{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:35:42Z","timestamp":1790746542852,"version":"4.1.0"},"reference-count":104,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Open Access Publication Fund of the Martin-Luther-University Halle-Wittenberg through the Open Access Publishing Program of the German Research Foundation (DFG)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Background\/Objectives: Falls and fractures are emerging as a near-pandemic and major global health concern, placing an enormous burden on ageing patients and public health economies. Despite the high risk of polypharmacy in the elderly patients, falls are usually attributed to age-related changes. For the \u201cIndividual Pharmacotherapy Management (IPM)\u201d established at the University Hospital Halle, the IPM medication adjustments and their association with in-hospital fall prevention were analysed. Methods: On the basis of the most updated digital overall patient view via his inpatient electronic health record (EHR), IPM adapts each drug\u2019s Summary of Product Characteristics to the patient\u2019s condition. A retrospective pre-post intervention study in geriatric traumatology on \u226570 years old patients compared 200 patients before IPM implementation (CG) with 204 patients from the IPM intervention period (IG) for the entire medication list, organ, cardiovascular and vital functions and fall risk parameters. Results: Statistically similar baseline data allowed a comparison of the average 80-year-old patient with a mean of 11.1 \u00b1 4.9 (CG) versus 10.4 \u00b1 3.6 (IG) medications. The IPM adjusted for drug-drug interactions, drug-disease interactions, overdoses, anticholinergic burden, adverse drug reactions, esp. from opioids inducing increased intrasynaptic serotonin, psychotropic drugs, benzodiazepines, contraindications and missing prescriptions. IPM was associated with a significant reduction in in-hospital falls from 18 (9%) in CG to 3 (1.5%) in IG, a number needed to treat of 14, relative risk reduction 83%, OR 0.17 [95% CI 0.04; 0.76], p = 0.021 in multivariable regression analysis. Factors associated with falls were antipsychotics, digitoxin, corticosteroids, W\u00fcrzburg pain drip (combination of tramadol, metamizole, metoclopramide), head injury, cognitive impairment and aspects of the Huhn Fall Risk Scale including urinary catheter. Conclusion: The results indicate medication risks constitute a major iatrogenic cause of falls in this population and support the use of EHR-based IPM in standard care for the prevention of falls in the elderly and for patient and drug safety. In terms of global efforts, IPM contributes to the running WHO and United Nations Decade of Healthy Ageing (2021\u20132030).<\/jats:p>","DOI":"10.3390\/ph17121587","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T11:25:33Z","timestamp":1732533933000},"page":"1587","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Individual Pharmacotherapy Management (IPM-II) for Patient and Drug Safety in Polypharmacy via Clinical Electronic Health Record Is Associated with Significant Fall Prevention"],"prefix":"10.3390","volume":"17","author":[{"given":"Ursula","family":"Wolf","sequence":"first","affiliation":[{"name":"Pharmacotherapy Management, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luise","family":"Drewas","sequence":"additional","affiliation":[{"name":"Internal Medicine Clinic II, Martha-Maria Hospital Halle-D\u00f6lau, 06120 Halle (Saale), Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Ghadir","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Cardiology, Johanniter-Hospital Geesthacht, 21502 Geesthacht, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Becherer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4691-3588","authenticated-orcid":false,"given":"Karl-Stefan","family":"Delank","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fcdiger","family":"Neef","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Trauma and Reconstructive Surgery, Division of Geriatric Traumatology, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/PL00004148","article-title":"World-wide projections for hip fracture","volume":"7","author":"Gullberg","year":"1997","journal-title":"Osteoporos. Int."