(C-087) DARWIN EU® - Prescription pattern of STOPP section K criteria medication in elderly with and without recurrent falls

Background: Falls in the elderly are associated with hospitalisations and increased mortality. STOPP section K criteria identify drug classes associated with an increased risk of falls in the elderly. However, the prevalence of potentially inappropriate prescriptions for these drug classes among individuals with recurrent falls remains uncertain across Europe.

Objectives: To estimate prevalence and incidence rates of STOPP section K criteria drug class use in individuals with and without recurrent falls, stratified by age and sex.

Methods: This retrospective cohort study analysed data from CPRD GOLD (United Kingdom), IQVIA DA Germany (Germany), FinOMOP-HILMO (Finland), NAJS (Croatia) and SIDIAP (Spain) between 2013 and 2023 as part of the DARWIN EU® initiative. All datasets were standardised to the OMOP Common Data Model. Recurrent falls were defined as two or more falls within 12 months. STOPP section K criteria drug classes included benzodiazepines, antipsychotics, hypnotic z-drugs, antiepileptics, first-generation antihistamines, opioids, antidepressants, alpha-blockers, centrally acting antihypertensives, vasodilating and antimuscarinic drugs. Annual incidence rates and period prevalence of STOPP section K criteria drug use were estimated in individuals aged 65 and older, categorised by recurrent falls.

Results: Benzodiazepines, opioids, vasodilating drugs and antidepressants were the most frequently prescribed STOPP section K criteria drug classes. The prevalence of benzodiazepine use in the elderly following recurrent falls ranged from 6% in IQVIA DA Germany to 23% in SIDIAP in 2013, declining slightly to 3% and 18% by 2023. Trends for vasodilator and opioid use varied, while antidepressant use remained stable or increased. These drug classes were prescribed at similar or greater proportions in the elderly following their diagnosis of recurrent falls than those without. Incidence rates of benzodiazepine use declined over time, while vasodilators and opioids exhibited mixed patterns. Incidence rates were also similar or greater in the elderly following the diagnosis of recurrent falls than in those without. Both prevalence and incidence rates increased with age and varied by sex.

Conclusions: STOPP section K criteria drugs were prescribed at similar or higher prevalence and incidence rates in the elderly following diagnosis of recurrent falls compared to those without recurrent falls, with benzodiazepines, opioids and vasodilators being the most common. These findings highlight the importance of identifying the elderly with recurrent falls as a high-risk population that may benefit from medication review.