ArticleJournal of the American Medical Directors Association2018
Age, Sex, and Dose Effects of Nonbenzodiazepine Hypnotics on Hip Fracture in Nursing Home Residents.
Article in Journal of the American Medical Directors Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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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.
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Who cites it
5 citing papers in PubMed, 14 citations in OpenAlex.
- Effects of anticholinergic and sedative medication use on fractures: A self-controlled design study.Journal of the American Geriatrics Society · 2021Article
- Adverse effects of Z-drugs for sleep disturbance in people living with dementia: a population-based cohort study.BMC medicine · 2020Article
- Non-Pharmacological Interventions towards Preventing the Triad Osteoporosis-Falls Risk-Hip Fracture, in Population Older than 65. Scoping Review.Journal of clinical medicine · 2020Article
- Predictors of Hip Fracture Despite Treatment with Bisphosphonates among Frail Older Adults.Journal of the American Geriatrics Society · 2020Article
- Effect of Bisphosphonates on Fracture Outcomes Among Frail Older Adults.Journal of the American Geriatrics Society · 2019Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveThe Food and Drug Administration recommends a reduced dose of nonbenzodiazepine hypnotics in women, yet little is known about the age-, sex-, and dose-specific effects of these drugs on risk of hip fracture, especially among nursing home (NH) residents. We estimated the age-, sex-, and dose-specific effects of nonbenzodiazepine hypnotics on the rate of hip fracture among NH residents. DESIGN AND
settingCase-crossover study in US NHs.
participantsA total of 691 women and 179 men with hip fracture sampled from all US long-stay NH residents. MEASUREMENTS: Measures of patient characteristics were obtained from linked Medicare and the Minimum Data Set (2007-2008). The outcome was hospitalization for hip fracture with surgical repair. We estimated rate ratios (RRs) and 95% confidence intervals (CIs) from conditional logistic regression models for nonbenzodiazepine hypnotics (vs nonuse) comparing 0 to 29 days before hip fracture (hazard period) with 60 to 89 and 120 to 149 days before hip fracture (control periods). We stratified analyses by age, sex, and dose.
resultsThe average RR of hip fracture was 1.7 (95% CI 1.5-1.9) for any use. The RR of hip fracture was higher for residents aged ≥90 years vs <70 years (2.2 vs 1.3); however, the CIs overlapped. No differences in the effect of the hypnotic on risk of hip fracture were evident by sex. Point estimates for hip fracture were greater with high-dose versus low-dose hypnotics (RR 1.9 vs 1.6 for any use), but these differences were highly compatible with chance.
conclusionsThe rate of hip fracture in NH residents due to use of nonbenzodiazepine hypnotics was greater among older patients than among younger patients and, possibly, with higher doses than with lower doses. When clinicians are prescribing a nonbenzodiazepine hypnotic to any NH resident, doses of these drugs should be kept as low as possible, especially among those with advanced age.
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