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Title ラメルテオン・スボレキサントを含めた睡眠薬の服用と転倒への影響 : 症例対照研究
Subtitle Regular Article
Authors 石郷友之a, 高田遼a, 近藤蕗a, 伊部裕太a, 中野敬太a, 立石莉穂a, 藤居賢a, 片野唆敏b, 北川学a, 木明智子a, 中田浩雅a, 橋本暁佳c,d, 宮本篤a
Authors (kana)
Organization a札幌医科大学附属病院薬剤部, b札幌医科大学附属病院リハビリテーション部, c札幌医科大学循環器・腎臓・代謝内分泌内科学講座, d札幌医科大学病院管理学
Journal YAKUGAKU ZASSHI
Volume 140
Number 8
Page 1041-1049
Year/Month 2020 / 8
Article 原著
Publisher 日本薬学会
Abstract 「緒言」転倒はときに骨折や機能障害を引き起こし, QOLの低下や寝たきり, 要介護状態の原因となるため, 医療安全管理上で最も重要な問題の1つである. また, 転倒に関連する因子には, 加齢, 女性, body mass index (BMI) 低値, 転倒歴, activities of daily living (ADL) の低下, 認知機能障害, 脳梗塞の既往, せん妄, うつ, 糖尿病, 薬剤の影響などの内因性の因子や履物や照明などの外因性の因子があり, それらが複雑に関連し転倒が発生する. 薬剤では, 睡眠薬, 抗不安薬, 抗うつ薬, 抗精神病薬などの向精神薬, 降圧薬, 利尿薬, β遮断薬, non-steroidal anti-inflammatory drugs (NSAIDs), 麻薬, 抗パーキンソン病薬などが転倒に影響し, 服用している薬剤の分類にかかわらず服用薬剤数の増加, つまりポリファーマシー自体も転倒のリスクとなることが報告されている.
Practice 薬学
Keywords fall, sedative hypnotics, suvorexant, ramelteon

English

Title Association Suvorexant and Ramelteon Use with the Risk of Falling : A Retrospective Case-control Study
Subtitle Regular Article
Authors Tomoyuki Ishigo(a), Ryo Takada(a), Fuki Kondo(a), Yuta Ibe(a), Keita Nakano(a), Riho Tateishi(a), Satoshi Fujii(a), Satoshi Katano(b), Manabu Kitagawa(a), Tomoko Kimyo(a), Hiromasa Nakata(a), Akiyoshi Hashimoto(c),(d), Atsushi Miyamoto(a)
Authors (kana)
Organization (a)Division of Hospital Pharmacy, Sapporo Medical University Hospital, (b)Division of Rehabilitation, Sapporo Medical University Hospital, (c)Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, (d)Division of Health Care Administration and Management, Sapporo Medical University School of Medicine
Journal YAKUGAKU ZASSHI (Journal of the Pharmaceutical Society of Japan)
Volume 140
Number 8
Page 1041-1049
Year/Month 2020 / 8
Article Original article
Publisher Pharmaceutical Society of Japan
Abstract Sedative hypnotics are among the classes of drugs reported to influence falls. However, the effects of the sedative hypnotic drugs, suvorexant and ramelteon, on falls are not well known. Therefore, we conducted this retrospective case-control study to examine the association of the use of these two sedative hypnotics with the risk of falls. Conducted at the Sapporo Medical University Hospital in Japan, our study included 360 patients with fall incidents and 819 randomly selected control patients. Patients in the fall group were significantly older with a lower body mass index, and had a history of falls, disabilities in activities of daily living, cognitive impairment, and delirium. Monovariate analysis revealed that patients in the fall group frequently used ramelteon [odds ratio (OR) 2.38, 95% confidence interval (CI) : 1.49-3.81, p < 0.001], but rarely used suvorexant (OR 0.66, 95% CI : 0.29-1.39, p = 0.317), compared with control patients. Furthermore, multivariate analysis revealed that ramelteon use did not increase the risk of falls (adjusted OR 1.43, 95% CI : 0.82-2.48, p = 0.207), whereas suvorexant use significantly decreased the risk of falls (adjusted OR 0.32, 95% CI : 0.13-0.76, p = 0.009). Although ramelteon tends to be used in patients at a high risk of falls, it may not increase the risk of falls. In contrast, the use of suvorexant may reduce the risk of falls.
Practice Pharmaceutical sciences
Keywords fall, sedative hypnotics, suvorexant, ramelteon
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