},{"key":"ref_2","unstructured":"GBD 2019 Fracture Collaborators (2021). Global, regional, and national burden of bone fractures in 204 countries and territories, 1990-2019: A systematic analysis from the Global Burden of Disease Study 2019. Lancet Healthy Longev., 2, e580\u2013e592."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1002\/jbmr.4821","article-title":"Global Epidemiology of Hip Fractures: Secular Trends in Incidence Rate, Post-Fracture Treatment, and All-Cause Mortality","volume":"38","author":"Sing","year":"2023","journal-title":"J. Bone Miner. Res."},{"key":"ref_4","unstructured":"World Health Organization (2024, August 10). WHO Global Report on Falls Prevention in Older Age. WHO 2008. Available online: https:\/\/iris.who.int\/handle\/10665\/43811."},{"key":"ref_5","unstructured":"World Health Organization (2024, August 10). Step Safely: Strategies for Preventing and Managing Falls Across the Life-Course. WHO 2021. Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/340962\/9789240021914-eng.pdf?sequence=1."},{"key":"ref_6","unstructured":"World Health Organization (2024, August 10). Falls. In: WHO Fact Sheets. WHO 2018. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/falls#:~:text=Key%20facts,greatest%20number%20of%20fatal%20falls."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1056\/NEJM198812293192604","article-title":"Risk factors for falls among elderly persons living in the community","volume":"319","author":"Tinetti","year":"1988","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1056\/NEJM199409293311301","article-title":"A multifactorial intervention to reduce the risk of falling among elderly people living in the community","volume":"331","author":"Tinetti","year":"1994","journal-title":"N. Engl. J. Med."},{"key":"ref_9","first-page":"A-2150\/B-1812\/C-17163","article-title":"Sturzpr\u00e4vention bei Senioren: Eine interdisziplin\u00e4re Aufgabe","volume":"102","author":"Icks","year":"2005","journal-title":"Dtsch. Arzteb"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/injuryprev-2019-043214","article-title":"Multifactorial falls prevention programmes for older adults presenting to the emergency department with a fall: Systematic review and meta-analysis","volume":"25","author":"Morello","year":"2019","journal-title":"Inj. Prev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"197","DOI":"10.7326\/0003-4819-157-3-201208070-00462","article-title":"U.S. Preventive Services Task Force. Prevention of falls in community-dwelling older adults: U.S. Preventive Services Task Force recommendation statement","volume":"157","author":"Moyer","year":"2012","journal-title":"Ann. Intern. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e2138911","DOI":"10.1001\/jamanetworkopen.2021.38911","article-title":"Evaluation of Clinical Practice Guidelines on Fall Prevention and Management for Older Adults: A Systematic Review","volume":"4","author":"Kamkar","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"afac205","DOI":"10.1093\/ageing\/afac205","article-title":"World guidelines for falls prevention and management for older adults: A global initiative","volume":"51","author":"Martin","year":"2022","journal-title":"Age Ageing"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1007\/s41999-023-00824-8","article-title":"European position paper on polypharmacy and fall-risk-increasing drugs recommendations in the World Guidelines for Falls Prevention and Management: Implications and implementation","volume":"14","author":"Seppala","year":"2023","journal-title":"Eur. Geriatr. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/S2213-8587(23)00060-8","article-title":"Vitamin D: 100 years of discoveries, yet controversy continues","volume":"11","author":"Gallagher","year":"2023","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1210\/clinem\/dgae290","article-title":"Vitamin D for the prevention of disease: An Endocrine Society clinical practice guideline","volume":"109","author":"Demay","year":"2024","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"145","DOI":"10.7326\/M20-3812","article-title":"The Effects of Four Doses of Vitamin D Supplements on Falls in Older Adults: A Response-Adaptive, Randomized Clinical Trial","volume":"174","author":"Appel","year":"2021","journal-title":"Ann. Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1056\/NEJM200011233432101","article-title":"Prevention of hip fracture in elderly people with use of a hip protector","volume":"343","author":"Kannus","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1080\/07853890510007197","article-title":"Non-pharmacological means to prevent fractures among older adults","volume":"37","author":"Kannus","year":"2005","journal-title":"Ann. Med."},{"key":"ref_20","unstructured":"United Nations, Department of Economic and Social Affairs, Population Division (2024, August 04). World Population Prospects 2019, Data Booklet (ST\/ESA\/SER.A\/424), pp. 1\u201325. Available online: https:\/\/population.un.org\/wpp\/publications\/files\/wpp2019_databooklet.pdf."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1055\/s-0036-1574864","article-title":"Vorsicht, Schwerkraft! Sturzprophylaxe","volume":"13","author":"Geisendorf","year":"2008","journal-title":"Kma"},{"key":"ref_22","unstructured":"AWMF (2024, August 04). Sterberisiko \u201cGebrochene H\u00fcfte\u201d: Experten warnen vor Schenkelhalsfraktur im Alter. 17 October 2012. Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, Medizinkommunikation. Available online: https:\/\/idw-online.de\/de\/news501977."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1055\/s-2007-992778","article-title":"Sozio\u00f6konomische Bedeutung von H\u00fcftfrakturen in Deutschland Socioeconomic Burden of Hip Fractures in Germany","volume":"69","author":"Weyler","year":"2007","journal-title":"Gesundheitswesen"},{"key":"ref_24","unstructured":"(2024, August 04). World Health Assembly, 73 (2020). Decade of Healthy Ageing: The Global Strategy and Action Plan on Ageing and Health 2016\u20132020: Towards a World in Which Everyone Can Live a Long and Healthy Life: Report by the Director-General. World Health Organization. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/355618."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1056\/NEJM199102073240604","article-title":"Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I","volume":"324","author":"Brennan","year":"1991","journal-title":"N. Engl. J. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"237","DOI":"10.5770\/cgj.24.478","article-title":"Medication Review in Preventing Older Adults\u2019 Fall-Related Injury: A Systematic Review & Meta-Analysis","volume":"24","author":"Ming","year":"2021","journal-title":"Can. Geriatr. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"afac191","DOI":"10.1093\/ageing\/afac191","article-title":"Medication reviews and deprescribing as a single intervention in falls prevention: A systematic review and meta-analysis","volume":"51","author":"Seppala","year":"2022","journal-title":"Age Ageing"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Jordan, S., Gabe-Walters, M.E., Watkins, A., Humphreys, I., Newson, L., Snelgrove, S., and Dennis, M.S. (2015). Nurse-Led Medicines\u2019 Monitoring for Patients with Dementia in Care Homes: A Pragmatic Cohort Stepped Wedge Cluster Randomised Trial. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0140203"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1093\/ageing\/afaa249","article-title":"STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk): A Delphi study by the EuGMS Task and Finish Group on Fall-Risk-Increasing Drugs","volume":"50","author":"Seppala","year":"2021","journal-title":"Age Ageing"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"By the 2023 American Geriatrics Society Beers Criteria\u00ae Update Expert Panel (2023). American Geriatrics Society 2023 updated AGS Beers Criteria\u00ae for potentially inappropriate medication use in older adults. J. Am. Geriatr. Soc., 71, 2052\u20132081.","DOI":"10.1111\/jgs.18372"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1007\/s00228-014-1731-9","article-title":"Effects of \u201cFit fOR The Aged\u201d (FORTA) on pharmacotherapy and clinical endpoints\u2014A pilot randomized controlled study","volume":"70","author":"Michalek","year":"2014","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1136\/ejhpharm-2016-001003","article-title":"Deprescribing medicines in the acute setting to reduce the risk of falls","volume":"24","author":"Marvin","year":"2017","journal-title":"Eur. J. Hosp. Pharm."