Using the Drug Burden Index to identify older adults at highest risk for medication-related falls

Susan J. Blalock, Chelsea P. Renfro, Jessica M. Robinson, Joel F. Farley, Jan Busby-Whitehead, Stefanie P. Ferreri

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


BACKGROUND: The Drug Burden Index (DBI) was developed to assess patient exposure to medications associated with an increased risk of falling. The objective of this study was to examine the association between the DBI and medication-related fall risk.

METHODS: The study used a retrospective cohort design, with a 1-year observation period. Participants (n = 1562) were identified from 31 community pharmacies. We examined the association between DBI scores and four outcomes. Our primary outcome, which was limited to participants who received a medication review, indexed whether the review resulted in at least one medication-related recommendation (e.g., discontinue medication) being communicated to the participant's health care provider. Secondary outcomes indexed whether participants in the full sample: (1) screened positive for fall risk, (2) reported 1+ falls in the past year, and (3) reported 1+ injurious falls in the past year. All outcome variables were dichotomous (yes/no).

RESULTS: Among those who received a medication review (n = 387), the percentage of patients receiving at least one medication-related recommendation ranged from 10.2% among those with DBI scores of 0 compared to 60.2% among those with DBI scores ≥1.0 (Chi-square (4)=42.4, p < 0.0001). Among those screened for fall risk (n = 1058), DBI scores were higher among those who screened positive compared to those who did not (Means = 0.98 (SD = 1.00) versus 0.59 (SD = 0.74), respectively, p < 0.0001).

CONCLUSION: Our findings suggest that the DBI is a useful tool that could be used to improve future research and practice by focusing limited resources on those individuals at greatest risk of medication-related falls.

Original languageEnglish (US)
Article number208
JournalBMC Geriatrics
Issue number1
StatePublished - Jun 12 2020

Bibliographical note

Funding Information:
This work was supported by Cooperative Agreement Number 1 U01 CE002769–01 from the Centers for Disease Control and Prevention and Grant Number 1C1CMS331338 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. The research presented here was conducted by the awardee. Findings might or might not be consistent with or confirmed by the findings of the independent evaluation contractor.

Publisher Copyright:
© 2020 The Author(s).


  • Accidental falls
  • Aging
  • Health services
  • Medication
  • Medication therapy management
  • Cholinergic Antagonists
  • Humans
  • Aged
  • Hypnotics and Sedatives
  • Pharmaceutical Preparations
  • Retrospective Studies
  • Accidental Falls

PubMed: MeSH publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Journal Article


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