.033), perencat sistem renin-angiotensin (p = 0.038), tempoh berada di rumahpenjagaan (p = 0.031), status kelemahan (p <0.001), jumlah ubatan yang diambil secara keseluruhan (p = 0.010) dan jumlah ubatan yang diambil bila perlu (p = 0.025) dengan peningkatan risiko untuk jatuh. Oleh itu, majoriti warga tua yang tinggal di rumahpenjagaan terdedah kepada penggunaan ubat yang mempunyai risiko untuk jatuh. Warga tua yang mempunyai sindrom lemah juga mempunyai risiko yang lebih besar untuk jatuh berbanding mereka yang tidak lemah.

Kata kunci: Kesan sampingan; penggunaan ubat; polifarmasi

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*Corresponding author; email: marhanis@ukm.edu.my