Home Medication Regimens Increase in Complexity After Admission for Fall in the Older Trauma Patient

Am Surg. 2023 Nov;89(11):4438-4444. doi: 10.1177/00031348221083958. Epub 2022 Jul 16.

Abstract

Background: Hospitalization for the older trauma patient is an opportunity to assess polypharmacy. We hypothesized that medication regimen complexity (RxCS) and pain medication prescriptions (PRxs) would increase in older home-going patients admitted for a fall.

Methods: We retrospectively chart reviewed patients ≥45 years old admitted for a fall at a level 1 trauma center who were discharged home with full medication documentation. RxCS was compared pre-admission and post-discharge with Wilcoxon signed-rank tests; opioid and non-opioid PRxs were compared with Fisher's exact test, α = .05.

Results: 103 patients met inclusion criteria; 58% were ≥65 years old. RxCS (9 [.5-13] to 11 [4.5-15], P < .01) increased on discharge. Opioid PRx rates increased significantly in all age groups. Non-opioid PRx rates increased significantly for patients <65 but not for patients ≥65.

Conclusions: Admission for a fall was associated with increases in RxCS, while PRx changes were age-dependent. Providers should recognize that admissions for older patients who fall after trauma are underutilized opportunities to address polypharmacy in high-risk patients.

Keywords: geriatrics; polypharmacy, trauma acute care; trauma.

MeSH terms

  • Aftercare*
  • Aged
  • Analgesics, Opioid / therapeutic use
  • Hospitalization
  • Humans
  • Middle Aged
  • Patient Discharge*
  • Polypharmacy
  • Retrospective Studies

Substances

  • Analgesics, Opioid