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Review of prescription drug use could help prevent a second fracture

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medication_review.jpgSome medications are associated with increased fracture risk, yet many patients continue to take them after suffering a first fragility fracture.

A new study has examined whether there is an opportunity to reduce the incidence of a second fall or fracture in elderly patients by re-evaluating their use of prescription drugs.

Researchers from The Dartmouth Institute for Health Policy and Clinical Practice and the Boston University School of Public Health analysed data on 168,133 patients who experienced a fracture of the hip, shoulder or wrist (the most common type of fragility fractures).

They found that more than three-quarters of the patients in the study were exposed to at least one non-opiate drug associated with an increased fracture risk in the four months before their fracture.

About 7% of patients discontinued these drugs after their fracture, but that decrease was offset by new users. As a result, the total proportion exposed to high-risk drugs did not change.

“The use of drugs that can contribute to elevated fracture risk was common among the group we studied,” commented lead author Dr Jeffrey Munson, assistant professor at The Dartmouth Institute. “To add to that, we did not see a consistent reduction in the use of these drugs after the fracture event. So that allows for the strong possibility we may be able to prevent at least some of these secondary fragility fractures through better management of high-risk drugs around the time of the first fracture.”

Further research is needed to determine the possible benefits of modifying post-fracture drug exposure in this high-risk population, the study authors noted.

http://tdi.dartmouth.edu/press/updates/dartmouth-institute-study-sheds-light-on-how-to-reduce-fracture-risk-in-elderly

http://archinte.jamanetwork.com/article.aspx?articleid=2544881