ABSTRACT Background: Falls and fall-risk-increasing-drugs (FRID) are strongly interlinked and have extensive prevalence among the older population. FRID are considered inappropriate, but in spite of deprescribing guidelines, limited studies have been performed about the feasibility and success of deprescribing intervention among older fallers. Objectives: The aim of our study was to assess the feasibility of deprescribing and its effect of falls among community-dwelling older fallers. Methods: This study is a substudy of randomized controlled trial; fallers (age ≥65 years and history of two falls or one injurious fall in the past 1 year) were included in the study. After obtaining history (i.e., demographics, comorbidities, and medication intake) and measurements, the participants were randomized into intervention and nonintervention arms. Participants in the intervention arm received a medication review followed by intervention (deprescribing, swapping with a safer alternative or dose-reduction of FRID) and both groups were followed for falls for 1 year. Results: Two hundred and sixty-eight fallers were randomized into the intervention and nonintervention arm (134 each), with diary return rate as 98 (87%) and 95 (86.3%), respectively. Due to randomization, no differences in the age, gender, number of comorbidities or medical conditions, number or type of medications and blood pressure readings or orthostatic hypotension were observed between the two groups. In the intervention group, it was possible to withdraw, substitute or reduce dosage in 42 (31.34%) of fallers through medication review intervention, no significant reduction in fall rates was observed during 1-year follow-up. Conclusion: Among older patients receiving multiple medications, FRID intervention may not be feasible while taking patient’s comorbidities into account, and hence, it may not prove to be a successful intervention in falls reduction.
Zia et al. (Thu,) studied this question.