摘要
【ABSTRACT】【Background】Falls pose a significant public health threat to older adults. Due to potential fall risk, guidelines recommend against the routine prescription of several medications commonly used for vestibular suppression, including meclizine and benzodiazepines.【Aims】We aimed to determine the factors associated with vestibular suppressant utilization among patients with dizziness ≥ 65 years of age and subsequent falls.【Methods and Results】A retrospective longitudinal database of US commercial insurance and Medicare beneficiaries was used to study medical claims data (January 1, 2006, through December 31, 2015). Of 190,348 individuals ≥ 65 years old who presented with dizziness, 60,658 (32%) filled a vestibular suppressant prescription (27% anti‐emetics, 73% anxiolytics), of which 20,448 were women (34%) within a month after their dizziness diagnosis. Of those individuals using suppressants, 8% experienced a fall resulting in a medical encounter within 60 days of filling the prescription. After adjusting for sociodemographics and comorbidity, individuals with dizziness who received vestibular suppressants were more likely to experience recorded fall incidents (hazard ratio (HR) 3.33, confidence interval (CI) 1.93–5.72, p < 0.0001), than those who did not receive vestibular suppressants.【Conclusions】Although vestibular suppressants may provide immediate relief from symptoms during an acute vestibular crisis, use is incongruent with guideline‐concordant care for most vestibular diagnoses and is also potentially counterproductive and injurious. Multi‐faceted interventions that engage clinicians and patients are needed to improve the value of care for patients with vestibular disorders to de‐implement the routine use of suppressants for dizziness.
摘要译文
【摘要】【背景】瀑布对老年人构成了重大的公共卫生威胁。由于潜在的跌倒风险，指南建议反对通常用于前庭抑制的几种药物的常规处方，包括麦克氨济和苯二氮卓类药物。受益人被用来研究医学索赔数据（2006年1月1日至2015年12月31日）。在190,348名≥65岁头晕的人中，有60,658（32％）填充了前庭抑制剂处方（27％的抗遗传学，73％的抗焦虑药），其中20,448名女性（34％）是头晕诊断后一个月内的女性（34％）。在使用抑制剂的那些人中，有8％的人经历了跌倒，导致填充处方后60天内发生医疗接触。在调整了社会人口统计学和合并症之后，患有头晕的人受到前庭抑制剂的可能性更有可能经历记录的秋季事件（HR危险比（HR）3.33，置信区间（CI）1.93-5.72，p <0.0001，比直接抑制的人可能会抑制症状。危机，使用与大多数前庭诊断的指南 - 有联系的护理不一致，并且可能适得其反和有害。需要进行临床医生和患者的多方面干预措施，以提高前庭疾病患者的护理价值，以消除常规使用抑制剂对头晕的使用。
Schelomo Marmor [1];Pinar Karaca‐Mandic [2];Meredith E. Adams [3];. Vestibular Suppressant Utilization and Subsequent Falls Among Patients 65 Years and Older With Dizziness in the United States[J]. Journal of the American Geriatrics Society, 2025,73(5): 1398-1405