USUAL CARE AND EVALUATION OF FALL RISK INCREASING DRUGS IN OLDER DIZZY PATIENTS IN DUTCH GENERAL PRACTICE

Introduction and objective For general practitioners (GPs) dizziness is a challenging symptom to deal with. Data on the management of dizziness in older patients are mostly lacking. Fall Risk Increasing Drugs (FRIDs) may contribute to dizziness in older patients. The aim of this study is to gain more insight into GP’s management of dizziness in older patients, including FRID evaluation and adjustment. Method Data were derived from electronic medical records of 46 Dutch general practices, obtained over a 12-month period in 2013. Patients were identified using International Classification of Primary Care codes and free text. Usual care was categorised into wait-and-see strategy (no treatment initiated); education and advice; additional testing; medication adjustment; and referral. In case of multiple treatment modalities in one consultation or in multiple consultations, all treatment modalities were categorised. Results and conclusions We identified 2812 dizzy patients older than 65 years. Frequently applied treatments included a wait-and-see strategy (28.4%) and education and advice (28.0%). Additional testing was performed in 26.8%; 19.0% of the patients were referred. Of the patients 87.2% had at least one FRID prescription. During the observation period, GPs adjusted prescriptions of one or more FRIDs for 11.7% of the patients. Concluding, this study revealed a wide variety in management strategies for dizziness in older adults. The referral rate for dizziness was high compared to prior research. Although many older dizzy patients use at least one FRID, FRID evaluation and adjustment is scarce. We expect that more FRID adjustments may reduce dizziness and dizziness-related impairment.