{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T18:17:49Z","timestamp":1759774669866,"version":"3.32.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australas J Ageing"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Older inpatients who fall are often frail, with multiple co\u2010morbidities and polypharmacy. Although the causes of falls are multifactorial, sedating and delirium\u2010inducing drugs increase that risk. The aims were to determine whether people who fell had a change in their sedative and anticholinergic medication burden during an admission compared to people who did not fall. A secondary aim was to determine the factors associated with change in drug burden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective, observational, case\u2013control study of inpatients who fell. Two hundred consecutive people who fell were compared with 200 randomly selected people who had not fallen. Demographics, functional ability, frailty and cognition were recorded. For each patient, their total medications and anticholinergic and sedative burden were calculated on admission and on discharge, using the drug burden index (DBI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>People who fell were more dependent and cognitively impaired than people who did not fallen. People who fell had a higher DBI on admission, than people who had not fall (mean: .69 vs .43, respectively, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and discharge (.66 vs .38, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). For both cohorts, the DBI decreased between admission and discharge (\u2212.03 and \u2212.05), but neither were clinically significant. Higher total medications and a higher number DBI medications on admission were both associated with greater DBI changes (<jats:italic>p<\/jats:italic>\u2009=\u2009.003 and &lt;.001, respectively). However, the presence (or absence) of cognitive impairment, dependency, frailty and single vs multiple falls were not significantly associated with DBI changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In older people, DBI medications and falls are both common and have serious consequences, yet this study was unable to demonstrate any clinically relevant reduction in average DBI either in people who fell or people who had not fallen during a hospital admission.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajag.13333","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T08:13:09Z","timestamp":1716279189000},"page":"706-714","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A comparison of changes in drug burden index between older inpatients who fell and people who have not fallen: A case\u2013control study"],"prefix":"10.1111","volume":"43","author":[{"given":"Claire E. T.","family":"O'Leary","sequence":"first","affiliation":[{"name":"Older Persons Health, Te Whatu Ora (Health New Zealand)\u2010Waitaha Burwood Hospital  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy J.","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Older Persons Health, Te Whatu Ora (Health New Zealand)\u2010Waitaha Burwood Hospital  Christchurch New Zealand"},{"name":"Department of Medicine University of Otago  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Carl","family":"Hanger","sequence":"additional","affiliation":[{"name":"Older Persons Health, Te Whatu Ora (Health New Zealand)\u2010Waitaha Burwood Hospital  Christchurch New Zealand"},{"name":"Department of Medicine University of Otago  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,21]]},"reference":[{"volume-title":"The Incidence and Costs of Inpatient Falls in Hospitals","year":"2017","author":"NHS Improvement","key":"e_1_2_10_2_1"},{"issue":"1","key":"e_1_2_10_3_1","article-title":"Reducing inpatient falls in a 100% single room elderly care environment: evaluation of the impact of a systematic nurse training programme on falls risk assessment (FRA)","volume":"5","author":"Singh I","year":"2016","journal-title":"BMJ Open Qual"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2017.01.012"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2010.444"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afu141"},{"key":"e_1_2_10_7_1","unstructured":"Health Quality and Safety Commission New Zealand.Health Quality & Safety Commission | Topic 8 supplement: which medicines increase the risk and consequences of falls?https:\/\/www.hqsc.govt.nz\/our\u2010programmes\/reducing\u2010harm\u2010from\u2010falls\/publications\u2010and\u2010resources\/publication\/2880\/"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.13402"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0091270006292126"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.8.781"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-017-0511-5"},{"issue":"7","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"e019042","DOI":"10.1136\/bmjopen-2017-019042","article-title":"Reducing the anticholinergic and sedative load in older patients on polypharmacy by pharmacist\u2010led medication review: a randomised controlled trial","volume":"8","author":"Meer HG","year":"2018","journal-title":"BMJ Open"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18691"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03386.x"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly176"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.15727"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269215513496801"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2019.01.004"},{"key":"e_1_2_10_19_1","unstructured":"National rehabilitation medicine integrated outcomes centre of Australia and New Zealand. 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