Authors: Montero-Balosa, Palma-Morgado, Alvarado Fernández, Vela-Márquez, Gutiérrez-Gil, Sánchez-Blanco, Pérez-Fuentes, Sagristá-González, Segura del Real, Vilches-Arenas.
Introduction and Objective: To investigate whether reducing the use of ≥2 benzodiazepines and Z–drugs (BZD-Z) to ≤1 was associated with a decreased fall risk in polymedicated and elderly patients.
Material and Methods: Prospective observational study to compare the fall risk in patients that remained taking 2 or more BZD-Z with those who tapered to 1 or none BZD-Z. Subjects were polymedicated patients, ≥65 years with concomitant use of ≥2 BZD-Z who received primary care in health centres. Main Measures: time to fall (Kaplan- Meier, Cox-regression model, multivariate analysis). Analyses was adjusted for confounder variables such as health problems and other treatments.
Results: A total of 228 patients taking BZD-Z were followed during 1,085 days. Patients using ≥2 BZD-Z had 2.76 times (95%CI:1.34-5.68; p=0.006) greater risk of fall at any moment of the follow-up than those taking ≤1 BZD-Z. Antidepressants and oral corticosteroids were the other specific medication classes that showed a greater risk of fall:1.99 (95%CI:1.17-3.41; p=0.011) and 2.34 (95%CI:1.13-5.07; p=0.023), respectively. The Kaplan-Meier method revealed a significant increase of fall risk for patients continuously taking ≥2 BZD-Z compared with those intermittently taking ≥2 BZD-Z or taking ≤1 BZD-Z (p=0.008). Those patients concurrently using ≥2 BZD-Z and antidepressants showed a tendency to an increased fall risk (p<0,043).
Conclusions: Reducing the number of BZD-Z to below 2 is associated with a reduced fall risk. The concomitant BZD-Z use with antidepressants is associated with an increased fall risk in polymedicated elderly patients.
View/Download pdf