Evidence map›Paper›PMID 40204302›Full record

ArticleBMJ open2025

Impact of potentially inappropriate psychotropic medicines on falls among older adults in 23 residential aged care facilities in Australia: a retrospective longitudinal cohort study.

Narjis Batool, Magdalena Z Raban, Karla Seaman, Johanna Westbrook, Nasir Wabe

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Narjis BatoolCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia narjis.batool@students.mq.edu.au.ORCID http://orcid.org/0000-0003-2821-1777
Magdalena Z RabanCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0002-6995-2849
Karla SeamanCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Johanna WestbrookCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0003-1083-8192
Nasir WabeCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0002-9740-6319

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveFalling is common among older adults in residential aged care facilities (RACFs) and potential inappropriate psychotropic medicines (PIPMs) use may increase the risk of falling. This study aimed to determine the impact of PIPMs on falls using longitudinal observational data.

methodsA retrospective longitudinal cohort study was conducted using routinely collected electronic health data from 23 RACFs in Sydney, New South Wales, Australia. The study included 3064 permanent residents aged ≥65 (2020-2021). PIPMs were identified using updated Beers criteria 2023. We considered three fall outcome groups: all falls, injurious falls and falls requiring hospitalisation. The falls incidence rates (IRs) were calculated for overall residents in RACFs as well as for central nervous system (CNS)-PIPM users and non-users. We applied a zero-inflated negative binomial regression model to assess the association between falls and CNS-PIPMs.

resultsA total of 40% (n=1224) of long-term care residents used at least one CNS-PIPM and 10% of residents (n=302) used two or more. The falls IRs of CNS-PIPM users were 16.2 falls per 1000 resident days (95% CI 15.9 to 16.5) for all falls, 5.68 falls per 1000 resident days (95% CI 5.48 to 5.88) for injurious falls and 1.77 falls per 1000 resident days (95% CI 1.66 to 1.88) for falls requiring hospitalisation, whereas the falls IRs of non-CNS-PIPM users were 10.8 falls per 1000 resident days (95% CI 10.6 to 11.0) for all falls, 3.65 falls per 1000 resident days (95% CI 3.52 to 3.78) for injurious falls and 1.26 falls per 1000 resident days (95% CI 1.19 to 1.33) for falls requiring hospitalisation. CNS-PIPM users had a significantly greater rate of falls overall compared with non-users (IRR 1.29; 95% CI 1.16 to 1.44) for all outcomes.

conclusionsFalls are frequent among CNS-PIPM users resulting in injury and hospitalisation, with 70% of CNS-PIPM users falling at least once and one in three requiring admissions to hospital. Reviewing residents' use of psychotropic medicines should be considered as part of strategies to reduce falls incidence among older adults in RACFs.

Indexed as

Accidental FallsHomes for the AgedInappropriate PrescribingPotentially Inappropriate Medication ListPsychotropic DrugsAgedAged, 80 and overAustraliaFemaleHospitalizationHumansIncidenceLongitudinal StudiesMaleNew South WalesRetrospective StudiesPsychotropic DrugsAgingMedicineNursing Homes

Identifiers

PMID40204302
PMCPMC12004465

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.