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Association of polypharmacy with fall-related fractures in older Taiwanese people: age- and gender-specific analyses.
BMJ Open. 2014 Mar 28; 4(3):e004428.BO

Abstract

OBJECTIVE

To elucidate the associations between polypharmacy and age- and gender-specific risks of admission for fall-related fractures.

DESIGN

Nested case-control study.

SETTING

This analysis was randomly selected from all elderly beneficiaries in 2007-2008, and represents some 30% of the whole older insurers using Taiwan's National Health Insurance Research Database.

PARTICIPANTS

We identified 5933 cases newly admitted for fall-related fractures during 2007-2008, and 29 665 random controls free from fracture.

PRIMARY AND SECONDARY OUTCOME MEASURES

Polypharmacy was defined as the use of fall-related drugs of four or more categories of medications and prescribed related to fall within a 1-year period. Logistic regression models were employed to estimate the ORs and related 95% CIs. The interaction of polypharmacy with age and sex was assessed separately.

RESULTS

Compared with those who consumed no category of medication, older people who consumed 1, 2, 3 and ≥4 categories of medications were all at significantly increased odds of developing fall-related fractures, with a significant dose-gradient pattern (β=0.7953; p for trend <0.0001). There were significant interactions between polypharmacy and age, but no significant interactions between polypharmacy and gender. The dose-gradient relationship between number of medications category and risk of fall-related fractures was more obvious in women than in men (β=0.1962 vs β=0.1873). Additionally, it was most evident in older people aged 75-84 years (β=0.2338).

CONCLUSIONS

This population-based study in Taiwan confirms the link between polypharmacy and increased risk of fall-related fractures in older people; and highlights that elderly women and older people aged 75-84 years will be the targeted participants for further prevention from fall-related fractures caused by polypharmacy.

Authors+Show Affiliations

Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

24682575

Citation

Pan, Hsueh-Hsing, et al. "Association of Polypharmacy With Fall-related Fractures in Older Taiwanese People: Age- and Gender-specific Analyses." BMJ Open, vol. 4, no. 3, 2014, pp. e004428.
Pan HH, Li CY, Chen TJ, et al. Association of polypharmacy with fall-related fractures in older Taiwanese people: age- and gender-specific analyses. BMJ Open. 2014;4(3):e004428.
Pan, H. H., Li, C. Y., Chen, T. J., Su, T. P., & Wang, K. Y. (2014). Association of polypharmacy with fall-related fractures in older Taiwanese people: age- and gender-specific analyses. BMJ Open, 4(3), e004428. https://doi.org/10.1136/bmjopen-2013-004428
Pan HH, et al. Association of Polypharmacy With Fall-related Fractures in Older Taiwanese People: Age- and Gender-specific Analyses. BMJ Open. 2014 Mar 28;4(3):e004428. PubMed PMID: 24682575.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of polypharmacy with fall-related fractures in older Taiwanese people: age- and gender-specific analyses. AU - Pan,Hsueh-Hsing, AU - Li,Chung-Yi, AU - Chen,Tzeng-Ji, AU - Su,Tung-Ping, AU - Wang,Kwua-Yun, Y1 - 2014/03/28/ PY - 2014/4/1/entrez PY - 2014/4/1/pubmed PY - 2014/4/1/medline KW - GENERAL MEDICINE (see Internal Medicine) KW - GERIATRIC MEDICINE KW - PREVENTIVE MEDICINE SP - e004428 EP - e004428 JF - BMJ open JO - BMJ Open VL - 4 IS - 3 N2 - OBJECTIVE: To elucidate the associations between polypharmacy and age- and gender-specific risks of admission for fall-related fractures. DESIGN: Nested case-control study. SETTING: This analysis was randomly selected from all elderly beneficiaries in 2007-2008, and represents some 30% of the whole older insurers using Taiwan's National Health Insurance Research Database. PARTICIPANTS: We identified 5933 cases newly admitted for fall-related fractures during 2007-2008, and 29 665 random controls free from fracture. PRIMARY AND SECONDARY OUTCOME MEASURES: Polypharmacy was defined as the use of fall-related drugs of four or more categories of medications and prescribed related to fall within a 1-year period. Logistic regression models were employed to estimate the ORs and related 95% CIs. The interaction of polypharmacy with age and sex was assessed separately. RESULTS: Compared with those who consumed no category of medication, older people who consumed 1, 2, 3 and ≥4 categories of medications were all at significantly increased odds of developing fall-related fractures, with a significant dose-gradient pattern (β=0.7953; p for trend <0.0001). There were significant interactions between polypharmacy and age, but no significant interactions between polypharmacy and gender. The dose-gradient relationship between number of medications category and risk of fall-related fractures was more obvious in women than in men (β=0.1962 vs β=0.1873). Additionally, it was most evident in older people aged 75-84 years (β=0.2338). CONCLUSIONS: This population-based study in Taiwan confirms the link between polypharmacy and increased risk of fall-related fractures in older people; and highlights that elderly women and older people aged 75-84 years will be the targeted participants for further prevention from fall-related fractures caused by polypharmacy. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/24682575/Association_of_polypharmacy_with_fall_related_fractures_in_older_Taiwanese_people:_age__and_gender_specific_analyses_ L2 - https://bmjopen.bmj.com/lookup/pmidlookup?view=long&amp;pmid=24682575 DB - PRIME DP - Unbound Medicine ER -