BACKGROUND: Withdrawal of fall-risk-increasing drugs has been proven to be effective in older persons. However, given the enormous rise in healthcare costs in recent decades, the effect of such withdrawals on healthcare costs also needs to be considered. METHOD: Within a common geriatric outpatient population, patients with a history of falls were assessed for falls risk (n = 139). Fall-risk-increasing drugs were withdrawn when appropriate (n = 75). All participants had a 2-month follow-up for fall incidents. The number of prevented falls was calculated using a loglinear regression model. The savings on health expenditures as a result of prevented injuries (estimated from a literature review) and reduced consumption of pharmaceuticals were compared with the intervention costs. RESULTS: After adjustment for confounders, drug withdrawal resulted in a falls risk reduction of 0.89 (95% CI 0.33, 0.98) per patient compared with the non-withdrawal group. Net cost savings were euro1691 (95% CI 662, 2181) per patient in the cohort. This resulted in a cost saving of euro491 (95% CI 465, 497) per prevented fall. CONCLUSION: Withdrawal of fall-risk-increasing drugs generates significant cost savings. Extrapolation of these findings to a national scale results in an estimated reduction of euro60 million in healthcare expenditures, that is, 15% of fall-related health costs.
BACKGROUND: Withdrawal of fall-risk-increasing drugs has been proven to be effective in older persons. However, given the enormous rise in healthcare costs in recent decades, the effect of such withdrawals on healthcare costs also needs to be considered. METHOD: Within a common geriatric outpatient population, patients with a history of falls were assessed for falls risk (n = 139). Fall-risk-increasing drugs were withdrawn when appropriate (n = 75). All participants had a 2-month follow-up for fall incidents. The number of prevented falls was calculated using a loglinear regression model. The savings on health expenditures as a result of prevented injuries (estimated from a literature review) and reduced consumption of pharmaceuticals were compared with the intervention costs. RESULTS: After adjustment for confounders, drug withdrawal resulted in a falls risk reduction of 0.89 (95% CI 0.33, 0.98) per patient compared with the non-withdrawal group. Net cost savings were euro1691 (95% CI 662, 2181) per patient in the cohort. This resulted in a cost saving of euro491 (95% CI 465, 497) per prevented fall. CONCLUSION: Withdrawal of fall-risk-increasing drugs generates significant cost savings. Extrapolation of these findings to a national scale results in an estimated reduction of euro60 million in healthcare expenditures, that is, 15% of fall-related health costs.
Authors: John T Chang; Sally C Morton; Laurence Z Rubenstein; Walter A Mojica; Margaret Maglione; Marika J Suttorp; Elizabeth A Roth; Paul G Shekelle Journal: BMJ Date: 2004-03-20
Authors: Nathalie van der Velde; Bruno H Ch Stricker; Huib A P Pols; Tischa J M van der Cammen Journal: Br J Clin Pharmacol Date: 2006-08-30 Impact factor: 4.335
Authors: Kristine E Ensrud; Terri L Blackwell; Carol M Mangione; Paula J Bowman; Mary A Whooley; Douglas C Bauer; Ann V Schwartz; Joseph T Hanlon; Michael C Nevitt Journal: J Am Geriatr Soc Date: 2002-10 Impact factor: 5.562
Authors: M E Tinetti; D I Baker; G McAvay; E B Claus; P Garrett; M Gottschalk; M L Koch; K Trainor; R I Horwitz Journal: N Engl J Med Date: 1994-09-29 Impact factor: 91.245
Authors: Allen R Huang; Louise Mallet; Christian M Rochefort; Tewodros Eguale; David L Buckeridge; Robyn Tamblyn Journal: Drugs Aging Date: 2012-05-01 Impact factor: 3.923
Authors: Carlos Chiatti; Silvia Bustacchini; Gianluca Furneri; Lorenzo Mantovani; Marco Cristiani; Clementina Misuraca; Fabrizia Lattanzio Journal: Drug Saf Date: 2012-01 Impact factor: 5.606
Authors: Suzanne Polinder; Nicole D A Boyé; Francesco U S Mattace-Raso; Nathalie Van der Velde; Klaas A Hartholt; Oscar J De Vries; Paul Lips; Tischa J M Van der Cammen; Peter Patka; Ed F Van Beeck; Esther M M Van Lieshout Journal: BMC Geriatr Date: 2016-11-04 Impact factor: 3.921