New research from Mount Sinai Hospital in New York shows that the electronic prescribing of certain high-risk medications to elderly patients could contribute to the likelihood of them falling.
The study, published in the Journal of the American Geriatrics Society, reported that of 287 individuals over the age of 65 who fell while hospitalized at an urban academic hospital, 62 percent of the incidents occurred in patients who had been administered high-risk medication within 24 hours before the fall.
Researchers found that the high-risk medications were usually given in higher doses than that which is recommended for elderly patients. Benzodiazepines and benzodiazepine-receptor agonists were medications particularly given in very high doses, accounting for 57 percent of the cases in which a patient fell.
Additionally, it was found that hospitals’ electronic medical record default doses that completed the electronic prescribing were higher than recommended for the patients in 41 percent of medications.
"Before the widespread use of electronic prescribing, physicians had to consciously determine the appropriate drug dosage for an individual,” said Rosanne Leipzig, MD, senior clinician-author of the study and a professor of geriatrics and palliative medicine at Mount Sinai. “This study highlights that with electronic prescribing, default doses do matter and lowering defaults for vulnerable patient groups such as elderly patients may be an easy way to reduce inappropriate use of high risk drugs for these patients.”
According to the Centers for Disease Control and Prevention, more than 800,000 elderly patients each year are hospitalized because of a fall injury, and in 2015, Medicare costs to treat falls totaled to more than $31 billion.