December 3, 1997

Reducing Falls Among Patients in Nursing Homes

Author Affiliations

Medical College of Georgia Athens

JAMA. 1997;278(21):1742. doi:10.1001/jama.1997.03550210040030

To the Editor.  —In the article on reducing falls in nursing homes by Dr Ray and colleagues,1 the context section of the abstract indicates that "no interventions have been shown to prevent falls in nursing home residents...." However, at least 2 studies2,3 have demonstrated that decreasing the use of psychoactive medications, and psychotropic agents in particular, reduces falls and fall-related injuries.One study2 has shown that consultation with recommendations to limit shorter-acting benzodiazepines to no more than 3 doses per week and reduce the dose of triazolam from 250 to 125 pg reduced the occurrence of falls from 4 to none in 7 patients over a 1-year period. In a subsequent 1-year study of 182 patients, 54% of whom fell an average of 2.9 times, consultant pharmacist intervention determined that medications contributed to 85% offalls.3 Psychotropic agents, other psychoactive drugs, and antihypertensive medications were the most