(P-246) An Evaluation of Injurious Falls and Fall-risk-increasing-drug (FRID) Prescribing Behaviors in a Nationally Representative Sample & the Pharmacist’s Role in Fall Prevention

Background: Falls are a major public health problem that affects millions of older adults in the United States each year. Little is known about fall risk increasing drug (FRID) prescribing behaviors after injurious falls occur.

Objectives: The primary objective of this study was to investigate whether an injurious fall reduces the odds of being prescribed a new FRID.

Methods: We conducted a cross-sectional analysis using data from the 2016 National Ambulatory Medical Care Survey (NAMCS) to investigate whether an injurious fall reduces the odds of being prescribed a new FRID. We included patients age >/= 65 years and classified visits based on presence of an injurious fall. The outcome of interest was prescription of a new FRID between those with and without an injurious fall. Multivariable logistic regression accounting for sampling and adjusted for demographics, health history and other medications was used. Age and Alzheimer’s disease (AD) were examined as potential effect modifiers. Odds ratios and 95% confidence intervals were reported.

Results: The subset of adults age >/= 65 years included 239,016,482 ambulatory care visits. 5,095,734 (2.1%) of the visits were related to an injurious fall. The mean (SD) and median (IQR) ages for the subset of adults >/= 65 years were approximately 74.8 (0.2) and 72.9 (68.3-79.3) years, respectively. Non-Hispanic whites made up 78.1% of the subset examined. The majority of visits were female (55.9%). Patients in the injurious fall group were more likely to be prescribed a new FRID compared to the non-fall group (15.6% [CI 2.3%, 28.8%] versus 10.5% [95% CI 8.9%, 12.2%]). In the adjusted logistic regression model, an injurious fall increased the odds of being prescribed at least one new FRID by 1.6 times (95% CI 0.6, 4.0). Age was an effect modifier, with an OR of 2.6 (0.9, 7.4) for ages 65 to 74 versus 0.4 (0.1, 1.6) for ages >/=75. In addition to age, AD was also identified as a statistically significant effect modifier, but stratum specific estimates were not determined due to small sample sizes.

Conclusions: An injurious fall impacts the odds of being prescribed a new FRID with age and AD being effect modifiers. Adults age 65 to 74 presenting with an injurious fall were more likely to be prescribed any new FRID in comparison to older adults age 75 years or older, who were less likely.