File Analysis of Falling Patients: Are Drugs Frequently Involved

File Analysis of Falling Patients: Are Drugs Frequently Involved

The damage caused by patient falls is a major public health problem, due to the large and growing number of people concerned, the potentially serious consequences but also the financial cost generated by their care.

These consequences can be physical as well as psychological. Fractures and pain are the first consequences that come to mind, but many others should be mentioned: post-fall syndrome, loss of autonomy or even entering an institution, fear of falling, loss of confidence in itself.

During 2018, 285 reports of falls were counted within the Paris Saint-Joseph Hospital Group (GhPSJ). Reducing these falls is one of the institutional goals. A dedicated working group has been created to put in place preventive and corrective measures.

These falls can be caused by many factors to the patient:

1. Intrinsic:

   • History of a fall,
   • pathologies (Parkinson's or Alzheimer's disease),
   • hearing and visual disturbances,
   • urinary incontinence.

2. extrinsic:

   • Unsuitable shoes
   • unsuitable habitat,
   • slippery floors (eg bathroom).

Among the intrinsic factors, polypharmacy is also found. It has been established that certain drug classes are at risk of falling, in particular psychotropic drugs (benzodiazepines, hypnotics, anxiolytics, antidepressants, neuroleptics) which promote sedation and dizziness, hypoglycemic drugs which cause hypoglycaemia in diabetic patients on -treated or antihypertensive drugs causing hypotension.

It is now clearly established that drug adherence to treatment is poor in cities, giving rise to omissions but also sometimes to overconsumption of certain drugs, including psychotropic drugs.

Inclusion Criteria:

• Major patient
• French-speaking patient
• Patient hospitalized within the Paris Saint-Joseph Hospital Group
• Patient who fell during hospitalization and for whom a fall report has been completed

Exclusion Criteria:

• Patients in the process of therapeutic limitation
• Patient under guardianship or curatorship
• Patient deprived of liberty
• Patient objecting to participation in the study
• Patient under legal protection