Medication, or medicines, is the most common way to prevent, treat, monitor, or cure a disease. However, they are a key risk factor for falls.
Medication-related falls can be prevented through routine questions and observation. For health and community professionals working with older adults, it’s important to encourage regular medication reviews with a doctor or pharmacist.
How do medicines increase falls risk?
Medicines affect everyone differently. They may cause drowsiness, dizziness, a drop in blood pressure, confusion, blurred vision, slowed reaction time, urinary urgency and impaired balance. These effects can build up when taking a combination of medications or drinking alcohol with certain medications. Being aware of the types of medicines that increase the risk of falls is important for recognising when a review is needed.
Common medicine groups that increase the risk of falls include:
- Psychotropic medicines: sleeping tablets, antipsychotics and some antidepressants. These can cause sedation, impaired balance, and affect cognition.
- Opioids: sedation, dizziness, cognitive slowing, postural hypotension.
- Blood pressure and other cardiovascular medicines: postural hypotension, dehydration, and dizziness. Diuretics may also increase nocturia (going to the toilet during the night).
- Medicines with anticholinergic effects: found in some bladder, allergy, cold and flu products. It can cause confusion, blurred vision, and dizziness.
What the Australian Falls Guidelines recommend
The Australian Falls Guidelines include medicines as a key risk factor in community care. In practice, this means asking about medicines during falls screening, recognising medicines that may raise falls risk, and encouraging review at least yearly, or sooner after a fall, near miss, hospital stay or major medication change.
When should medicines be reviewed?
Encourage older adults to get their medicines reviewed every year, or if they:
- had a recent fall, including a slip, trip or stumble
- developed concerns of falling
- are experiencing dizziness, light-headedness, or unsteadiness
- are feeling drowsy, confused, or slower
- have started a new medicine, changed the dose of a current medicine, or stopped a medicine
- are unsure why they are taking a certain medicine or what the side effects are.
What does a medication review involve?
A doctor or pharmacist will review all medicines, including prescription and non-prescription, over-the-counter, and even herbal medicines or natural supplements. They consider whether each medicine is still needed, whether the dose is appropriate, what side effects or interactions may be contributing to the risk of falls, and whether it can be changed to a safer alternative for the older adult.
Home Medicine Reviews in WA are a free service where a pharmacist will visit the home to review medications and can be arranged through a GP or doctor. It is an opportunity for older adults to ask any questions about side effects and how to manage their medicines safetly.
Start a conversation
If you work with older adults, it’s worth starting a conversation with them about their medicines and how they’re feeling. Try:
- Asking about any symptoms: “Have you felt tired, dizzy or confused? Do you feel off balance, unsteady, or moving slower?
- Ask when they last got their medicines checked: “When was the last time you got your medicines checked? Have you changed your medicines recently?”
- Encouraging them to ask a GP or pharmacist: “Are any of my medicines increasing my falls risk? What side effects should I watch for?” How can I manage my medications safely?”
Medicines are only one part of falls prevention. Medication reviews should be combined with other falls prevention strategies such as strength and balance exercises, vision and foot care, continence support and home safety reviews.
Learn more about tools, such as Webster packs and medicine lists, to help older adults manage their medications.