Survey of Fall Rates in Classification of Hypnotics / 日本農村医学会雑誌

ABSTRACT

Hospitalized patients often have insomnia, and in many cases it is necessary to administer hypnotics. Although the hypnotics currently used in Japan are mainly benzodiazepine receptor agonists, there is an associated risk of falling due to muscle relaxant action, and carryover effect. It is believed that orexin receptor antagonists, which have a different mechanism of action from conventional hypnotics, have no muscle relaxant action and are thus considered to be much safer. Therefore, in this study we compared fall rate according to the class of hypnotics that the patient had been taking. 　　We analyzed hospitalized patients taking orexin receptor antagonists (ORB), benzodiazepines (BZDs), and non-BZDs, who had falls and were treated in our hospital from April 1, 2017 to December 31, 2017. Patients were grouped according to the drug they were taking before the fall occurred and the fall rate was calculated and compared. The total number of falls in the target patients was 45, and the total number of people prescribed hypnotics in the study period was 1682. Fall rate by classification of hypnotics was the lowest in the ORB group at 1.45％, which was significantly lower than that of the BZD group, suggesting the possibility that ORBs have minimal influence on falls. In addition, the fall rate in the non-BZD group was significantly lower than that of the BZD group.