SynthesisPloS one2017
Benzodiazepines, Z-drugs and the risk of hip fracture: A systematic review and meta-analysis.
Synthesis in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 101 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
101 citing papers in PubMed, 6 syntheses or guidelines pooled it, 213 citations in OpenAlex.
- Prevalence of Benzodiazepine, Z-Drug and Melatonin Use in Australian Residential Aged Care Facilities: A Systematic Review and Meta-Analysis.Australasian journal on ageing · 2026Pooled it
- Domain-specific cognitive function in euthymic bipolar disorder: a systematic review and meta-analysis.Psychological medicine · 2025Pooled it
- Comparative effectiveness of interventions to facilitate deprescription of benzodiazepines and other sedative hypnotics: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2025Pooled it
- Barriers and enablers for deprescribing benzodiazepine receptor agonists in older adults: a systematic review of qualitative and quantitative studies using the theoretical domains framework.Implementation science : IS · 2022Pooled it
- Association between long-term oxygen therapy provided outside the guidelines and mortality in patients with COPD.BMJ open · 2022Pooled it
- Association Between Atrial Fibrillation and Dementia: A Meta-Analysis.Frontiers in aging neuroscience · 2019Pooled it
- Effectiveness of Information and Communication Technology-Based Cognitive Behavioral Therapy Using the Smart Sleep App on Insomnia in Older Adults: Randomized Controlled Trial.Journal of medical Internet research · 2025Trial
- Trial
- Association between loneliness and incident use of benzodiazepines and opioids: analyses of the Canadian Longitudinal Study on Aging.Age and ageing · 2026Article
- Initial Z-Drug Prescription Duration and Long-Term Use.JAMA network open · 2026Article
- Potentially Inappropriate Medication Use in Older Adults: Concordance Among the Chinese and AGS/Beers and STOPP Criteria.Journal of clinical medicine · 2026Article
- Trajectories Associated With the Use and Deprescription of Benzodiazepines and Z-Drugs in a Network of Geriatric Outpatient Clinics.Pharmacoepidemiology and drug safety · 2026Article
- Pharmacological principles for safe benzodiazepine and Z-drug dose reduction.Psychological medicine · 2026Review
- The incidence and clinical variables associated with new and new persistent benzodiazepine use after admission to internal medicine: a retrospective study.Scientific reports · 2026Article
- Association between skeletal fractures and sleep medication in patients with chronic kidney disease.BMC nephrology · 2026Article
- Psychotherapy initiation is associated with discontinuation of psychotropic medications without dose escalation: a ten-year real-world cohort study (2014-2024).Frontiers in psychiatry · 2026Article
- Article
- Mapping care trajectories for hospital-initiated benzodiazepine deprescribing in older adults: a multicentre qualitative study.BMC health services research · 2025Article
- Lifetime burden of prescription medication for insomnia in middle-aged and older adults in the US: a microsimulation study.Lancet regional health. Americas · 2025Article
- Barriers to discontinuing benzodiazepine receptor agonists in older adults: a survey of older adults across Europe.Age and ageing · 2025Observational
41 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHip fractures in the older person lead to an increased risk of mortality, poorer quality of life and increased morbidity. Benzodiazepine (BNZ) use is associated with increased hip fracture rate, consequently Z-drugs are fast becoming the physician's hypnotic prescription of choice yet data on their use is limited. We compared the risk of hip fracture associated with Z-drugs and BNZ medications, respectively, and examined if this risk varied with longer-term use. METHODS AND
findingsWe carried out a systematic review of the literature and meta-analysis. MEDLINE and SCOPUS were searched to identify studies involving BNZ or Z-drugs and the risk of hip fracture up to May 2015. Each included study was quality-assessed. A pooled relative risk of hip fracture was calculated using the generic inverse variance method, with a random effects model, with the length of hypnotic usage as a subgroup. Both BNZ, and Z-drug use respectively, were significantly associated with an increased risk of hip fracture (RR = 1.52, 95% CI 1.37-1.68; and RR = 1.90, 95% CI 1.68-2.13). Short-term use of BNZ and Z-drugs respectively, was also associated with the greatest risk of hip fracture (RR = 2.40, 95% CI 1.88-3.05 and RR = 2.39, 95% CI 1.74-3.29).
conclusionsThere is strong evidence that both BNZ and Z-drugs are associated with an increased risk of hip fracture in the older person, and there is little difference between their respective risks. Patients newly prescribed these medicines are at the greatest risk of hip fracture. Clinicians and policy makers need to consider the increased risk of fallings and hip fracture particularly amongst new users of these medications.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.