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"afab205","DOI":"10.1093\/ageing\/afab205","article-title":"Potentially inappropriate medications and their effect on falls during hospital admission","volume":"51","author":"Raven","year":"2022","journal-title":"Age Ageing"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Drewas, L., Ghadir, H., Neef, R., Delank, K.S., and Wolf, U. (2022). Individual Pharmacotherapy Management (IPM)\u2014I: A group-matched retrospective controlled clinical study on prevention of complicating delirium in the elderly trauma patients and identification of associated factors. BMC Geriatr., 22.","DOI":"10.1186\/s12877-021-02630-y"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Wolf, U., Ghadir, H., Drewas, L., and Neef, R. (2023). Underdiagnosed CKD in Geriatric Trauma Patients and Potent Prevention of Renal Impairment from Polypharmacy Risks through Individual Pharmacotherapy Management (IPM-III). J. Clin. Med., 12.","DOI":"10.3390\/jcm12134545"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Wolf, U., Baust, H., Neef, R., and Steinke, T. (2022). Individual Pharmacotherapy Management (IPM)\u2014IV: Optimized Usage of Approved Antimicrobials Addressing Under-Recognized Adverse Drug Reactions and Drug-Drug Interactions in Polypharmacy. Antibiotics, 11.","DOI":"10.3390\/antibiotics11101381"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Wolf, U. (2023). A Drug Safety Concept (I) to Avoid Polypharmacy Risks in Transplantation by Individual Pharmacotherapy Management in Therapeutic Drug Monitoring of Immunosuppressants. Pharmaceutics, 15.","DOI":"10.3390\/pharmaceutics15092300"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Wolf, U. (2024). A Drug Safety Briefing (II) in Transplantation from Real-World Individual Pharmacotherapy Management to Prevent Patient and Graft from Polypharmacy Risks at the Very Earliest Stage. Pharmaceuticals, 17.","DOI":"10.3390\/ph17030294"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"471","DOI":"10.7326\/0003-4819-157-7-201210020-00003","article-title":"Two novel equations to estimate kidney function in persons aged 70 years or older","volume":"15","author":"Schaeffner","year":"2012","journal-title":"Ann. Intern. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s40520-023-02657-8","article-title":"Optimal assessment of the glomerular filtration rate in older chinese patients using the equations of the Berlin Initiative Study","volume":"36","author":"Yang","year":"2024","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e8525","DOI":"10.1136\/bmj.e8525","article-title":"Concurrent use of diuretics, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers with non-steroidal anti-inflammatory drugs and risk of acute kidney injury: Nested case-control study","volume":"346","author":"Lapi","year":"2013","journal-title":"BMJ"},{"key":"ref_42","unstructured":"(2024, August 31). Memantine Mylan 10 mg Film-Coated Tablets. Healthcare Professionals (SmPC). 19 October 2021. Available online: https:\/\/www.medicines.org.uk\/emc\/product\/716\/smpc#gref."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Schlereth, T. (2019). Diagnose und nicht interventionelle Therapie neuropathischer Schmerzen, S2k-Leitlinie. Leitlinien f\u00fcr Diagnostik und Therapie in der Neurologie, Deutsche Gesellschaft f\u00fcr Neurologie (Hrsg.). Available online: https:\/\/register.awmf.org\/assets\/guidelines\/030-114l_S2k_Diagnose-nicht-interventionelle-Therapie-neuropathischer-Schmerzen_2023-07-abgelaufen.pdf.","DOI":"10.1007\/s42451-019-00139-8"},{"key":"ref_44","unstructured":"(2024, August 31). Pregabalin Milpharm 150 mg Capsules, Hard. Healthcare Professionals (SmPC), Last Updated on Emc: 21 February 2024. Available online: https:\/\/www.medicines.org.uk\/emc\/product\/7132\/smpc#gref."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Ludwig, W.D., M\u00fchlbauer, B., and Seifert, R. (2022). 1. Arzneiverordnungen 2021 im \u00dcberblick. Arzneiverordnungs-Report 2022, Springer. Chapter 1, 15.","DOI":"10.1007\/978-3-662-66303-5_1"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.1001\/archinternmed.2009.357","article-title":"Meta-analysis of the impact of 9 medication classes on falls in elderly persons","volume":"169","author":"Woolcott","year":"2009","journal-title":"Arch. Intern. Med."