Journal of the American Geriatrics Society

Electronic Prescribing of High Risk Medications May Be Contributing to Falls in Elderly Patients

Certain medications are considered high risk in elders. In a recent study of 287 individuals ≥65 years who experienced a fall while hospitalized at an urban academic hospital, 62 percent of falls occurred in patients in whom high risk medications had been administered within the 24 hours before the fall.

High risk medications were often administered at higher than recommended geriatric daily doses, in particular benzodiazepines and benzodiazepine-receptor agonists, for which the dose was higher than recommended in 57 percent of cases. The hospital’s electronic medical record default doses for electronic prescribing were higher than recommended for 41 percent of medications that were examined.

“Before the widespread use of electronic prescribing, physicians had to consciously determine the appropriate drug dosage for an individual. This study highlights that with electronic prescribing, default doses do matter and lowering defaults for vulnerable patient groups such as elderly patients may be an easy way to reduce inappropriate use of high risk drugs for these patients”, said Dr. Rosanne Leipzig, senior clinician-author of the Journal of the American Geriatrics Society study.