09/16/2025    Bob Smith, DPM, MSc, RPh

RE: Increased Risk of Fatal Falls (Paul Kesselman, DPM)

I would like to thank and applaud Dr. Kesselman
for his communication centered on the increased
risk of fatal falls. I also encourage all medical
professionals to not only explore these recent
suggested literature sources. Twenty-five years
ago, I started researching and developed a
narrative that was published as: Smith RG. Fall-
contributing adverse effects of the most
frequently prescribed drugs. J Am Podiatr Med
Assoc. 2003 Jan-Feb;93(1):42-50. The foremost
reason, purpose of this narrative was to document
the possible plausibility and causality of
medication inducing adverse effects. Given the
advances in technology and leaders in our
profession indicate that podiatrists should be the
leading professionals to identify and prevent
falls among our most vulnerable populations.

In July of 2025, I began a systematic literature
review to obtain actual statistics and numbers of
medications that induce fall injury. I have
obtained a wealth of information described as The
FDA adverse event reporting system database, drug
monographs describing the pharmacokinetics
properties, The AGS Beers Criteria 2023, and
auditory and vestibular side-effects of FDA-
Approved Drugs for Diabetes, and medication that
affect balance. A further goal for obtaining this
objective data is to develop an electronic
predicative tool. Moreover, with any tool that
prevails, the properties of clinimetrics is my
hope.

Perhaps podiatrists can integrate assessments for
fall risk in their prehabilitation; that provides
patients with exercise programs to optimize
strength and range of motion while also increasing
patient knowledge of and exposure to interventions
that they will receive after surgery. Andrews ,et
al’s (2022) retrospective cohort study design at a
single institution found a high incidence of
postoperative falls in the first 6 weeks after
foot and ankle surgery. They underscored that
baseline antidepressant uses and higher 2-week VAS
pain scores were associated with post-operative
falls. It is acknowledged that there are check-
lists for inpatient and nursing home residences.
My hope is that this revisiting of fall-
contributing adverse effects of the most
frequently prescribed drugs twenty-five years
later and the development of an electronic
predictive tool available to all healthcare
professions for all patient populations.
Bob Smith, DPM, MSc, RPh, Ormond Beach, FL

There are no more messages in this thread.