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Salahudeen, M.S., Duffull, S.B., and Nishtala, P.S. (2015). Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: A systematic review. BMC Geriatr., 15.","DOI":"10.1186\/s12877-015-0029-9"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s00482-015-1512-0","article-title":"Serotoninsyndrom und medikament\u00f6se Schmerztherapie","volume":"29","author":"Schenk","year":"2015","journal-title":"Schmerz"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1097\/ALN.0b013e31823940c0","article-title":"Case scenario: Opioid association with serotonin syndrome: Implications to the practitioners","volume":"115","author":"Rastogi","year":"2011","journal-title":"Anesthesiology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1111\/bph.14105","article-title":"Opioid-induced inhibition of the human 5-HT and noradrenaline transporters in vitro: Link to clinical reports of serotonin syndrome","volume":"175","author":"Rickli","year":"2018","journal-title":"Br. J. Pharmacol."},{"key":"ref_51","first-page":"46","article-title":"Sturz-Risiko-Skala: Was aus dem Tritt bringt","volume":"106","author":"Huhn","year":"2000","journal-title":"Forum Sozialstation"},{"key":"ref_52","first-page":"359","article-title":"St\u00e4rken und Schw\u00e4chen der \u201cNumber needed to treat\u201d (NNT)","volume":"98","author":"Raspe","year":"2004","journal-title":"Z\u00e4rztl Fortbild. Qual. Gesundhwes"},{"key":"ref_53","unstructured":"(2024, November 19). Statistisches Bundesamt, Genesis Online Datenbank, Eigene Berechnung. Bev\u00f6lkerung nach Altersgruppen und Geschlecht 2023, in Sozialpolitik-aktuell.de, 2024. Available online: https:\/\/www.sozialpolitik-aktuell.de\/files\/sozialpolitik-aktuell\/_Politikfelder\/Bevoelkerung\/Datensammlung\/PDF-Dateien\/abbVIII3.pdf."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1007\/s00198-008-0779-8","article-title":"Remaining lifetime and absolute 10-year probabilities of osteoporotic fracture in Swiss men and women","volume":"20","author":"Lippuner","year":"2009","journal-title":"Osteoporos. Int."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1016\/S0140-6736(02)08657-9","article-title":"Epidemiology and outcomes of osteoporotic fractures","volume":"359","author":"Cummings","year":"2002","journal-title":"Lancet"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Li, G., Thabane, L., Papaioannou, A., Ioannidis, G., Levine, M.A., and Adachi, J.D. (2017). An overview of osteoporosis and frailty in the elderly. BMC Musculoskelet. Disord., 18.","DOI":"10.1186\/s12891-017-1403-x"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1111\/jnu.12322","article-title":"Frailty as a risk factor for falls among community dwelling people: Evidence from a metaanalysis","volume":"49","author":"Cheng","year":"2017","journal-title":"J. Nurs. Scholarsh."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Liu, S.Y., Yang, Y.K., Kor, C.T., Sun, Y.W., Wang, H.Y., Yang, Y.T., and Chou, M.C. (2024). Factors Impacting Fall Severity in Hospitalized Patients: A Retrospective Cohort Study. J. Clin. Med., 13.","DOI":"10.3390\/jcm13102827"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Greco, E.A., Pietschmann, P., and Migliaccio, S. (2019). Osteoporosis and Sarcopenia Increase Frailty Syndrome in the Elderly. Front. Endocrinol., 10.","DOI":"10.3389\/fendo.2019.00255"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Thong, B.K.S., Ima-Nirwana, S., and Chin, K.Y. (2019). Proton Pump Inhibitors and Fracture Risk: A Review of Current Evidence and Mechanisms Involved. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16091571"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s00228-021-03237-3","article-title":"Proton pump inhibitors and osteoporosis risk: Exploring the role of TRPM7 channel","volume":"78","author":"Desai","year":"2022","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2489","DOI":"10.1002\/jbmr.2279","article-title":"Long-term proton pump inhibitor therapy and falls and fractures in elderly women: A prospective cohort study","volume":"29","author":"Lewis","year":"2014","journal-title":"J. Bone Miner. Res."