Regional Variation in Fracture-Associated Prescription Drug Use and Hip Fractures in Long-Term Care: an Observational Study

Excerpt

We previously demonstrated that concurrent exposure to three or more fracture-associated drugs (FADs) increases individual fracture risk up to 4-fold.¹ Moreover, intensity of FAD exposure in long-term care (LTC) is twice that of community-dwelling Medicare beneficiaries.² To advance knowledge of the impact of intense prescribing as potential iatrogenic risk, we explore regional variation of prescription drug use intensity and its association with hip fracture rates among LTC residents. We examined intensity of prescription use categorized as total, or FAD and non-FAD in LTC beneficiaries across Hospital Referral Regions (HRRs), and we assess the association between this intensity and hip fracture rates. We hypothesize that measuring variation in prescription intensity can identify regions (and LTC facilities) with relatively high use of concurrent FADs; this may inform interventions aimed at improving health outcomes and safety of this vulnerable population. …