New research published in 2006 shows that older adults discharged from the hospital with new prescriptions for sedatives, especially benzodiazepines and antipsychotics, are at increased risk of falls and other negative outcomes. CMJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.251965.
”Our results showed that discharging older adults after admission to an acute hospital with a new prescription for these drugs is associated with an increased risk of falls requiring medical attention, need for further acute hospital treatment, and death in the 30 days after discharge, whereas previously exposed individuals did not see a similar increased risk.,” wrote Dr. Lisa Barry, a clinical scientist at Mount Sinai Hospital Sinai Health and the University of Toronto in Toronto, Ontario, along with co-authors.
Falls are a major public health burden, particularly affecting older people. Because sedatives and antipsychotics are associated with adverse events, clinical guidance recommends against prescribing these potentially inappropriate medications to older adults.
The study, which included more than 1.86 million adults aged 66 and older, aimed to understand prescribing patterns to inform future hospital discharge prescribing. We looked at all patients discharged from hospital from April 2003 to August 2023 based on ICES data. In total, 13% (246,440 people) had at least one sedative prescription filled within 7 days of hospital discharge, and of these, about one-third (76,335 people) had not filled a sedative prescription within 6 months before admission. Newly prescribed sedatives had a 20% higher risk of falls and increased risk of emergency department visits, readmissions, and death within 30 days.
”Although the overall absolute magnitude of the risk of the identified adverse events is modest from a population perspective, the impact on patients and their families is clinically and socially important.“Write the author.”Furthermore, considering the number of hospitalized elderly people, With an aging population, even small increases in risk have large implications for health systems. ”
The authors suggest caution when prescribing these drugs upon discharge and ensuring medical follow-up for 1 to 2 weeks after discharge to monitor patients, continue risk assessment, and consider the need for prescribing.
”Given the identified associations, clinicians should consider whether a new sedative prescription is mandatory or whether the prescription can be discontinued or tapered before or immediately after discharge. If continued sedation is required, community support such as falls and mobility assessments and ongoing medication reviews may help reduce risk.” concludes the author.
sauce:
Canadian Medical Association Journal
Reference magazines:
Barry, L.D. Others. (2026). Association between postdischarge sedative prescription and falls and other adverse events in older adults: a population-based cohort study. Journal of the Canadian Medical Association. DOI: 10.1503/cmaj.251965. https://www.cmaj.ca/content/198/25/E958
