Dhalwani NN, et al. - This article is written with the objective to evaluate the longitudinal relationship amongst polypharmacy and falls and analyze the differences in this relationship by different thresholds for polypharmacy definitions in a nationally representative sample of adults aged more than 60 years from England. In this study, they observed nearly 33% of the total population utilizing at least five drugs, which was significantly connected with 21% increased rate of falls over a 2-year period. Further exploration of the impacts of these complex drug combinations in the real world with a detailed standardised assessment of polypharmacy is greatly required along with pragmatic studies in primary care, which will help inform whether the threshold for a detailed medication review ought to be lowered.

Methods

• For this research, they designed a longitudinal cohort study.
• The English Longitudinal Study of Ageing waves 6 and 7.
• Total 5213 adults aged 60 or older were selected for this study.

Results

• A total of 5213 participants contributed 10502 person-years of follow-up, with a median follow-up of 2.02 years (IQR 1.9-2.1 years).
• Of the 1611 participants with polypharmacy, 569 reported not less than one fall within the past 2 years (rate: 175 per 1000 person-years, 95% CI 161 to 190), and of the 3602 participants without polypharmacy 875 reported at least one fall (rate: 121 per 1000 person-years, 95% CI 113 to 129).
• The rate of falls was 21% higher in people with polypharmacy compared with people without polypharmacy (adjusted IRR 1.21, 95% CI 1.11 to 1.31).
• Utilizing ≥ 4 drugs threshold the rate of falls was 18% higher in people with polypharmacy compared with people without (adjusted IRR 1.18, 95% CI 1.08 to 1.28), whereas utilizing ≥ 10 drugs threshold polypharmacy was related to a 50% higher rate of falls (adjusted IRR 1.50, 95% CI 1.34 to 1.67).