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Drug Utilisation of Fall-Risk-Increasing Drugs (FRIDs) and Risk of Hospitalisation: A Nested Case-Control Study Among
Lara Perrella1, Elena Olmastroni2,3, Sara Mucherino1,4
1Department of Pharmacy, University of Naples Federico II, Naples, Italy.
Drugs & Aging
|June 24, 2026
Summary
Older adults taking fall-risk-increasing drugs face a significantly higher risk of hospitalisation due to falls. Optimising medication and managing polypharmacy are key to improving patient safety and reducing healthcare costs.
Area of Science:
- Gerontology
- Pharmacology
- Public Health
Background:
- Falls are a primary cause of hospitalisation in older adults, impacting quality of life and healthcare expenditure.
- Fall-risk-increasing drugs (FRIDs) are a significant, modifiable risk factor for falls in this population.
Purpose of the Study:
- To investigate the association between the use of fall-risk-increasing drugs and the likelihood of hospitalisation due to fall-related injuries among community-dwelling older adults.
- To quantify the increased risk of fall-related hospitalisation associated with FRID exposure.
Main Methods:
- A nested case-control study utilized administrative healthcare data from Italian older adults (≥65 years).
- Cases were individuals hospitalised for fall-related injuries in 2018, matched 1:1 with controls without fall-related injuries.
- FRID exposure was analyzed by drug class, duration, and recency, with adjusted odds ratios (aORs) calculated via logistic regression, controlling for polypharmacy and comorbidities.
Main Results:
- The study included 16,118 cases and 16,118 controls, with cases exhibiting higher rates of polypharmacy and multimorbidity.
- FRID use was more prevalent in cases (37.70% vs 26.49%), correlating with a 51% increased risk of fall-related hospitalisation (aOR 1.51).
- Opioids and antidepressants showed the highest associated risks, with prolonged or recent FRID exposure further elevating odds.
Conclusions:
- Fall-risk-increasing drug use is significantly associated with an elevated risk of fall-related hospitalisations in the elderly population.
- Strategies focusing on optimizing prescribing practices and managing polypharmacy are crucial for enhancing patient safety and mitigating the healthcare burden associated with falls.
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