Authors: (including presenting author): :
Wong SL(1), Soo MYA(1), Suen PW(1), Leung YY(1), Taiang CH(1), Lam SFF(1)
Affiliation: :
(1)Kwai Chung Hospital
Keyword 2: :
Psychotropic Medications
Keyword 3: :
Polypharmacy
Keyword 4: :
Patient Safety
Keyword 5: :
Fall Severity
Introduction: :
Inpatient falls represent a serious adverse event, leading to injury, prolonged hospitalization, and increased healthcare costs. The risk is markedly elevated in psychiatric settings, where psychotropic medications constitute a key modifiable risk factor. While previous research identify medication effects are the predominant risk factor for younger psychiatric inpatients (< 65 years), existing research has primarily focused on geriatric populations. This critical lack of Hong Kong-specific evidence impedes the development of effective fall prevention protocols tailored to local clinical practice. Therefore, this study aimed to determine the associations between medication use and falls among adult psychiatric inpatients in a Hong Kong setting, providing clinical staff with necessary evidence for targeted prevention strategies.
Objectives: :
To determine the associations between psychotropic medications and falls among adult psychiatric inpatients.
To provide clinical staff with locally validated data on medication-associated fall risk.
Methodology: :
This study retrospectively reviewed fall incidents among adult psychiatric inpatients at Kwai Chung Hospital between 1 January 2019 and 31 December 2024. Falls secondary to acute medical events (eg, cardiac arrest or seizures) were excluded. An operational definition of >4 medications for general polypharmacy and >3 psychotropic medications for psychotropic polypharmacy were used. Fall severity was categorised as severity category (SC) 1, which refers to minor injuries resulting in no or simple treatment, or SC2, which includes injuries that require surgical treatments.
Result & Outcome: :
In total, 67 SC1 and 58 SC2 falls occurring in 86 female and 39 male inpatients (mean age, 51.8 years) were included in the analysis. Among the 125 inpatients, 64 (51.2%) had general polypharmacy alone, one had psychotropic polypharmacy alone (0.8%), and 35 (28.0%) had both. In univariable logistic regression analysis, SC2 falls were associated with general polypharmacy (odds ratio [OR] = 3.69, p = 0.010), psychotropic polypharmacy (OR = 2.73, p = 0.014), number of psychotropic medications (OR = 1.45, p = 0.023), and number of anticonvulsants (OR = 1.94, p = 0.012). Results indicated General polypharmacy, psychotropic polypharmacy, and anticonvulsant use are associated with increased severity of fall-related injuries in adult psychiatric inpatients. These findings underscore the importance of medication review and fall prevention strategies for at-risk patients. This work constitutes the first local study on this topic. The results have been disseminated via presentation in clinical meeting and published to peer-reviewed journal to inform local clinical practice.