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Wolf, U., and Wegener, M. (2024). Proton Pump Inhibitor Prescription in Nursing Home Residents: Prevalence, Appropriateness, and Associated Factors\u2014A Secondary Data Analysis from Three German Regions and the Impact of Guideline Recommendations. Pharmaceuticals, 17.","DOI":"10.3390\/ph17081082"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1111\/joim.12842","article-title":"Evidence supporting the best clinical management of patients with multimorbidity and polypharmacy: A systematic guideline review and expert consensus","volume":"285","author":"Muth","year":"2019","journal-title":"J. Intern. Med."},{"key":"ref_65","unstructured":"World Health Organization (2024, July 25). Medication Safety in Polypharmacy. 2019, Geneva, (WHO\/UHC\/SDS\/2019.11). Licence: CCBY-NC-SA 3.0 IGO. Available online: https:\/\/www.who.int\/docs\/default-source\/patient-safety\/who-uhc-sds-2019-11-eng.pdf."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"217","DOI":"10.4140\/TCP.n.2021.217","article-title":"Impact of a Pharmacy-Led Fall Prevention Program for Institutionalized Older People","volume":"36","author":"Gross","year":"2021","journal-title":"Sr. Care Pharm."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e035978","DOI":"10.1136\/bmjopen-2019-035978","article-title":"Deprescribing fall-risk increasing drugs (FRIDs) for the prevention of falls and fall-related complications: A systematic review and meta-analysis","volume":"11","author":"Lee","year":"2021","journal-title":"BMJ Open"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"3360","DOI":"10.1111\/bcp.15287","article-title":"Effects of a comprehensive medication review intervention on health-related quality of life and other clinical outcomes in geriatric outpatients with polypharmacy: A pragmatic randomized clinical trial","volume":"88","author":"Kornholt","year":"2022","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_69","first-page":"705","article-title":"Drug Safety for Nursing-Home Residents-Findings of a Pragmatic, Cluster-Randomized, Controlled Intervention Trial in 44 Nursing Homes","volume":"18","author":"Krause","year":"2021","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"15","DOI":"10.2165\/11598420-000000000-00000","article-title":"Psychotropic drug-induced falls in older people: A review of interventions aimed at reducing the problem","volume":"29","author":"Hill","year":"2012","journal-title":"Drugs Aging"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e067386","DOI":"10.1136\/bmjopen-2022-067386","article-title":"Prevalence of undiagnosed stage 3 chronic kidney disease in France, Germany, Italy, Japan and the USA: Results from the multinational observational REVEAL-CKD study","volume":"13","author":"Tangri","year":"2023","journal-title":"BMJ Open"},{"key":"ref_72","unstructured":"Todd, C., and Skelton, D. (2024, August 10). What Are the Main Risk Factors for Falls Among Older People and What Are the Most Effective Interventions to Prevent These Falls? Copenhagen, WHO Regional Office for Europe. Health Evidence Network Report 2004. Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/363812\/9789289057318-eng.pdf?sequence=1."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1111\/jan.12542","article-title":"Systematic review of fall risk screening tools for older patients in acute hospitals","volume":"71","author":"Matarese","year":"2015","journal-title":"J. Adv. Nurs."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/1941874412470665","article-title":"Inpatient falls: Defining the problem and identifying possible solutions. Part I: An evidence-based review","volume":"3","author":"Cumbler","year":"2013","journal-title":"Neurohospitalist"},{"key":"ref_75","first-page":"408","article-title":"Is it possible to identify risks for injurious falls in hospitalized patients?","volume":"38","author":"Mion","year":"2012","journal-title":"Jt. Comm. J. Qual. Patient Saf."