What question did this study set out to answer?

June 26, 2026Open Access

Drug Utilisation of Fall-Risk-Increasing Drugs (FRIDs) and Risk of Hospitalisation: A Nested Case–Control Study Among Community-Dwelling Older Adults

Key Points

This study evaluates the link between fall-risk-increasing drug use and the risk of fall-related hospitalisation in older adults.
Nested case-control study using administrative healthcare data from older adults aged ≥65 in Italy.
Matched 1:1 by sex and age, comparing those with fall-related hospitalisation to those without.
Logistic regression was used to estimate adjusted odds ratios for drug exposure, controlling for polypharmacy and comorbidities.
Cases showed higher polypharmacy prevalence, with 42.03% on 5-9 drugs versus 37.16% in controls (p < 0.0001).
Fall-risk-increasing drug use was 37.70% in cases compared to 26.49% in controls (p < 0.0001), with an aOR of 1.51 (95% CI 1.44-1.59).
Opioids (aOR 1.40, 95% CI 1.31-1.50) and antidepressants (aOR 1.45, 95% CI 1.36-1.54) presented the highest risk for hospitalisation.

Abstract

Falls are a leading cause of hospitalisation among older adults, with substantial impacts on quality of life and healthcare costs. Fall-risk-increasing drugs represent an important risk factor. This study aimed to evaluate the association between fall-risk-increasing drug use and the risk of fall-related hospitalisation. A nested case-control study was conducted using administrative healthcare data from a sample of Italian community-dwelling older adults. Cases included individuals aged ≥65 years hospitalised for fall-related injuries in 2018, matched 1:1 by sex and age with controls who had no fall-related injuries. Fall-risk-increasing drug exposure was assessed by drug class, duration and recency of use. Adjusted odds ratios (aORs) were estimated using logistic regression, controlling for polypharmacy and comorbidities. Among 16,118 cases and 16,118 controls (68.77% female, mean age 79.76 years), cases showed a higher prevalence of polypharmacy (five to nine drugs: 42.03 vs 37.16%; ten or more drugs: 7.02 vs 5.44%; p 9 months; aOR 1.69, 95% CI 1.57–1.83) and current exposure (within 30 days before hospitalisation; aOR 1.78, 95% CI 1.68–1.89) showed higher odds. Fall-risk-increasing drug use was associated with a higher risk of fall-related hospitalisations in older adults. These findings support the importance of optimising prescribing and managing polypharmacy as potential strategies to improve patient safety and reduce the healthcare burden.

Perguntar à IA

Bookmark

View Full Paper