Analysis of potential cost reductions related to falls in hospitalized elderly patients by correcting high‐dose prescriptions of sedative hypnotics

Abstract

Background: Risk factors for falls include older age, diseases, and certain medications. High‐dose sedative hypnotics have been shown to increase the risk of falls, necessitating caution when these medications are used. High‐dose sedative hypnotics have an increased half‐life in elderly patients with reduced hepatic and renal function, which may increase fall risk. Methods: This retrospective survey evaluated the potential cost reductions associated with fall prevention by changing high‐dose prescriptions. For this purpose, the association between falls and high‐dose usage of sedative hypnotics was analyzed in hospitalized elderly patients. Study participants were 267 ambulatory patients aged ≥65 years who were taking sedative hypnotics and were hospitalized for ≥3 days from May 2012 to April 2013 at the Gifu Municipal Hospital, Japan. Patients' age, sex and usage of sedative hypnotics (high‐dose vs. non‐highdose) were analyzed, as well as the costs incurred by tests, drugs, and wages for medical personnel for patients on high‐dose sedative hypnotics who experienced falls. Results: Analysis revealed a significantly higher rate of falls in the group using high‐dose sedative hypnotics (21.4%; 14/224) compared to the non‐high‐dose group (6.3%; 9/42, p=0.004). Assessment of cost demonstrated potential savings of ¥589 per case if falls could be prevented by correcting high‐dose prescriptions. Conclusions: This study indicates that high‐dose prescriptions of sedative hypnotics may be associated with fall risk in the elderly. Correcting high‐dose prescriptions for these drugs would be beneficial not only for medical safety, but also the medical economy.