Polypharmacy and falls in older people: Balancing evidence-based medicine against falls risk

Abstract

The term polypharmacy has negative connotations due to its association with adverse drug reactions and falls. This spectrum of adverse events widens when polypharmacy occurs among the already vulnerable geriatric population. To date, there is no consensus definition of polypharmacy, and diverse definitions have been used by various researchers, the most common being the consumption of multiple number of medications. Taking multiple medications is considered a risk factor for falls through the adverse effects of drug–drug or drug–disease interactions. Falls studies have determined that taking ≥ 4 drugs is associated with an increased incidence of falls, recurrent falls, and injurious falls. In light of existing evidence, careful and regular medication reviews are advised to reduce the effect of polypharmacy on falls. However, intervention studies on medication reviews and their effectiveness on falls reduction have been scarce. This article reviews and discusses the evidence behind polypharmacy and its association with falls among older individuals, and highlights important areas for future research.

Keywords:

• Accidental falls
• aged
• inappropriate prescribing
• polypharmacy

Acknowledgment

This work was supported by the Ministry of Science, Technology, and Innovation Science Funds grant, Malaysia (SF017-2013). The authors have also received research grants from the University of Malaya (RP-010-2012A) and the Malaysian Ministry of Education High-Impact Research grant (UM.C/625/1/HIRMOHE/ASH/02). There are no relationships of this research with any industry.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.