Study: Prescription Drugs Tied to Fall Risk, Bone Density Often Continued Post-Fracture

The majority of patients who have experienced an initial fragility fracture continue to use medications associated with increased fracture risk, according to recent research.

For their study, the researchers aimed to describe the use of prescription drugs associated with fracture risk before and after fractures occurred.
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They collected data from 168,133 community-dwelling Medicare beneficiaries from 2007 to 2011 who were living in the United States.

Beneficiaries were included if they had survived a hip, shoulder, or wrist fracture; were enrolled in fee-for-service Medicare with drug coverage (Parts A, B, and D); and were living in a community for at least 30 days in the immediate 4-month postfracture period.

The researchers then reviewed prescription fills for medications that increase fall risk, medications that decrease/increase bone density, and medications with unclear fracture risk mechanism.

After analyzing the data, the researchers found no change in the average number of fracture-associated drugs used.

Within the 4-month period before an initial fracture, a majority of patients with hip (77.1%), wrist (74.1%), and shoulder (75.9%) fractures had been taking a nonopiate drug associated with increased fracture risk. Only 7% of these patients stopped taking the drug after their fracture.

“Exposure to prescription drugs associated with fracture risk is infrequently reduced following fragility fracture occurrence,” the researchers concluded.

“While some patients eliminate their exposure to drugs associated with fracture, an equal number initiate new high-risk drugs. This pattern suggests there is a missed opportunity to modify at least one factor contributing to secondary fractures.”

—Amanda Balbi

Reference:

Munson JC, Bynum JPW, Bell JE, et al. Patterns of prescription drug use before and after fragility [published online August 22, 2016]. JAMA Intern Med. doi:10.1001/jamainternmed.2016.4814.