Featured Research

from universities, journals, and other organizations

Hip Fractures Not Caused By Sedative Use After All, Study Suggests

Date:
January 18, 2007
Source:
Harvard Medical School
Summary:
Benzodiazepine use was not shown to be associated with hip fractures after all, according to a new study from the Department of Ambulatory Care and Prevention (of Harvard Medical School and Harvard Pilgrim Health Care). Previous epidemiological studies suggesting an association have been used to support legislation and policy decisions that limit access to these drugs among the elderly. These policies may need to be reexamined based on these new findings, which are being published in the Jan. 16 Annals of Internal Medicine.

Benzodiazepine use was not shown to be associated with hip fractures after all, according to a new study from the Department of Ambulatory Care and Prevention (of Harvard Medical School and Harvard Pilgrim Health Care). Previous epidemiological studies suggesting an association have been used to support legislation and policy decisions that limit access to these drugs among the elderly. These policies may need to be reexamined based on these new findings, which are being published in the Jan. 16 Annals of Internal Medicine.

Benzodiazepines are sedative drugs prescribed for anxiety, sleep, and seizure disorders. Concerns about abuse, misuse, and adverse effects of these drugs--including hip fractures among the elderly--have prompted state and national policies intended to regulate access to them. Since January 2006, benzodiazepines have been excluded from coverage through the Medicare Part D drug benefit.

Hip fractures are the most serious individual and public health risks attributed to benzodiazepines because they often lead to disability and death among the elderly. An expected benefit of limiting access to these drugs is a decrease in the incidence of falls and resulting hip fractures. However, no data exist to demonstrate this policy effect.

Anita Wagner, PharmD, MPH, DrPH, lead author of the study and assistant professor of ambulatory care and prevention in the Department of Ambulatory Care and Prevention (DACP) of Harvard Medical School and Harvard Pilgrim Health Care, and colleagues studied whether a state policy that drastically decreased use of benzodiazepines resulted in fewer hip fractures among the elderly. They looked for changes in hip fracture rates in a stable population of more than 90,000 Medicaid recipients age 65 and older before and after a policy was implemented in New York in 1989 requiring benzodiazepine prescribing on triplicate forms. Since then, all physicians in the state are required to obtain, pay for, and use serially-numbered triplicate forms to prescribe benzodiazepines. Pharmacists forward one copy of the prescription to state health authorities for surveillance, allowing for monitoring of each physician's prescribing, each pharmacy's dispensing, and each patient's receipt of benzodiazepines.

The policy resulted in an immediate 60 percent reduction in benzodiazepine use among women and 58 percent among men. The neighboring demographically-similar state New Jersey did not regulate benzodiazepine prescribing and benzodiazepine use did not change. Incidence of hip fracture before and after the policy change was similar.

"The policy drastically decreased use of benzodiazepines in New York and we did not see any decline in hip fracture rates compared to New Jersey; in fact, we seem to see an increase in New York over New Jersey," says Wagner.

There are several possible explanations for the study results. Most plausible, however, are biases in the previous studies that found a relationship between these drugs and hip fractures.

"It is very challenging to answer the question whether or not benzodiazepines cause hip fractures. People who get benzodiazepines, such as chronically ill elderly patients with dementia, have conditions, like dementia, that can cause hip fractures--and their hip fractures may not be due to their benzodiazepines," says Wagner.

"The challenge of disentangling the effects of benzodiazepines from other causes of hip fractures in the elderly is especially concerning when study results are used to guide policies that restrict access to medicines for huge populations," says senior author Stephen Soumerai, ScD, professor of ambulatory care and prevention at DACP.

Policy makers may expect that reducing access to benzodiazepines under Medicare Part D and other policies will decrease hip fracture risk. "Our study suggests that these expectations are not justified," says Soumerai.

Additionally, if benzodiazepine medications are abruptly terminated, as may be the case when people lose coverage of a drug, negative effects can occur, such as withdrawal reactions, seizures, emergency department visits, and hospital admissions. These may offset any potential savings achieved by limiting coverage of benzodiazepines.

The investigators are currently funded by a grant from the National Institute on Aging to monitor the impact of the Medicare Drug Benefit. They believe future studies based on these new data will shed additional light on how policies that exclude coverage for benzodiazepines affect the rate of hip fracture among the elderly.

This study was supported by the National Institute on Aging and the National Institute on Drug Abuse (both of the National Institutes of Health).


Story Source:

The above story is based on materials provided by Harvard Medical School. Note: Materials may be edited for content and length.


Cite This Page:

Harvard Medical School. "Hip Fractures Not Caused By Sedative Use After All, Study Suggests." ScienceDaily. ScienceDaily, 18 January 2007. <www.sciencedaily.com/releases/2007/01/070115215655.htm>.
Harvard Medical School. (2007, January 18). Hip Fractures Not Caused By Sedative Use After All, Study Suggests. ScienceDaily. Retrieved September 2, 2014 from www.sciencedaily.com/releases/2007/01/070115215655.htm
Harvard Medical School. "Hip Fractures Not Caused By Sedative Use After All, Study Suggests." ScienceDaily. www.sciencedaily.com/releases/2007/01/070115215655.htm (accessed September 2, 2014).

Share This




More Health & Medicine News

Tuesday, September 2, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

U.N. Says Ebola Travel Restrictions Will Cause Food Shortage

U.N. Says Ebola Travel Restrictions Will Cause Food Shortage

Newsy (Sep. 2, 2014) The U.N. says the problem is two-fold — quarantine zones and travel restrictions are limiting the movement of both people and food. Video provided by Newsy
Powered by NewsLook.com
Get on Your Bike! London Cycling Popularity Soars Despite Danger

Get on Your Bike! London Cycling Popularity Soars Despite Danger

AFP (Sep. 1, 2014) Wedged between buses, lorries and cars, cycling in London isn't for the faint hearted. Nevertheless the number of people choosing to bike in the British capital has doubled over the past 15 years. Duration: 02:27 Video provided by AFP
Powered by NewsLook.com
Can You Train Your Brain To Eat Healthy?

Can You Train Your Brain To Eat Healthy?

Newsy (Sep. 1, 2014) New research says if you condition yourself to eat healthy foods, eventually you'll crave them instead of junk food. Video provided by Newsy
Powered by NewsLook.com
We've Got Mites Living In Our Faces And So Do You

We've Got Mites Living In Our Faces And So Do You

Newsy (Aug. 30, 2014) A new study suggests 100 percent of adult humans (those over 18 years of age) have Demodex mites living in their faces. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins