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The Fall Risk with Alpha blockers Given InitiaL dose or Elderly status (FRAGILE) Study.
Chelsea C McDonnell1, Kelly C Rogers1,2, Sloan M Regen1
1Memphis Veterans Affairs Medical Center, Memphis, TN, USA.
The Annals of Pharmacotherapy
|October 4, 2019
Summary
Alpha-1 blockers did not significantly increase adverse drug events (ADEs) or fall-related side effects in at-risk veterans. Pharmacists can help optimize medication use to minimize potential risks.
Area of Science:
- Pharmacology
- Geriatrics
- Patient Safety
Background:
- Alpha-1 adrenergic antagonists are widely prescribed.
- Safety concerns exist for patients at increased risk of falls.
- The FRAGILE study investigated these safety concerns.
Purpose of the Study:
- To determine the risk of adverse drug events (ADEs) in veterans prescribed alpha-1 blockers.
- To compare ADEs in at-risk versus control groups.
- To evaluate fall-related ADEs and discontinuation rates.
Main Methods:
- Retrospective, observational cohort study of 300 veterans.
- Categorized veterans into at-risk (age ≥ 65 or high initial dose) and control groups.
- Primary outcome: composite all-cause ADEs (hospitalizations, ED visits); Secondary outcomes: fall-related ADEs, discontinuation rates.
Main Results:
- No significant difference in composite all-cause ADEs between at-risk and control groups.
- No significant differences in secondary outcomes, including fall-related ADEs.
- Fall-related side effects occurred in 8% of the total cohort.
Conclusions:
- Alpha-1 blockers did not significantly increase all-cause or fall-related ADEs in this veteran cohort.
- An 8% discontinuation rate due to fall-related ADEs was observed.
- Pharmacists can optimize alpha-1 blocker administration, considering co-prescribed medications.
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