Acta Biomedica Scientia

MANAGEMENT OF DIZZINESS IN OLDER ADULTS: A RETROSPECTIVE STUDY ON FALL-RISK-INCREASING DRUG (FRID) ADJUSTMENTS IN PRIMARY CARE

Dr. Varun. Mullugura1*, Dr. Vishnuvardhan Reddy2, Thota Sreekanth3

Dizziness, Fall-risk-increasing drugs (FRIDs), General practitioners, older adults, Medication adjustment

Dizziness is a common complaint among older adults and poses a significant challenge for general practitioners (GPs) due to its diverse etiologies, including peripheral, central, and medication-related causes. The role of fall-risk-increasing drugs (FRIDs) in dizziness remains an area of concern, yet limited research has been conducted on FRID adjustments in older patients. Objective: This study aimed to assess the management of dizziness in older adults, with a particular focus on evaluating and modifying FRID prescriptions in primary care settings. Methods: A retrospective study was conducted at Indira Medical College & Hospitals, Pandur, and Melmaruvathur Adhiparasakthi Medical College and Hospitals, Melmaruvathur, Chengalpattu District, Tamilnadu, India, from October to December 2024. Data were extracted from electronic medical records of 5624 patients aged 51 and above who presented with dizziness. Statistical analysis included chi-square tests and logistic regression models to compare treatment strategies and FRID adjustments across different age groups. Results: The prevalence of dizziness among older adults was 12.8%, with a median patient age of 76 years. Most patients were female, and dizziness prevalence increased with age. The most common diagnoses were symptom-based, cardiovascular conditions, and peripheral vestibular disorders. Treatment strategies primarily included observation (28.4%), patient education and advice (28.0%), additional testing (26.8%), and medication adjustments (11.7%). FRIDs were prescribed to 88.2% of patients, with an average of 4.1 FRIDs per patient. FRID adjustments were infrequent, with dose reductions in 262 patients (4.7%) and discontinuations in 438 patients (7.8%). Referral rates to specialists were higher (19.0%) compared to previous studies. Conclusion: FRID adjustments were the least utilized management strategy, despite their significant association with dizziness. GPs should regularly assess and adjust FRID prescriptions to minimize dizziness-related risks in older adults. Given the increasing prevalence of dizziness in this population, a systematic approach to medication review and targeted interventions is essential to improve patient outcomes and reduce unnecessary referrals