Reducing Falls Among Patients in Nursing Homes

To the Editor. —In the article on reducing falls in nursing homes by Dr Ray and colleagues,1the context section of the abstract indicates that interventions have been shown to prevent falls in nursing home residents.... However, at least 2 studies2,3have demonstrated that decreasing the use of psychoactive medications, and psychotropic agents in particular, reduces falls and fall-related injuries. One study2has shown that consultation with recommendations to limit shorter-acting benzodiazepines to no more than 3 doses per week and reduce the dose of triazolam from 250 to 125 pg reduced the occurrence of falls from 4 to none in 7 patients over a 1-year period. In a subsequent 1-year study of 182 patients, 54% of whom fell an average of 2.9 times, consultant pharmacist intervention determined that medications contributed to 85% offalls.3Psychotropic agents, other psychoactive drugs, and antihypertensive medications were the most