Reviewing Your Meds Can Reduce Your Risk of Falling

As we age, our risk of falling increases. This is no surprise to anyone but more of us are living to an old age and the number of elderly people falling is growing. None of us want to fall and certainly none of us wishes to be injured or hospitalized due to a fall.

It turns out that the medications we take are one of the most important yet preventable risks for falling. What this means is that while we can't prevent all falls, we can prevent many falls by making sure that the medications we take are carefully looked at by medication experts, such as pharmacists, to make sure they are not the cause of falling.

UW Clinical Professor of Pharmacy Don Downing leads UW Pharmacy Cares, created to educate and support those taking multiple medicines and promote the safe and healthy use of medicines.

Not only do we fall more, we take more medications as we age. We take these medications to treat the many conditions we acquire as we age; therefore, we must balance the benefits of taking a medication with the risk of falling due to these medications. To be sure, most medications don't cause falls and many of them help us better manage medical conditions—conditions that by themselves may cause us to fall. For example, a medication to treat dizziness may prevent many falls that dizziness itself might have caused if left untreated.

As we age, our bodies require different doses of medications from what we needed when we were younger. For example, it is not uncommon for someone with high blood pressure to stay on the same medication for years and years. Because of the changes in our bodies are we grow older, we may need a different—often smaller—dose of medications than we needed in the past.

Too much medication is often a cause of preventable falls. Even if you have been on the same medications for years, you should ask a health care provider to do a full review of your medications each year. It may keep you from falling or otherwise becoming sick.

So how do we decide which medications may be increasing our risk of falling? Thankfully, health care providers such as pharmacists, physicians, nurses, and others are trained to watch for medications that may be causing falls.

A common problem is that people often see more than one health care provider and receive their medications from more than one pharmacy. Dangerous drug interactions that might increase your risk of falling may come from medications prescribed by more than one health care provider. Therefore, it's very important that all your health care providers—including your pharmacist—be aware of ALL the medications you are taking, not just the ones provided by a particular doctor or pharmacist.

Older adults with multiple prescription and over-the-counter medications should ask their health care provider or pharmacist to review everything they take.

The more medications you are taking, the more likely you are to fall. You should talk to your pharmacist and other providers to make sure that you are not taking unnecessary medications. If your medicine cabinet is full of medications that you no longer take or you can't remember what they were prescribed for, ask your pharmacist or other provider for information and whether the old medications should be destroyed.

While we know that certain kinds of medications are more frequently associated with falls, you can't simply stop taking a medication just because of this possible risk. The potential harm associated with stopping an important medication may be far greater than the risk of falling from this medication.

This said, there are several categories of medications that should be carefully monitored, especially if you have already had a fall or two. These medications include those used for heart disease, high blood pressure, depression, anxiety, pain relief, bladder or bowl spasms, Parkinson's disease, and seizures. Sometimes the medications used for these conditions are also used for other conditions and carry the same risk for falling. For instance, sometimes medications used to treat seizures are also used to treat diabetes leg pain and other conditions.

So what should you do if you are worried that your medications may cause you to fall? First of all, don't stop any of your medications unless your health care provider has told you to do so. In addition, you might consider having your pharmacist review ALL of your medications prescribed by all of your health care providers to make sure you are not unnecessarily taking medications that might cause you to fall.

Your pharmacist can talk with your doctors about possible drug interactions, about possibly lowering the dose of a medication if the dose is too high, or about alternative medications that might have a lower fall risk. They may even find that you don't need to take as many medications as you are currently taking. Furthermore, be sure to maintain as much physical activity and good eating habits as you can to keep your muscles strong.

Let your health care providers know if you've taken a spill or two, even if you weren't injured. People who have fallen previously, even without injury, are at the highest risk of injury of a future fall.

—Don Downing, University of Washington School of Pharmacy

Don Downing, a pharmacist and clinical professor of pharmacy at the University of Washington School of Pharmacy, participates in managing the medications of geriatric patients through a licensed pharmacy called UW Pharmacy Cares—a pharmacy that doesn’t sell medications but rather helps people manage their medications.

Fall Free Plan

Use the Washington State's Department of Health's worksheet My Fall-Free Plan (PDF) to learn more about common risks and possible next steps for you to take to prevent falls. Better yet—take it with you to your next doctor's appointment or pharmacy visit.