EuGMS Task and Finish group on Fall-Risk-Increasing Drugs (FRIDs): Position on Knowledge Dissemination, Management, and Future Research

L J Seppala¹, N van der Velde², T Masud³, H Blain⁴, M Petrovic⁵, T J van der Cammen⁶, K Szczerbińska⁷, S Hartikainen⁸, R A Kenny^{9

10

11}, J Ryg^{12

13}, P Eklund¹⁴, E Topinková^{15

16}, A Mair¹⁷, L Laflamme¹⁸, H Thaler¹⁹, G Bahat²⁰, M Gutiérrez-Valencia²¹, M A Caballero-Mora²², F Landi²³, M H Emmelot-Vonk²⁴; EuGMS Task and Finish Group on Fall-Risk-Increasing Drugs; A Cherubini²⁵, J P Baeyens^{26

27}, A Correa-Pérez²⁸, A Gudmundsson^{29

30}, A Marengoni³¹, D O'Mahony^{32

33}, N Parekh³⁴, F E Pisa^{35

36}, C Rajkumar³⁷, M Wehling³⁸, G Ziere^{39

40}; EuGMS Special Interest Group on Pharmacology

Affiliations

¹ Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
² Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands. n.vandervelde@amc.uva.nl.
³ Nottingham University Hospitals NHS Trust, Nottingham, UK.
⁴ Department of Internal Medicine and Geriatrics, University Hospital of Montpellier, Montpellier University, Euromov, France.
⁵ Department of Internal Medicine (Geriatrics), Ghent University, Ghent, Belgium.
⁶ Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands.
⁷ Unit for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
⁸ School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
⁹ The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin 2, Ireland.
¹⁰ Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland.
¹¹ Falls and Syncope Unit, Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin 8, Ireland.
¹² Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.
¹³ Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
¹⁴ Department of Computing Science, Umeå University, Umeå, Sweden.
¹⁵ Department of Geriatrics and Gerontology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
¹⁶ Faculty of Health and Social Sciences, South Bohemian University, Česke Budějovice, Czech Republic.
¹⁷ Effective Prescribing and Therapeutics, Health and Social Care Directorate, Scottish Government, Edinburgh, Scotland, UK.
¹⁸ Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, Widerströmska huset, 17177, Stockholm, Sweden.
¹⁹ Trauma Center Wien-Meidling, Kundratstrasse 37, 1120, Vienna, Austria.
²⁰ Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Capa, 34093, Istanbul, Turkey.
²¹ Department of Health Sciences, Public University of Navarra (UPNA), Avda, Barañain s/n, 31008, Pamplona, Spain.
²² Servicio de Geriatría, Hospital Universitario de Getafe and CIBER de Fragilidad y Envejecimiento Saludable, Getafe, Madrid, Spain.
²³ Department of Gerontology, Neuroscience and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
²⁴ Department of Geriatrics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
²⁵ Geriatria, Accettazione geriatrica e Centro di ricerca per l'Invecchiamento, Italian National Research Center on Aging (INRCA), Ancona, Italy.
²⁶ University of Luxembourg, Ezch-sur-Alzette, Luxembourg.
²⁷ AZ Alma, Eeklo, Belgium.
²⁸ Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain.
²⁹ Landspitali University Hospital, Reykjavik, Iceland.
³⁰ Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
³¹ Department of Clinical and Experimental Science, University of Brescia, Brescia, Italy.
³² Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland.
³³ Department of Medicine, University College Cork, Cork, Ireland.
³⁴ Academic Department of Geriatric Medicine, Brighton and Sussex Medical School, Brighton, Sussex, UK.
³⁵ Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
³⁶ Institute of Hygiene and Clinical Epidemiology, University Hospital of Udine, Udine, Italy.
³⁷ Department of Elderly Medicine, Brighton and Sussex University Hospitals NHS Trust, Sussex, UK.
³⁸ Institute of Clinical Pharmacology Mannheim, University of Heidelberg, Heidelberg, Germany.
³⁹ Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
⁴⁰ Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.

PMID: 30741371
PMCID: PMC6435622
DOI: 10.1007/s40266-018-0622-7

EuGMS Task and Finish group on Fall-Risk-Increasing Drugs (FRIDs): Position on Knowledge Dissemination, Management, and Future Research

L J Seppala et al. Drugs Aging. 2019 Apr.

. 2019 Apr;36(4):299-307.

doi: 10.1007/s40266-018-0622-7.

