Fall Risk and Medication Use Near End of Life Among Adults With Chronic Obstructive Pulmonary Disease

Area of Science:

• Gerontology
• Pharmacology
• Pulmonology

Background:

• Falls are a significant concern for individuals with chronic obstructive pulmonary disease (COPD).
• These falls lead to increased illness, death, and healthcare expenses.
• Identifying medication-related risk factors is crucial for fall prevention in COPD patients.

Purpose of the Study:

• To investigate the association between fall-risk increasing drug (FRID) burden and injurious falls in patients with COPD.
• To understand the prevalence of FRID use and specific drug classes associated with falls in this population.

Main Methods:

• Retrospective cohort study using electronic health records and death certificates (2014-2018).
• Included adults aged 40+ with COPD.
• Identified demographics, comorbidities, FRID burden, and injurious falls using ICD codes within two years prior to death.

Main Results:

• 30% of 8204 COPD decedents experienced an injurious fall within two years of death.
• 65% of patients used FRIDs; higher use of anticonvulsants, antipsychotics, and antidepressants was observed in patients with falls.
• FRID burden was significantly associated with increased odds of injurious falls (OR 1.07, 95% CI 1.04-1.09).

Conclusions:

• An opportunity exists for collaborative interventions between healthcare professionals and patients.
• Deprescribing and optimizing FRID use in COPD patients can enhance safety.
• This study underscores the importance of medication management in fall prevention for COPD patients.