The impact of fall-risk medications on injuries in COPD patients

People with COPD experience more falls and related injuries requiring medical care when using common fall-risk increasing drugs, according to a new study. The study is published in the November 2024 issue of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, a peer-reviewed, open-access journal. 

Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease, comprising several conditions, including chronic bronchitis and emphysema. Symptoms include breathlessness, fatigue and chronic cough. The disease affects more than 30 million Americans and is the fourth leading cause of death worldwide. 

Previous research has shown that people with COPD have a higher risk of falling due to increased frailty, impaired gait and the tripping hazard of oxygen tubing. They also commonly experience pain, anxiety, insomnia and other comorbidities, such as diabetes or hypertension. Opioids, benzodiazepines and other medications used to treat these comorbidities and symptoms can increase a person's risk of falling and fall-related injuries. 

Fall-risk increasing drugs are commonly prescribed to people with COPD because they experience a high number of symptoms and conditions that indicate use of these drugs. However, injuries from falls can lead to emergency department visits or hospitalization, resulting in a lower quality of life and increased health care costs."

Cara L. McDermott, PharmD, PhD, Study Lead Author and Assistant Professor, Division of Geriatrics and Palliative Care, School of Medicine, Duke University

The study examined data from a single health system linked to Washington State death certificates of adults 40 or older with COPD who died between 2014 and 2018. Of the 8,204 people, 65% were prescribed at least one fall-risk increasing drug, and 30% had a fall with injury in the two years prior to their death. 

"Our study compared the number of falls in the two years prior to death in people with COPD who used fall-risk increasing drugs to those with COPD who did not use these drugs. We found that the chance of a person falling increased relative to how many fall-risk increasing drugs they used," Dr. McDermott said. "Pulmonologists and pharmacists need to collaborate with each other and with patients to develop fall prevention strategies and to increase patient safety by reducing the use of fall-risk increasing drugs and discussing other ways to mitigate fall risk."