26gaa21 10.3205/26gaa21 urn:nbn:de:0183-26gaa216 Meeting Abstract Schechner Schechner Miriam M

Institute of General Practice and Family Medicine, LMU University Hospital, LMU Munich, Munich, Germany

Miriam.Schechner@med.uni-muenchen.de author Rottenkolber Rottenkolber Marietta M

Institute of General Practice and Family Medicine, LMU University Hospital, LMU Munich, Munich, Germany

author Oehler Oehler Patrick P

Institute of General Practice and Family Medicine, LMU University Hospital, LMU Munich, Munich, Germany

author Guthrie Guthrie Bruce B

Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom

author Grill Grill Eva E

Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany

author Hoffmann Hoffmann Sabine S

Department of Statistics, LMU Munich, Munich, Germany

author Piller Piller Johannes J

Statistical Consulting Unit (StaBLab), LMU Munich, Munich, Germany

author Bender Bender Andreas A

Munich Center for Machine Learning, LMU Munich, Munich, Germany

author Dreischulte Dreischulte Tobias T

Institute of General Practice and Family Medicine, LMU University Hospital, LMU Munich, Munich, Germany

Tobias.Dreischulte@med.uni-muenchen.de author German Medical Science GMS Publishing House

Düsseldorf

610 20261021 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0661 21 Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA) 33. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie Abstracts München 20261129 20261130 26gaa21 TextBackground/Aim: Falls are a major cause of morbidity among older adults. While deprescribing fall-risk-increasing drugs (FRIDs) is recommended for secondary prevention, their high prevalence limits efficient targeting in primary prevention. Stratification by pharmacological FRID subclasses or drugs with fall-risk-increasing adverse reactions (FRIAR-drugs) may improve identification of high-risk patients, yet their added value in routine care is uncertain. Therefore, the aim of this study is to compare pharmacological FRID classifications with a FRIAR-based framework for predicting fall-related hospitalisations and to identify drug subgroups that differentiate fall-risk among exposed older adults in a primary prevention context.Methods: We conducted a retrospective cohort study including 120,867 adults aged ≥65 years prescribed at least one FRID or FRIAR-drug at baseline. Fall-related hospitalisations in 2019 were identified using ICD-10 codes. Multivariate logistic regression evaluated pharmacological FRID (sub)groups and FRIAR-drug classifications, adjusted for established general predictors. Model performance was assessed using internal validation and sensitivity analyses.Results: During follow-up, 2,788 individuals (2.3%) experienced a fall-related hospitalisation. Pharmacological subgroups associated with higher risk included serotonin re-uptake inhibitors, older antiepileptics, and drugs with moderate anticholinergic properties. In contrast, the FRIAR-drug framework added little prognostic information beyond established FRID classifications. The final model demonstrated moderate discrimination (AUC 0.73) with stable predictive performance on internal validation.Discussion/Conclusion: Pharmacological stratification of FRIDs allows clinically useful differentiation of fall-risk among exposed older adults, whereas FRIAR-based classification adds limited prognostic value. These findings support more selective prioritisation of medication review in primary-preventive fall strategies, although external validation and evaluation of decision-relevant risk stratification are required. 0 0 0 0