Use of Psychotropic Medications by Older Adults Presenting to the Emergency Department After Fall-Related Injuries

Falls are among the leading causes of morbidity and mortality in older adults in Hawai'i. According to a recent report, 101 older adults in Hawai'i died from falls from 2011 to 2015, while another 9,158 had fall injuries resulting in hospitalizations or emergency department visits. Because certain medications can increase the risk of falls, medication reviews should be a component of any fall treatment plan. The purpose of this column is to examine medication interventions attempted before hospital discharge in patients taking psychotropic medications upon admission after a fall. A retrospective review of electronic medical records was conducted for the year 2016. All older adults admitted to a large hospital in Hawai'i after a fall-related injury who were taking a psychotropic medication were included. During the study period, 19 patients were admitted to the hospital on a psychotropic medication after a fall. Of the 19 patients, 18 (95%) had no change in their psychotropic medication during hospitalization. In 15 patients (79%), EMR documentation did not demonstrate an attempt to review psychotropic medications. The study confirms the need for medication reviews to address potentially inappropriate medications in older adults who are admitted to the hospital after a fall.