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Association of Receiving Multiple, Concurrent Fracture-Associated Drugs With Hip Fracture Risk.


ABSTRACT: Importance:Many prescription drugs increase fracture risk, which raises concern for patients receiving 2 or more such drugs concurrently. Logic suggests that risk will increase with each additional drug, but the risk of taking multiple fracture-associated drugs (FADs) is unknown. Objective:To estimate hip fracture risk associated with concurrent exposure to multiple FADs. Design, Setting, and Participants:This cohort study used a 20% random sample of Medicare fee-for-service administrative data for age-eligible Medicare beneficiaries from 2004 to 2014. Sex-stratified Cox regression models estimated hip fracture risk associated with current receipt of 1, 2, or 3 or more of 21 FADs and, separately, risk associated with each FAD and 2-way FAD combination vs no FADs. Models included sociodemographic characteristics, comorbidities, and use of non-FAD medications. Analyses began in November 2018 and were completed April 2019. Exposure:Receipt of prescription FADs. Main Outcomes and Measures:Hip fracture hospitalization. Results:A total of 11.3 million person-years were observed, reflecting 2?646?255 individuals (mean [SD] age, 77.2 [7.3] years, 1?615?613 [61.1%] women, 2?136?585 [80.7%] white, and 219?579 [8.3%] black). Overall, 2?827?284 person-years (25.1%) involved receipt of 1 FAD; 1?322?296 (11.7%), 2 FADs; and 954?506 (8.5%), 3 or more FADs. In fully adjusted, sex-stratified models, an increase in hip fracture risk among women was associated with the receipt of 1, 2, or 3 or more FADs (1 FAD: hazard ratio [HR], 2.04; 95% CI, 1.99-2.11; P?

SUBMITTER: Emeny RT 

PROVIDER: S-EPMC6902800 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Association of Receiving Multiple, Concurrent Fracture-Associated Drugs With Hip Fracture Risk.

Emeny Rebecca T RT   Chang Chiang-Hua CH   Skinner Jonathan J   O'Malley A James AJ   Smith Jeremy J   Chakraborti Gouri G   Rosen Clifford J CJ   Morden Nancy E NE  

JAMA network open 20191101 11


<h4>Importance</h4>Many prescription drugs increase fracture risk, which raises concern for patients receiving 2 or more such drugs concurrently. Logic suggests that risk will increase with each additional drug, but the risk of taking multiple fracture-associated drugs (FADs) is unknown.<h4>Objective</h4>To estimate hip fracture risk associated with concurrent exposure to multiple FADs.<h4>Design, setting, and participants</h4>This cohort study used a 20% random sample of Medicare fee-for-servic  ...[more]

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