Long-Term Use of Proton Pump Inhibitor and Statins in Patients Aged ≥ 70 Years and Fall Risk: A Clinical Audit at UHK

Background: Falls in older adults represent a major cause of morbidity, hospitalization, and mortality worldwide. Polypharmacy and fall-risk–increasing drugs (FRIDs) are recognized modifiable contributors.

Proton pump inhibitors (PPIs) and statins are frequently prescribed long term in elderly populations, often without periodic reassessment.

Aim: To evaluate the relation between long-term PPI and statin therapy in patients aged ≥70 years and increase of fall risk.

Methods: A retrospective clinical audit was conducted at UHK reviewing 48 consecutive patients aged ≥70 years admitted following a fall. Data collected included medication history, duration of therapy, documented indication, adverse effects, and biochemical monitoring.

Results: Among 48 patients, 28 (58.3%) were receiving long-term PPI therapy (1–5 years), with 14 (50%) lacking documented indication. Statins were prescribed in 40 patients (83.3%), primarily for primary cardiovascular prevention and hyperlipidemia. Polypharmacy was common: 83.3% were on antihypertensives, 16.7% antipsychotics, 10.4% opioids, and 10.4% antidepressants. Adverse effects potentially contributing to falls were identified in 35 patients (72.9%), including hypomagnesemia and muscle weakness/myopathy. Biochemical monitoring was performed only at hospital admission, with no evidence of routine outpatient surveillance.

Conclusion: There is a high prevalence of potentially inappropriate long-term PPI and extensive statin use among elderly patients presenting with falls. Inadequate documentation and absence of routine biochemical monitoring represent significant safety gaps. Structured medication review and deprescribing strategies are recommended.