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Association between the use of benzodiazepines and opioids with the risk of falls and hip fractures in older adults

Published online by Cambridge University Press:  10 December 2017

Manuel E. Machado-Duque ,
Juan Pablo Castaño-Montoya ,
Diego A. Medina-Morales ,
Alejandro Castro-Rodríguez ,
Alexandra González-Montoya  and
Jorge E. Machado-Alba Open the ORCID record for Jorge E. Machado-Alba [Opens in a new window]
Manuel E. Machado-Duque
Affiliation:
Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia
Juan Pablo Castaño-Montoya
Affiliation:
Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia
Diego A. Medina-Morales
Affiliation:
Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia
Alejandro Castro-Rodríguez
Affiliation:
Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia
Alexandra González-Montoya
Affiliation:
Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia
Jorge E. Machado-Alba*
Affiliation:
Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia
*
Correspondence should be addressed to: Jorge Enrique Machado-Alba, Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia. Universidad Tecnológica de Pereira-Audifarma S.A, Calle 105 No. 14-140, Pereira, Risaralda, 660003Colombia. Phone: 57 3108326970; fax: +57 63137822. ORCID: 0000-0002-8455-0936. Email: machado@utp.edu.co.
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Abstract

Background:

To determine the association between the use of opioids and benzodiazepines and the risk of falls with hip fracture in populations older than 65 years in Colombia.

Methods:

A case-control study with patients older than 65 years with diagnosis of hip fracture. Two controls were obtained per case. The drugs dispensed in the previous 30 days were identified. Sociodemographic, diagnostic, pharmacological (opioids and benzodiazepines), and polypharmacy variables were analyzed. A logistic regression model was used to analyze the risk of fall with hip fracture while using these drugs.

Results:

We included 287 patients with hip fractures and 574 controls. There was a female predominance (72.1%) and a mean age of 82.4 ± 8.0 years. Of the patients, 12.7% had been prescribed with opioids and 4.2% with benzodiazepines in the previous month. The adjusted multivariate analysis found that using opioids (OR:4.49; 95%CI:2.72–7.42) and benzodiazepines (OR:3.73; 95%CI:1.60–8.70) in the month prior to the event was significantly associated with a greater probability of suffering a fall with hip fracture.

Conclusions:

People who are taking opioids and benzodiazepines have increased risk for hip fracture in Colombia. Strategies to educate physicians regarding the pharmacology of older adults should be strengthened.

Keywords

opioidsbenzodiazepinesfallship fracturesfrail elderlyinappropriate prescribing
Type
Original Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 7: Issue Theme: Benzodiazepines and Hypnotics , July 2018 , pp. 941 - 946
Copyright
Copyright © International Psychogeriatric Association 2017 

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