The Relation Of Benign Prostatic Hyperplasia Medications With The Risk Of Falls

As men age, many will start developing signs and symptoms of benign prostatic hyperplasia (BPH). Symptoms include frequent urination, urgency, and weak urinary stream. This condition is treatable with medication such as prostate-specific (second generation) α antagonist. Medications include alfuzosin, Tamsulosin, and silodosin. As a class of α antagonist, they have been related with side effects such as dizziness and hypotension. This questions if the new generation drug to treat BPH symptoms related with the risk of falls.

The effect of BPH and falls/fractures has been identified as an important research question in nursing because patients who take this medication are related with falls largely in the elderly population. Patients for the study outcomes for 90 days after the measure date. This time period was chosen because adverse events are highest in the first few weeks after starting an α antagonist. Beginning of treatment with prostate-specific α antagonists leads to a notable rise in the risk of arriving to a hospital emergency room or being admitted to hospital because of a fall, fracture, or head injury. The size of this risk increase is small, but the potential seriousness of these events in elderly people, men should be advised on ways to decrease this risk.

The study established a cohort of men aged 66 years or older who filled their first outpatient prescription for Tamsulosin, alfuzosin, or silodosin between 1 June 2003 and 31 December 2013. Welk, McArthur, Fraser, Hayward, Dixon, Hwang, and Ordon conducted a research to provide concepts related to the increase of falls and relating to the initiation of treatment with prostate-specific α antagonist. Several sources were reviewed by the authors to establish the need for the study in order to provide accurate data and to stress the relation of the increased falls associated with prostate-specific α antagonist medication.

This research study was conducted between June 2003 and December 2013. This study was approved in 2015 by the research ethics board at Sunnybrook Hospital. The research demonstrated validity and reliability by the Registered Persons Database, Ontario drug benefit database, Canadian Institute for Health Information Discharge Abstract Database, and National Ambulatory Care Reporting System. The theoretical framework was based on concepts that incorporate gathering data from patients going to the emergency room after having a fall and starting BPH treatment. Specific identifications were used such as the participants age, sex, and department of the hospital. The framework in this study focused on the use administrative data to assess the 90-day risk of fall or fracture among men initiating a prostate-specific α antagonist.

The independent variable influences the dependent variable or outcome, intervention, or treatment that is manipulated by the researcher. In this study the independent variable is the age, sex, emergency room, and the admission to the hospital. The dependent variable in this study is the value that is tested and measured. Operational definitions of the variables are given. This study measured the number of patients who are 66 years and older with the rise of falls, the number of fractures, and hospitalization or emergency room assessment for low blood pressure or head trauma by taking BPH medication in the first 90 days or starting the medication. The research question is if the new generation drug to treat BPH symptoms associate with the risk of falls.

Quantitative studies test the hypothesis, the study showed that a small but notable increase in risk of hospitalization or emergency room assessment for a fall, and an increase in the risk of fracture by 16% and of head trauma by 15% during the first 90 days of use. 80% of men who sustained a fracture were connected as having a fall, hospital admission or emergency room visit for hypotension or head trauma, both of which were significantly increased among men exposed to α antagonists (odds ratios 1. 80 (1. 59 to 2. 03) and 1. 15 (1. 04 to 1. 27)). Quantitative researchers also gather evidence and make their observation by obtaining accurate measurements and can be statistically analyzed. Inductive reasoning was used in this study and was associated with the qualitative approaches. The sample size was large due to gathering data from almost 100 administrative data bases and used men who are 66 years of age and older who came to the emergency room for a fall after initiating BPH medication. The sampling methods were purposive because it recruited specific participants with a specific age and taking an antagonist medication the first 90 days.

This research study was conducted between June 2003 and December 2013 and approved in 2015 by the research ethics board at Sunnybrook Hospital. The research demonstrated validity and dependibility by the Registered Persons Database, Ontario drug benefit database, Canadian Institute for Health Information Discharge Abstract Database, and National Ambulatory Care Reporting System. Health care staff is educating the patients on the increase risk of falls prior to starting the medication. Data analysis was used and collected when the patients came into the emergency room with either a fall or fracture when taking a prostate - a antagonist. The results were presented by using administrative datasets from the province of Ontario, Canada. The primary outcome was in the hospital emergency room visit or the inpatient admission for a fall or fracture in the 90 days after starting medication. The study found that the relationship between falls and the medication was related to the side effects of the medication. This research study has a number of strengths. The research was one of the first studies of prostate-specific antagonist that measures both adverse event of falls and the potentially fractures and head injury.

Almost 100 administrative data were used and was able to create a large cohort of men. Some weakness in the research showed that they were not able to relate if the fall was also related to the physical condition or mobility impairment. The study only included men 66 years of age or older who predominately included Tamsulosin. Only a small number or patients used alfuzosin and silodosin. As a qualitative study reliability and validity in the research study was demonstrated with all the sources that supported the research.

What this study did prove is that there was a relation of taking BPH medications and the risk of falling. The sample was taken very carefully through database with these findings. As to the field of nursing, this can serve as a guideline to educate the patient about the side effects of the medication and understand the risk of falling when taking the medication.