Authors

Affiliations

¹ Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
² Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands. n.vandervelde@amc.uva.nl.
³ Nottingham University Hospitals NHS Trust, Nottingham, UK.
⁴ Department of Internal Medicine and Geriatrics, University Hospital of Montpellier, Montpellier University, Euromov, France.
⁵ Department of Internal Medicine (Geriatrics), Ghent University, Ghent, Belgium.
⁶ Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands.
⁷ Unit for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
⁸ School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
⁹ The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin 2, Ireland.
¹⁰ Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland.
¹¹ Falls and Syncope Unit, Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin 8, Ireland.
¹² Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.
¹³ Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
¹⁴ Department of Computing Science, Umeå University, Umeå, Sweden.
¹⁵ Department of Geriatrics and Gerontology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
¹⁶ Faculty of Health and Social Sciences, South Bohemian University, Česke Budějovice, Czech Republic.
¹⁷ Effective Prescribing and Therapeutics, Health and Social Care Directorate, Scottish Government, Edinburgh, Scotland, UK.
¹⁸ Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, Widerströmska huset, 17177, Stockholm, Sweden.
¹⁹ Trauma Center Wien-Meidling, Kundratstrasse 37, 1120, Vienna, Austria.
²⁰ Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Capa, 34093, Istanbul, Turkey.
²¹ Department of Health Sciences, Public University of Navarra (UPNA), Avda, Barañain s/n, 31008, Pamplona, Spain.
²² Servicio de Geriatría, Hospital Universitario de Getafe and CIBER de Fragilidad y Envejecimiento Saludable, Getafe, Madrid, Spain.
²³ Department of Gerontology, Neuroscience and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
²⁴ Department of Geriatrics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
²⁵ Geriatria, Accettazione geriatrica e Centro di ricerca per l'Invecchiamento, Italian National Research Center on Aging (INRCA), Ancona, Italy.
²⁶ University of Luxembourg, Ezch-sur-Alzette, Luxembourg.
²⁷ AZ Alma, Eeklo, Belgium.
²⁸ Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain.
²⁹ Landspitali University Hospital, Reykjavik, Iceland.
³⁰ Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
³¹ Department of Clinical and Experimental Science, University of Brescia, Brescia, Italy.
³² Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland.
³³ Department of Medicine, University College Cork, Cork, Ireland.
³⁴ Academic Department of Geriatric Medicine, Brighton and Sussex Medical School, Brighton, Sussex, UK.
³⁵ Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
³⁶ Institute of Hygiene and Clinical Epidemiology, University Hospital of Udine, Udine, Italy.
³⁷ Department of Elderly Medicine, Brighton and Sussex University Hospitals NHS Trust, Sussex, UK.
³⁸ Institute of Clinical Pharmacology Mannheim, University of Heidelberg, Heidelberg, Germany.
³⁹ Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
⁴⁰ Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.

PMID: 30741371
PMCID: PMC6435622
DOI: 10.1007/s40266-018-0622-7

Abstract

Falls are a major public health concern in the older population, and certain medication classes are a significant risk factor for falls. However, knowledge is lacking among both physicians and older people, including caregivers, concerning the role of medication as a risk factor. In the present statement, the European Geriatric Medicine Society (EuGMS) Task and Finish group on fall-risk-increasing drugs (FRIDs), in collaboration with the EuGMS Special Interest group on Pharmacology and the European Union of Medical Specialists (UEMS) Geriatric Medicine Section, outlines its position regarding knowledge dissemination on medication-related falls in older people across Europe. The EuGMS Task and Finish group is developing educational materials to facilitate knowledge dissemination for healthcare professionals and older people. In addition, steps in primary prevention through judicious prescribing, deprescribing of FRIDs (withdrawal and dose reduction), and gaps in current research are outlined in this position paper.

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Conflict of interest statement

Martin Wehling was employed by AstraZeneca R&D, Mölndal, as Director of Discovery Medicine (= translational medicine) from 2004 to 2006 while on sabbatical leave from his professorship at the University of Heidelberg. After returning to this position in January 2007, he received lecturing and consulting fees from Bristol Myers, Bayer, LEO, Boehringer-Ingelheim, Mundipharma, Novartis, Pfizer, Roche, AstraZeneca, Allergan, Polyphor, Helsinn, Sanofi-Aventis, Shire, Otsuka, Lilly, Berlin-Chemie, and Novo-Nordisk. The work of Eva Topinkova was partially supported by grant no. 16-33463A from the Czech Ministry of Health, Czech Republic. LJS, NvdV, TM, HB, MP, TJvdC, KS, SH, RAK, JR, PE, AMair, LL, HT, GB, MG-V, MAC-M, FL, MHE-V, AC, JPB, AC-P, AG, AM, DO, NP, FEP, CR, GZ have no conflicts of interest that are directly relevant to the content of this article.

Figures

**Fig. 1**
Decision tree for management of fall-risk-increasing drugs (FRIDs)

See this image and copyright information in PMC

References

1. Hartholt KA, van Beeck EF, Polinder S, van der Velde N, van Lieshout EM, Panneman MJ, et al. Societal consequences of falls in the older population: injuries, healthcare costs, and long-term reduced quality of life. J Trauma. 2011;71:748–753. doi: 10.1097/TA.0b013e3181f6f5e5. - DOI - PubMed
1. Centers for Disease Control and Prevention. Home and Recreational Safety. Important facts about falls. 2017. http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html Accessed 1 May 2018.
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1. Carroll NV, Slattum PW, Cox FM. The cost of falls among the community-dwelling elderly. J Manag Care Pharm. 2005;11:307–316. - PMC - PubMed

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EuGMS Task and Finish group on Fall-Risk-Increasing Drugs (FRIDs): Position on Knowledge Dissemination, Management, and Future Research

Affiliations

EuGMS Task and Finish group on Fall-Risk-Increasing Drugs (FRIDs): Position on Knowledge Dissemination, Management, and Future Research

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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LinkOut - more resources

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Medical