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01.07.2014 | Original Research Article

Medication Use Before and After Hip Fracture: A Population-Based Cohort and Case-Control Study

verfasst von: Maurizio Rossini, Ombretta Viapiana, Silvano Adami, Luca Idolazzi, Stefano Buda, Chiara Veronesi, Luca Degli Esposti, Davide Gatti

Erschienen in: Drugs & Aging | Ausgabe 7/2014

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Abstract

Background

Osteoporosis, together with age, is the main risk factor for hip fracture, the incidence of which has also been associated with an increased risk of falling or co-morbidities and related pharmacological treatments.

Objectives

The aim of this study was to investigate changes in concomitant pharmacological treatments prescribed before and after hip fracture in elderly patients compared with treatments prescribed to a matched cohort of subjects without hospitalisation for fractures.

Methods

Data relating to the study population were extracted from a large population-based administrative database of the Italian National Health Authorities. A retrospective analysis was conducted involving female patients (6,431) aged ≥65 years and hospitalised for a hip fracture. The control group comprised age-matched subjects (38,586) not hospitalised for fracture. Changes in drug prescriptions 1 year before and 1 year after hip fracture and differences versus controls were compared.

Results

Prior to the fracture, patients were taking more anti-Parkinson medications, antidepressants, medications for chronic obstructive pulmonary disease (COPD), bisphosphonates and calcium–vitamin D supplements, although the intake of the routinely monitored drug classes was significantly infrequent. Polypharmacy was less frequent in fractured women before fracture than in controls (22 vs. 25 %, respectively; P < 0.001), but it was more frequent (30 %, P < 0.001) post-fracture. The incidence of fracture was associated with a significant increase in the use of a number of drug classes: insulin, NSAIDs or analgesics, gastroprotectants, loop diuretics, β-blockers, antidepressants, antiparkinson drugs, antiepileptics and drugs for COPD.

Conclusion

Our study confirms a strong association between the use of some drugs (antidepressants, antiparkinson drugs, drugs for COPD) and the risk of hip fracture, but drug use is globally less common than in controls. Hip fracture is associated with a significant increase in drug use, suggesting a global deterioration of health conditions.

Hernlund E, Svedbom A, Ivergård M, et al. Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2013;8:136.PubMedCentralPubMedCrossRef

Rossini M, Piscitelli P, Fitto F, et al. Incidence and socioeconomic burden of hip fractures in Italy. Reumatismo. 2005;57:97–102.PubMed

Piscitelli P, Iolascon G, Gimigliano F, et al. Incidence and costs of hip fractures compared to acute myocardial infarction in the Italian population: a 4-year survey. Osteoporos Int. 2007;18:211–9.PubMedCrossRef

Stevens JA, Anne Rudd R. Declining hip fracture rates in the United States. Age Ageing. 2010;39:500–3.PubMedCrossRef

Piscitelli P, Gimigliano F, Gatto S, et al. Hip fractures in Italy: 2000–2005 extension study. Osteoporos Int. 2010;21:1323–30.PubMedCrossRef

Kanis JA, Oden A, McCloskey EV, et al. A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int. 2012;23:2239–56.PubMedCentralPubMedCrossRef

Oden A, McCloskey EV, Johansson H, et al. Assessing the impact of osteoporosis on the burden of hip fractures. Calcif Tissue Int. 2013;92:42–9.PubMedCrossRef

Wilkin TJ, Devendra D. Bone densitometry is not a good predictor of hip fracture. BMJ. 2001;323:795–9.PubMedCrossRef

Kaptoge S, Benevolenskaya LI, Bhalla AK, et al. Low BMD is less predictive than reported falls for future limb fractures in women across Europe: results from the European Prospective Osteoporosis Study. Bone. 2005;36:387–98.PubMedCrossRef

10.

Wainwright SA, Marshall LM, Ensrud KE, et al. Hip fracture in women without osteoporosis J Clin Endocrinol Metab. 2005;90:2787–93.CrossRef

11.

Edwards MH, Jameson K, Denison H, et al. Clinically risk factors, bone density and fall history in the prediction of incident fracture among men and women. Bone. 2013;52:541–7.PubMedCentralPubMedCrossRef

12.