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40520-017-0749-0","article-title":"Tools for assessing fall risk in the elderly: A systematic review and meta-analysis","volume":"30","author":"Park","year":"2018","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_77","first-page":"f6234","article-title":"The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: Systematic review and meta-analysis of randomised controlled trials","volume":"347","author":"Cassou","year":"2013","journal-title":"BMJ"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Guirguis-Blake, J.M., Michael, Y.L., Perdue, L.A., Coppola, E.L., Beil, T.L., and Thompson, J.H. (2018). Interventions to Prevent Falls in Community-Dwelling Older Adults: A Systematic Review for the U.S. Preventive Services Task Force [Internet], Report No.:17-05232-EF-1.","DOI":"10.1001\/jama.2017.21962"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Dahl, M.L., Leander, K., Vikstr\u00f6m, M., Frumerie, C., Nordenmalm, S., M\u00f6ller, J., and S\u00f6derberg-L\u00f6fda, K. (2021). CYP2D6-inhibiting drugs and risk of fall injuries after newly initiated antidepressant and antipsychotic therapy in a Swedish, register-based case-crossover study. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-85022-x"},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Kirsch, I., Deacon, B.J., Huedo-Medina, T.B., Scoboria, A., Moore, T.J., and Johnson, B.T. (2008). Initial severity and antidepressant benefits: A meta-analysis of data submitted to the Food and Drug Administration. PLoS Med., 5.","DOI":"10.1371\/journal.pmed.0050045"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1016\/S0140-6736(18)30668-8","article-title":"Development and validation of a Hospital Frailty Risk Score focusing on older people in acute care settings using electronic hospital records: An observational study","volume":"391","author":"Gilbert","year":"2018","journal-title":"Lancet"},{"key":"ref_82","unstructured":"Fachinfo-Service (2024, August 04). Fachinformationsverzeichnis Deutschland. Available online: https:\/\/www.fachinfo.de\/."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/j.1532-5415.1999.tb01899.x","article-title":"Drugs and falls in older people: A systematic review and meta-analysis: II. Cardiac and analgesic drugs","volume":"47","author":"Leipzig","year":"1999","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_84","first-page":"371","article-title":"Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: I. Cardiovascular Drugs","volume":"19","author":"Seppala","year":"2018","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1093\/gerona\/60.5.622","article-title":"Psychotropic medications and risk for falls among community-dwelling frail older people: An observational study","volume":"60","author":"Landi","year":"2005","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"371.e11","DOI":"10.1016\/j.jamda.2017.12.098","article-title":"Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: II. Psychotropics","volume":"19","author":"Seppala","year":"2018","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_87","unstructured":"(2024, September 01). Tramadol 50 mg Capsules. Aurobindo Pharma\u2014Milpharm Ltd. SmPC, Last Updated on Emc: 4 July 2024. Available online: https:\/\/www.medicines.org.uk\/emc\/product\/7123\/smpc#gref."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1007\/s10198-015-0673-1","article-title":"Tramadol and the risk of fracture in an elderly female population: A cost utility assessment with comparison to transdermal buprenorphine","volume":"17","author":"Hirst","year":"2016","journal-title":"Eur. J. Health Econ."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1111\/papr.12467","article-title":"Metamizole (Dipyrone) as an Alternative Agent in Postoperative Analgesia in Patients with Contraindications for Nonsteroidal Anti-Inflammatory Drugs","volume":"17","author":"Ekhart","year":"2017","journal-title":"Pain Pract."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1921","DOI":"10.1111\/bcp.14094","article-title":"Prescribing medicines to older people-How to consider the impact of ageing on human organ and body functions","volume":"86","author":"Wilting","year":"2020","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1007\/s12603-016-0741-y","article-title":"A Comprehensive Fracture Prevention Strategy in Older Adults: The European Union Geriatric Medicine Society (EUGMS) Statement","volume":"20","author":"Blain","year":"2016","journal-title":"J. Nutr. Health Aging"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"21501319231221002","DOI":"10.1177\/21501319231221002","article-title":"Prescribing Patterns of Proton Pump Inhibitors in Germany: A Retrospective Study Including 472\u2009146 Patients","volume":"14","author":"Plehhova","year":"2023","journal-title":"J. Prim. Care Community Health"},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Wolf, U., Eckert, S., Walter, G., Wienke, A., Bartel, S., Plontke, S.K., and Naumann, C. (2021). Prevalence of oropharyngeal dysphagia in geriatric patients and real-life associations with diseases and drugs. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-99858-w"},{"key":"ref_94","first-page":"70033","article-title":"Commentary on \u201cPrevalence of Oropharyngeal Dysphagia in Geriatric Patients and Real-Life Associations with Diseases and Drugs\u201d: Do we need a Dysphagia Risk Scale as a Preventive Patient Safety Concern? And a Regulation for Obligatory Medication Review in Oropharyngeal Dysphagia?","volume":"7","author":"Wolf","year":"2022","journal-title":"J. Healthc. Commun."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1007\/s41999-021-00511-6","article-title":"Association between psychotropic drug use and handgrip strength in older hospitalized patients","volume":"12","author":"Sandvik","year":"2021","journal-title":"Eur. Geriatr. Med."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/PTS.0000000000000163","article-title":"Medications and Patient Characteristics Associated With Falling in the Hospital","volume":"14","author":"Krauss","year":"2018","journal-title":"J. Patient Saf."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1007\/s00432-021-03625-3","article-title":"Interactions in cancer treatment considering cancer therapy, concomitant medications, food, herbal medicine and other supplements","volume":"148","author":"Wolf","year":"2022","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1007\/s00432-021-03675-7","article-title":"Complementary and alternative medicine (CAM) supplements in cancer outpatients: Analyses of usage and of interaction risks with cancer treatment","volume":"148","author":"Wolf","year":"2022","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_99","unstructured":"Dosing (2024, August 04). Arzneimitteldosierung bei Niereninsuffizienz. 1998\u20132023 Abt. Klinische Pharmakologie & Pharmakoepidemiologie, Universit\u00e4tsklinikum Heidelberg. Available online: https:\/\/dosing.de\/nierelst.php\/."},{"key":"ref_100","unstructured":"(2024, September 03). Stanford Health Care Antimicrobial Dosing Reference Guide. ABX Subcommittee Approved: 12\/2022. Pharmacy & Therapeutics Committee Approved 1\/2023. Available online: https:\/\/med.stanford.edu\/content\/dam\/sm\/bugsanddrugs\/documents\/antimicrobial-dosing-protocols\/SHC%20Antimicrobial%20Dosing%20Guide.pdfobial%20Dosing%20Guide.pdf."},{"key":"ref_101","unstructured":"(2024, September 03). Renal Dose Adjustment Guidelines for Antimicrobials. CRRT Dosing Recommendations. Prepared by Peitz, G.; Rolek, K.; Van Schooneveld, T. Approved by Antimicrobial Stewardship Program: June 2016. Available online: https:\/\/www.unmc.edu\/intmed\/_documents\/id\/asp\/dose-renal-dose-adjustment-guidelines-for-antimicrobial.pdf."},{"key":"ref_102","unstructured":"(2024, August 04). Drugs.com. Drug Interaction Checker. Available online: https:\/\/www.drugs.com\/drug_interactions.html."},{"key":"ref_103","unstructured":"(2024, August 31). DrugBank Online. Interaction Checker. Available online: https:\/\/go.drugbank.com\/drug-interaction-checker#results."},{"key":"ref_104","unstructured":"Wolf, U. (2019, January 21\u201322). Cross-sector postgraduate interprofessional workshops as a preventive tool to avoid risks of polypharmacy in the elderly\u20141. Feasibility? 2. Resonance?\u2026 and a revelation. Proceedings of the 26th Annual Meeting of the German Drug Utilisation Research Group (GAA), Bonn, Germany."}],"container-title":["Pharmaceuticals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8247\/17\/12\/1587\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:39:17Z","timestamp":1760114357000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8247\/17\/12\/1587"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,25]]},"references-count":104,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["ph17121587"],"URL":"https:\/\/doi.org\/10.3390\/ph17121587","relation":{},"ISSN":["1424-8247"],"issn-type":[{"value":"1424-8247","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,25]]}}}