Complexity of fall prevention and whether deprescribing fall-risk-increasing drugs works

Being one of the leading causes of death in the elderly, falls can cause numerous health complications. Prescribing is important to protect the health of the frail and vulnerable, just as much as the use of deprescribing can be used for the same purpose. In response to the significant health and financial burden on patients and healthcare systems brought about by falls, Lee et al (2021) carried out a systematic review and meta-analysis to examine the deprescribing of fall-risk-increasing drugs (FRIDs) for the prevention of falls and associated complications. Deprescribing such medications is often common practice for fall prevention, despite an apparent scarcity of robust evidence to support this move. In the community, falls are common, and patient medication should be reviewed regularly.

Despite limited evidence of effectiveness, deprescribing FRIDs is common practice and typically included in both multifactorial and single-intervention strategies. The justification for deprescribing is often based on observational studies that suggest that certain medications are linked to an increased risk of falls, as well as some randomised controlled trials (RCTs) showing medication management interventions (including those with a broader focus of reducing polypharmacy and/or potentially inappropriate prescribing) may reduce the risk of falls.