Wei TS, Hu CH, Wang SH, et al. Fall characteristics, functional mobility and bone mineral density as risk factors of hip fracture in the community-dwelling ambulatory elderly. Osteoporos Int. 2001;12:1050–5.PubMedCrossRef

13.

Norton R, Campbell J, Lee-Joe T, et al. Circumstances of falls resulting in hip fractures among older people. J Am Geriatr Soc. 1997;45:1108–12.PubMed

14.

Kanis JA, Borgstrom F, De Laet C, et al. Assessment of fracture risk. Osteoporos Int. 2005;16:581–9.PubMedCrossRef

15.

Dennison EM, Compston JE, Flahive J, et al. Effect of co-morbidities on fracture risk: findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW). Bone. 2012;50:1288–93.PubMedCrossRef

16.

Lawlor DA, Patel R, Ebrahim S. Association between falls in elderly women and chronic diseases and drug use: cross sectional study. BMJ. 2003;327:712.PubMedCentralPubMedCrossRef

17.

Leveille SG, Jones RN, Kiely DK, et al. Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA. 2009;302:2214–21.PubMedCentralPubMedCrossRef

18.

Vestergaard R, Rejnmark L, Mosekilde L. Fracture risk in patients with chronic lung diseases treated with bronchodilator drugs and inhaled and oral corticosteroids. Chest. 2007;132:1599–607.PubMedCrossRef

19.

Prieto-Alhambra D, Nogues X, Javaid MK, et al. An increased rate of falling leads to a rise in fracture risk in postmenopausal women with self-reported osteoarthritis: a prospective multinational cohort study (GLOW). Ann Rheum Dis. 2013;72:911–7.PubMedCrossRef

20.

Janghorbani M, Feskanich D, Willett WC, et al. Prospective study of diabetes and risk of hip fracture: the Nurses’ Health Study. Diabetes Care. 2006;29:1573–8.PubMedCrossRef

21.

Cumming RG, Klineberg RJ. Psychotropics, thiazide diuretics and hip fractures in the elderly. Med J Aust. 1993;158:414–7.PubMed

22.

Cumming RG, Le Couteur DG. Benzodiazepines and risk of hip fractures in older people: a review of the evidence. CNS Drugs. 2003;17:825–37.PubMedCrossRef

23.

Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: II. Cardiac and analgesic drugs. J Am Geriatr Soc. 1999;47:40–50.PubMed

24.

Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc. 1999;47:30–9.PubMed

25.

Barrett-Connor E, Weiss TW, McHorney CA, et al. Predictors of falls among postmenopausal women: results from the National Osteoporosis Risk Assessment (NORA). Osteoporos Int. 2009;20:715–22.PubMedCrossRef

26.

Evans JG. Drugs and falls in later life. Lancet. 2003;361:448.PubMedCrossRef

27.

Neutel CI, Perry S, Maxwell C. Medication use and risk of falls. Pharmacoepidemiol Drug Saf. 2002;11:97–104.PubMedCrossRef

28.

Woolcoot JC, Richardson KJ, Wiens MO, et al. Meta-analysis of the impact of 9 classes on falls in elderly persons. Arch Intern Med. 2009;169:1952–60.CrossRef

29.

Darowsky A, Chambers SACF, Chambers DJ. Antidepressants and falls in the elderly. Drugs Aging. 2009;26:381–94.CrossRef

30.

van den Brand MW, Pouwels S, Samson MM, et al. Use of anti-depressants and the risk of fracture of the hip or femur. Osteoporos Int. 2009;20:1705–13.PubMedCentralPubMedCrossRef

31.

Carbone LD, Johnson KC, Bush AJ, et al. Loop diuretic use and fracture in postmenopausal women: findings from the Women’s Health Initiative. Arch Intern Med. 2009;169:132–40.PubMedCrossRef

32.

Pouwels S, van Staa TP, Egberts AC, et al. Antipsychotic use and the risk of hip/femur fracture: a population-based case–control study. Osteoporos Int. 2009;20:1499–506.PubMedCentralPubMedCrossRef

33.

Carbone LD, Johnson KC, Robbins J, et al. Antiepileptic drug use, falls, fractures, and BMD in postmenopausal women: findings from the women’s health initiative (WHI). J Bone Miner Res. 2010;25:873–81.PubMedCentralPubMed

34.

