Falls as Adverse Drug Reaction - Do We Recognise and Report Them?

Introduction:

Medication is recognised as potential contributory cause for falls and NICE guidelines recommend a medication review for all hospital inpatients, as a standard component of comprehensive assessment. Recent research suggest that up to 16% of hospital admissions are either a direct result or contributed by an adverse reaction to medication. Understanding the frequency of medication contributing towards falls admission however has not been clearly defined in literature.

Method:

Data was collected retrospectively, using local coding for hospital admissions over 12 month period (01.04.2024 - 31.03.2025) for completed episodes. Hospital pharmacy team records of adverse drug reactions reported to the MHRA via yellow card system were also analysed.  A review of the number of adverse reactions and culprit medication was completed with the aim of increasing awareness and utilising existing reporting systems more effectively.

Results:

There were a total of 382 instances of adverse reactions documented on coding records out of 1177 patients. Most commonly implicated group of medication were cardiovascular drugs with 63/382 (16%) of the total reports, followed by hormones 52/382 (14%) and others 43/382 (11%). In 13 from 63 (21%) ADRs relating to cardiovascular system, orthostatic or other hypotension was documented. Syncope and collapse appeared twice but falls were not available as a code. No yellow card submitted to the MHRA over this period included falls as an adverse drug reaction to medication.

Conclusions:

There are potential missed opportunities to identify falls as a consequence of adverse reaction to medication, both locally and globally. Integrating better system for reviewing drugs, documenting potential treatment which contributed towards hospital admission and utilising hospital coding to capture these would allow focused interventions to be applied with the aim of reducing risk. Education of clinical, coding and pharmacy teams would be the first step in achieving this aim.