Falls prevention in the community: does deprescribing FRIDs work?

Falls are a leading cause of death in older adults, and can cause numerous health complications. Prescribing in the community is important to protect the health of the frail and vulnerable, just 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 can be common practice for falls prevention, despite an apparent scarcity of robust evidence to support this move. In the community, falls are common, and it is always a consideration that patient medication should be reviewed regularly to look at risks and requirements.

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