Riche DM. Travis King S. Bone loss and fracture risk associated with thiazolidinedione therapy. Pharmacotherapy. 2010;30:716–27.PubMedCrossRef

35.

Pouwels S, Lalmohamed A, van Staa T, et al. Use of organic nitrates and the risk of hip fracture: a population-based case-control study. J Clin Endocrinol Metab. 2010;95:1924–31.PubMedCentralPubMedCrossRef

36.

Pouwels S, Lalmohamed A, Souverein P, et al. Use of proton pump inhibitors and risk of hip/femur fracture: a population-based case-control study. Osteoporos Int. 2011;22:903–10.PubMedCentralPubMedCrossRef

37.

Solomon DH, Mogun H, Garneau K, et al. Risk of fractures in older adults using antihypertensive medications. J Bone Miner Res. 2011;26:1561–7.PubMedCrossRef

38.

Yang S, Nguyen ND, Center JR, et al. Association between beta-blocker use and fracture risk: the Dubbo Osteoporosis Epidemiology Study. Bone. 2011;48:451–5.PubMedCrossRef

39.

Kwok CS, Yeong JKY, Loke YK. Meta-analysis: risk of fractures with acid-suppressing medication. Bone. 2011;48:768–76.PubMedCrossRef

40.

Abrahamsen B, Eiken P, Eastell R. Proton pump inhibitor use and the antifracture efficacy of alendronate. Arch Intern Med. 2011;171:998–1004.PubMed

41.

Diem SJ, Blackwell TL, Stone KL, et al. Use of antidepressant medications and risk of fracture in older women. Calcif Tissue Int. 2011;88:476–84.PubMedCentralPubMedCrossRef

42.

Miller M, Stürmer T, Azrael D, et al. Opioid analgesics and the risk of fractures in older adults with arthritis. J Am Geriatr Soc. 2011;59:430–8.PubMedCentralPubMedCrossRef

43.

Arbouw ME, Movig KL, van Staa TP, et al. Dopaminergic drugs and the risk of hip or femur fracture: a population-based case-control study. Osteoporos Int. 2011;22:2197–204.PubMedCentralPubMedCrossRef

44.

Wu Q, Qu W, Crowell MD, et al. Tricyclic antidepressant use and risk of fractures: a meta-analysis of cohort and case-control studies. J Bone Miner Res. 2013;28:753–63.PubMedCrossRef

45.

Wu Q, Bencaz AF, Hentz JG, et al. Selective serotonin reuptake inhibitor treatment and risk of fractures: a meta-analysis of cohort and case-control studies. Osteoporos Int. 2012;23:365–75.PubMedCrossRef

46.

Eom CS, Lee HK, Ye S, et al. Use of selective serotonin reuptake inhibitors and risk of fracture: a systematic review and meta-analysis. J Bone Miner Res. 2012;27:1186–95.PubMedCrossRef

47.

Rabenda V, Bruyère O, Reginster JY. Risk of non vertebral fractures among elderly postmenopausal women using antidepressants. Bone. 2012;51:674–9.PubMedCrossRef

48.

Vestergaard P, Preto-Alhambra D, Javaid MK, et al. Fractures in users of antidepressants and anxiolytics and sedatives: effects of age and dose. Osteoporos Int. 2013;24:671–80.PubMedCentralPubMedCrossRef

49.

Khong TP, de Vries F, Goldenberg JS, et al. Potential impact of benzodiazepine use on the rate of hip fractures in five large European countries and the United States. Calcif Tissue Int. 2012;91:24–31.PubMedCentralPubMedCrossRef

50.

Eom CS, Park SM, Myung SK, et al. Use of acid-suppressive drugs and risk of fracture: a meta-analysis of observational studies. Ann Fam Med. 2011;9:257–67.PubMedCentralPubMedCrossRef

51.

Fraser LA, Leslie WD, Targownik LE, et al. The effect of proton pump inhibitors on fracture risk: report from the Canadian Multicenter Osteoporosis Study. Osteoporos Int. 2013;24:1161–8.PubMedCrossRef

52.

Vestergaard P, Hermann P, Jensen JE, et al. Effects of paracetamol, non-steroidal anti-inflammatory drugs, acetylsalicylic acid, and opioids on bone mineral density and risk of fracture: results of the Danish Osteoporosis Prevention Study (DOPS). Osteoporos Int. 2012;23:1255–65.PubMedCrossRef

53.

