Introduction: Fall related injuries (FRIs) are sentinel events for older adults, and serve as an opportune time for medication review. The objective of this study was to identify whether there are disparities in prescribing patterns of medications in United States (US) NH residents following a hospitalized FRI according to the racial composition of the facility.

Methods: This cohort study included all long-stay (≥100 days) NH residents, aged 65 years or older, enrolled in Medicare fee-for-service with a hospitalized FRI between 1/1/2016-12/31/2016. Benzodiazepine and non-benzodiazepine sedatives were grouped, and osteoporosis medications included oral bisphosphonates. Resident were categorized as new users, discontinuers, continued users, or non-users. Results were stratified by the percentage of Black residents in the facility. Chi-square tests compared medication changes.

Results: The final cohort of 27,134 NH residents with a hospitalized FRI had a mean age was 83.9 years and 75.7% were women. Use of sedatives was common (6.0% new users, 14.7% discontinuers, 14.0% continued users). Discontinuation of sedatives after a FRI was more likely to occur in facilities with a high Black population (high vs low Black population: 15.4% versus 13.4%, p-value 0.0003). However, use of osteoporosis medications was low with no statistically significant variation in new users across facilities.

Conclusions: Despite the known association with falls, sedatives remain commonly prescribed in NH residents before and after a FRI, whereas osteoporosis medications are less commonly prescribed. Our findings suggest that most US NHs could benefit from models of care that optimize medication prescribing in NH residents after FRIs.

Authors:
Kathryn Sine, Alpert Medical School of Brown University; Brown School of Public Health, United States
Laiji Yang, Marcus Institute for Aging Research, Hebrew Senior Life, United States
Andrew Zullo, Brown University School of Public Health, United States
Sarah Berry, Marcus Institute for Aging Research, Hebrew Senior Life, United States

About the Presenter(s)
Ms Kathryn Sine is a University Doctoral Student at Brown University in United States

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