ArticleJournal of the American Geriatrics Society2025
Appropriateness of Antiplatelets and Anticoagulants Among Older Adults Experiencing Falls.
Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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Who cites it
3 citing papers in PubMed.
- Attitudes Toward Deprescribing Among Older Adults Seeking Care in the Emergency Department.Journal of the American College of Emergency Physicians open · 2026Article
- Emerging strategies in venous thromboembolism: a narrative review of pharmacological innovations.Thrombosis journal · 2026Review
- Navigating Medication Risk in the ED: Communication Preferences of Older Adults Regarding Deprescribing.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundAntiplatelet and anticoagulant (collectively called antithrombotics) use remains ubiquitous in older adults due to well-established benefits in treating atherosclerotic and thromboembolic disease. It is unclear whether these benefits outweigh the risk of traumatic hemorrhage in older adults with elevated fall risk. Emergency department (ED) providers are well-positioned to identify opportunities to deprescribe likely inappropriate antithrombotics following an emergency visit for a fall. The objective was to determine the prevalence of likely inappropriate antithrombotic use among older adults on antithrombotics presenting to an ED with a fall.
methodsThis was a secondary analysis of a prospective cohort study of older adults presenting to an ED with a fall enrolled from 2020 to 2021 in a pharmacist-led medication reconciliation program at a southeastern academic ED. We utilized the Medication Appropriateness Index (MAI) to assess antithrombotic appropriateness, categorized: appropriate (MAI = 0), potentially inappropriate (MAI = 1-2), and likely inappropriate (MAI ≥ 3).
results171 out of 514 enrolled patients who presented with a fall to the ED were on an antithrombotic. Their mean age was 81.2 years (std dev 9.2) and 66.1% were female (113/171; 95% CI: 58.6%-72.8%). The median MAI score was 2 (IQR: 2-4). Potentially inappropriate or likely inappropriate use was observed in 82.5% (141/171; 95% CI: 76.0%-87.5%) of participants. Aspirin had the highest prevalence of likely inappropriate use at 60% (59/98; 95% CI: 50%-69%), while P2Y12 inhibitors, warfarin, and direct oral anticoagulants had prevalence of likely inappropriate use at 53% (8/15; 95% CI: 27%-78%), 30% (3/10; 95% CI: 8%-67%), and 29% (21/72; 95% CI: 20%-41%), respectively.
conclusionThere was a high prevalence of likely inappropriate antithrombotic use among older adults presenting to the ED with a fall. While aspirin had the highest rate of likely inappropriate use, all antithrombotics had 30% or greater rates of likely inappropriate use. An ED encounter presents a critical opportunity to evaluate the appropriateness of antithrombotic use in patients who have fallen.
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