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- Title
The association between the number of prescription medications and incident falls in a multi-ethnic population of adult type-2 diabetes patients: the diabetes and aging study.
- Authors
Huang, Elbert S.; Karter, Andrew J.; Danielson, Kirstie K.; Warton, E. Margaret; Ahmed, Ameena T.
- Abstract
<bold>Background: </bold>Use of four or more prescription medications is considered a risk factor for falls in older people. It is unclear whether this polypharmacy-fall relationship differs for adults with diabetes.<bold>Objective: </bold>We evaluated the association between number of prescription medications and incident falls in a multi-ethnic population of type-2 diabetes patients in order to establish an evidence-based medication threshold for fall risk in diabetes.<bold>Design: </bold>Baseline survey (1994-1997) with 5 years of longitudinal follow-up.<bold>Participants: </bold>Eligible subjects (N = 46,946) had type-2 diabetes, were >or=18 years old, and enrolled in the Kaiser Permanente Northern California Diabetes Registry.<bold>Measurements and Main Results: </bold>We identified clinically recognized incident falls based on diagnostic codes (ICD-9 codes: E880-E888). Relative to regimens of 0-1 medications, regimens including 4 or more prescription medications were significantly associated with an increased risk of falls [4-5 medications adjusted HR 1.22 (1.04, 1.43), 6-7 medications 1.33 (1.12, 1.58), >7 medications 1.59 (1.34, 1.89)]. None of the individual glucose-lowering medications was found to be significantly associated with a higher risk of falls in predictive models.<bold>Conclusions: </bold>The prescription of four or more medications was associated with an increased risk of falls among adult diabetes patients, while no specific glucose-lowering agent was linked to increased risk. Baseline risk of falls and number of baseline medications are additional factors to consider when deciding whether to intensify diabetes treatments.
- Subjects
UNITED States; TYPE 2 diabetes; INTERNAL medicine; PUBLIC health; MEDICAL literature; TYPE 2 diabetes complications; AGING; COMPARATIVE studies; ETHNIC groups; ACCIDENTAL falls; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MEDICAL prescriptions; RESEARCH; RESEARCH funding; EVALUATION research; PREDICTIVE tests; DISEASE incidence; ACQUISITION of data; POLYPHARMACY
- Publication
JGIM: Journal of General Internal Medicine, 2010, Vol 25, Issue 2, p141
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-009-1179-2