Williams LJ, Pasco JA, Henry MJ, et al. Paracetamol (acetaminophen) use, fracture and bone mineral density. Bone. 2011;48:1277–81.PubMedCrossRef

54.

Degli Esposti L, Adami S, Iolascon G, et al. Il costo delle fratture da osteoporosi in Italia. Risultati dello studio BLOCK (Bone Loss and Osteoporosis: Cost-of-illness Knowledge). Farmeconomia e Percorsi Terapeutici. 2011;12:89–95.

55.

Motheral BR, Fairman KA. The use of claims databases for outcomes research: rationale, challenges, and strategies. Clin Ther. 1997;19:346–66.PubMedCrossRef

56.

Birnbaum HG, Cremieux PY, Greenberg PE, et al. Using healthcare claims data for outcome research and pharmacoeconomic analyses. Pharmacoeconomics. 1999;16:1–8.PubMedCrossRef

57.

Fulton MM, Allen ER. Polypharmacy in the elderly: a literature review. J Am Acad Nurse Pract. 2005;17:123–32.PubMedCrossRef

58.

Cameron ID, Chen JS, March LM, et al. Hip fracture causes excess mortality owing to cardiovascular and infectious disease in institutionalized older people: a prospective 5-year study. J Bone Miner Res. 2010;25:866–72.PubMed

59.

De Laet C, Kanis JA, Oden A, et al. Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int. 2005;16:1330–8.PubMedCrossRef

60.

Tang X, Liu G, Kang J, et al. Obesity and risk of hip fracture in adults: a meta-analysis of prospective cohort studies. PLoS One. 2013;8:e55077.PubMedCentralPubMedCrossRef

61.

Roerholt C, Eiken P, Abrahamsen B. Initiation of anti-osteoporotic therapy in patients with recent fractures: a nationwide analysis of prescription rates and persistence. Osteoporos Int. 2009;20:299–307.PubMedCrossRef

62.

Leslie WD, Giangregorio LM, Yogendran M, et al. A population-based analysis of the post-fracture care gap 1996–2008: the situation is not improving. Osteoporos Int. 2012;23:1623–9.PubMedCrossRef

63.

Adami S, Bertoldo F, Brandi ML, et al. Guidelines for the diagnosis, prevention and treatment of osteoporosis. Reumatismo. 2009;61:260–84.PubMed

64.

van Helden S, Cals J, Kessels F, et al. Risk of new clinical fractures within 2 years following a fracture. Osteoporos Int. 2006;17:348–54.PubMedCrossRef

65.

Center JR, Bliuc D, Nguyen TV, et al. Risk of subsequent fracture after low-trauma fracture in men and women. JAMA. 2007;297:387–94.PubMedCrossRef

66.

Silverman SL, Watts NB, Delmas PD, et al. Effectiveness of bisphosphonates on nonvertebral and hip fractures in the first year of therapy: the risedronate and alendronate (REAL) cohort study. Osteoporos Int. 2007;18:25–34.PubMedCentralPubMedCrossRef

67.

Harris ST, Reginster JY, Harley C, et al. Risk of fracture in women treated with monthly oral ibandronate or weekly bisphosphonates: the eValuation of IBandronate Efficacy (VIBE) database fracture study. Bone. 2009;44:758–65.PubMedCrossRef

68.

Kragh A, Elmstahl S, Atroshi I. Older adults’ medication use 6 months before and after hip fracture: a population-based cohort study. J Am Geriatr Soc. 2011;59:863–8.PubMedCrossRef

Titel: Medication Use Before and After Hip Fracture: A Population-Based Cohort and Case-Control Study
verfasst von: Maurizio Rossini
Ombretta Viapiana
Silvano Adami
Luca Idolazzi
Stefano Buda
Chiara Veronesi
Luca Degli Esposti
Davide Gatti
Publikationsdatum: 01.07.2014
Verlag: Springer International Publishing
Erschienen in: Drugs & Aging / Ausgabe 7/2014
Print ISSN: 1170-229X
Elektronische ISSN: 1179-1969
DOI: https://doi.org/10.1007/s40266-014-0184-2

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