Evidence map›Paper›PMID 40167043›Full record

Trial reportJournal of the American Geriatrics Society2025

Impact of Discontinuation of Fall-Risk-Increasing Drugs on Falls in Multimorbid Older Patients With Polypharmacy.

Namiko A Goto, Dayna A M van Heel, Lauren Dautzenberg, François-Xavier Sibille, Emma Jennings, Douglas C Bauer, Carole E Aubert, Anne Spinewine, Nicolas Rodondi, Huiberdina L Koek and 2 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Deprescribing: Reducing Harm, Enhancing Care.Rambam Maimonides medical journal · 2026
    Review
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Namiko A GotoDepartment of Geriatric Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.ORCID 0000-0003-0840-9823
Dayna A M van HeelDepartment of Geriatric Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
Lauren DautzenbergDepartment of Geriatric Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
François-Xavier SibilleDepartment of Geriatric Medicine, CHU UCL Namur, Yvoir, Belgium.
Emma JenningsSchool of Medicine, University College Cork, Cork, Republic of Ireland.
Douglas C BauerDepartment of Medicine, Epidemiology and Biostatistics, University of California, San Francisco, USA.ORCID 0000-0001-5261-7721
Carole E AubertInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.ORCID 0000-0001-8325-8784
Anne SpinewineClinical Pharmacy and Pharmacoepidemiology Research Group, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium.
Nicolas RodondiInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Huiberdina L KoekDepartment of Geriatric Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Mariëlle H Emmelot-VonkDepartment of Geriatric Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Wilma KnolDepartment of Geriatric Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.

Funding

European Union's Horizon 2020 research and innovation program 634238Fund for Scientific Research-FNRS 1M70823FSwiss National Science Foundation PZ00P3_201672/1Swiss State Secretariat for Education, Research and Innovation (SERI) 15.0137
6 · The paper itself

Abstract

backgroundFalls are a major concern in the older population. An important cause of falls is fall-risk-increasing drugs (FRID). However, it is not known if the discontinuation of FRID leads to a reduction of falls. Therefore, the aim of this study was to assess the association between discontinuation of FRID and the occurrence of falls and recurrent falls.

methodsThis study included adults aged ≥ 70 years with multimorbidity and polypharmacy who were enrolled in a cluster randomized controlled trial assessing hospital pharmacotherapy optimization (OPERAM). Participants who were using FRID at baseline, were alive after 2 months of follow-up, and provided data on fall occurrence were included. FRID discontinuation was defined as discontinuation of ≥ 1 FRID within 2 months after inclusion, including the following groups: antidepressants, antiepileptics, antihistamines, antipsychotics, benzodiazepines and z-drugs, diuretics, opioids, and alpha-blockers. Multivariable cox regression analysis, using inverse probability weighting, was performed to assess the association between FRID discontinuation and the occurrence of falls.

resultsOur analysis included 1546 participants, with a median age of 79 years (IQR 74-84) and 45% female. After 2 months of follow-up, FRID were discontinued in 878 (57%) participants. Among all participants, 378 (24%) experienced a fall within 1 year of follow-up, with 137 (9%) of the participants experiencing two or more falls, and 199 (13%) participants experiencing a serious fall. No association was found between FRID discontinuation and the occurrence of falls. In a subgroup of participants with a previous fall, discontinuation of antipsychotics was associated with a lower occurrence of falls (HR 0.32 [CI 0.12-0.84], p = 0.02).

conclusionsIn multimorbid older patients using FRID, falls are highly prevalent. No association was found between discontinuation of FRID and the risk of falls, except for the discontinuation of antipsychotics in patients who experienced a previous fall.

Indexed as

Accidental FallsMultimorbidityPolypharmacyAgedAged, 80 and overFemaleHumansMaleRisk Factorsaccidental fallsdeprescribingfall interventionsFRID

Identifiers

PMID40167043
PMCPMC12205291

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.