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National outpatient medication profiling: medications associated with outpatient fractures in community-dwelling elderly veterans.
Br J Clin Pharmacol. 2007 Feb; 63(2):238-44.BJ

Abstract

AIMS

The primary objective of this retrospective case-control study in an elderly veteran population was to assess the impact of specific medications with recognized side-effects that increase the risk of a fall and were prescribed prior to fractures treated in the outpatient setting compared with patients treated for nonspecific chest pain.

METHODS

Two national Veterans Health Administration (VHA) databases were used to identify 17 273 unique patients, aged > or =65 years, treated in outpatient settings with a fracture in fiscal year 2005, and for whom we could link to all of their outpatient prescriptions (809 536). For comparison, we identified other elderly patients with outpatient clinic visits for nonspecific chest pain (N = 62 331) for whom we could link with their 2 987 394 outpatient prescriptions. We categorized the fall-related medications as drugs that primarily affect the cardiovascular (CVS), the central nervous (CNS) or the muscular skeletal system (MSS).

RESULTS

Significant differences in the two patient groups occurred in the CNS category. Approximately 41% of the patients with fracture-coded encounters were prescribed CNS drugs compared with 31% of the patients in the comparison group (P < 0.0003). Finally, the use of muscle relaxants in the MSS category was significantly higher in the fracture group than in the nonspecific chest pain group.

CONCLUSIONS

Studies using administrative data can foster the development of more proactive pharmacovigilance systems and assist in formulary refinement, particularly in countries with national healthcare systems that have integrated patient data. Particular attention and monitoring of elderly patients taking CNS medications may be important for injury prevention.

Authors+Show Affiliations

VISN-8 Patient Safety Center of Inquiry, James A. Haley Hospital, Tampa, FL 33612, USA. Dustin.French@va.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

17096682

Citation

French, Dustin D., et al. "National Outpatient Medication Profiling: Medications Associated With Outpatient Fractures in Community-dwelling Elderly Veterans." British Journal of Clinical Pharmacology, vol. 63, no. 2, 2007, pp. 238-44.
French DD, Campbell R, Spehar A, et al. National outpatient medication profiling: medications associated with outpatient fractures in community-dwelling elderly veterans. Br J Clin Pharmacol. 2007;63(2):238-44.
French, D. D., Campbell, R., Spehar, A., Rubenstein, L. Z., Branch, L. G., & Cunningham, F. (2007). National outpatient medication profiling: medications associated with outpatient fractures in community-dwelling elderly veterans. British Journal of Clinical Pharmacology, 63(2), 238-44.
French DD, et al. National Outpatient Medication Profiling: Medications Associated With Outpatient Fractures in Community-dwelling Elderly Veterans. Br J Clin Pharmacol. 2007;63(2):238-44. PubMed PMID: 17096682.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - National outpatient medication profiling: medications associated with outpatient fractures in community-dwelling elderly veterans. AU - French,Dustin D, AU - Campbell,Robert, AU - Spehar,Andrea, AU - Rubenstein,Laurence Z, AU - Branch,Laurence G, AU - Cunningham,Francesca, Y1 - 2006/11/10/ PY - 2006/11/14/pubmed PY - 2007/5/22/medline PY - 2006/11/14/entrez SP - 238 EP - 44 JF - British journal of clinical pharmacology JO - Br J Clin Pharmacol VL - 63 IS - 2 N2 - AIMS: The primary objective of this retrospective case-control study in an elderly veteran population was to assess the impact of specific medications with recognized side-effects that increase the risk of a fall and were prescribed prior to fractures treated in the outpatient setting compared with patients treated for nonspecific chest pain. METHODS: Two national Veterans Health Administration (VHA) databases were used to identify 17 273 unique patients, aged > or =65 years, treated in outpatient settings with a fracture in fiscal year 2005, and for whom we could link to all of their outpatient prescriptions (809 536). For comparison, we identified other elderly patients with outpatient clinic visits for nonspecific chest pain (N = 62 331) for whom we could link with their 2 987 394 outpatient prescriptions. We categorized the fall-related medications as drugs that primarily affect the cardiovascular (CVS), the central nervous (CNS) or the muscular skeletal system (MSS). RESULTS: Significant differences in the two patient groups occurred in the CNS category. Approximately 41% of the patients with fracture-coded encounters were prescribed CNS drugs compared with 31% of the patients in the comparison group (P < 0.0003). Finally, the use of muscle relaxants in the MSS category was significantly higher in the fracture group than in the nonspecific chest pain group. CONCLUSIONS: Studies using administrative data can foster the development of more proactive pharmacovigilance systems and assist in formulary refinement, particularly in countries with national healthcare systems that have integrated patient data. Particular attention and monitoring of elderly patients taking CNS medications may be important for injury prevention. SN - 0306-5251 UR - https://www.unboundmedicine.com/medline/citation/17096682/National_outpatient_medication_profiling:_medications_associated_with_outpatient_fractures_in_community_dwelling_elderly_veterans_ L2 - https://doi.org/10.1111/j.1365-2125.2006.02798.x DB - PRIME DP - Unbound Medicine ER -