RISK OF ANTICHOLINERGIC DRUGS USE AND FALLS IN THE ELDERLY PATIENTS: A RETROSPECTIVE COHORT STUDY
DOI:
https://doi.org/10.69598/tbps.17.1.43-56Keywords:
anticholinergic drugs, elderly patients, fallsAbstract
Anticholinergic drug use can cause adverse drug reactions to include sedation, blurred vision and others which, in turn, results in hospital-related falls. However, there is no report of the association between anticholinergic drug use and falls in Thailand. The objectives of this study were to measure the incidence rate of falls and the association between anticholinergic drug use and falls. This retrospective cohort study using data from electronic medical records (EMRs) of patients who received medical services in Warinchamrab Hospital and 22 Health Promoting Hospitals in the network from 1 January 2010 through 31 December 2019. The patients included were 65 years or older, firstly prescribed with and continuously used either anticholinergic drugs or other medications. They were divided into groups by Anticholinergic Cognitive Burden score (ACB). Data was analyzed by incidence rate and the association between anticholinergic drug use and falls was identified by Cox proportional hazard regression model. Of the 16,624 patients included, average age was 73.02±6.77 years and mean follow-up time was 4.15±1.52 years. The incidence rate of patients with falls in anticholinergic users and other drug users were 60.80 and 22.77 cases per 1,000 person-years, respectively. The adjusted hazard ratio (95% CI) for ACB scores of 1, 2-3, and ≥4 compared with the control group (ACB=0) for hospital-related falls were 1.28 (1.14 - 1.44, p<0.001), 1.83 (1.61 - 2.09, p<0.001) and 3.25 (2.71 - 3.89, p<0.001), respectively. Anticholinergic drugs increase the risk of falls in elderly patients. If the elderly use anticholinergic drugs continuously, the risk of falls should be monitored and assessed. Patient information about anticholinergic drugs-induced falls must be provided for active self-monitoring.
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