Prevalence and types of fall-risk-increasing drugs identified by STOPPFall in hospitalized older adults: A retrospective observational study

Background

Falls are a major public health concern, with fall-risk-increasing drugs (FRIDs) recognized as modifiable risk factors. The STOPPFALL— Screening Tool of Older Persons Prescriptions in older adults with high fall risk was recently developed to provide a comprehensive list of FRIDs, but few studies have assessed FRID prevalence using this tool.

Aim

This study aimed to describe the prevalence of FRIDs in a Swiss hospital, investigate changes in FRID prescription among patients identified by nurses at high risk of fall, and explore the association between FRID exposure and in-hospital falls.

Methods

This retrospective study analyzed health records of hospitalized patients over a one-year period. FRID prevalence at admission and discharge was assessed using the STOPPFall. Patients at risk of fall were identified based on the STRATIFY score. In-hospital falls were identified through incident reports.

Results

Of 741 participants, 44% (n = 332) were identified at high risk of fall, of whom 75% (n = 250) were prescribed at least one FRID at admission. The most frequently prescribed FRID classes were benzodiazepines, diuretics, and opioids. A significant reduction in FRID prescriptions was observed during hospitalization (p < 0.001). When high fall risk was documented by nurses, patients were less likely to be discharged with a FRID (p = 0.032). No significant association was found between FRID exposure and in-hospital falls.

Conclusion

Incorporating the STOPPFall into clinical practice could provide a structured framework to identify FRIDs, support the prioritization of patients for medication review, and improve medication safety in older adults.