Risk of Hip Fracture in Older People Using Selective Serotonin Reuptake Inhibitors and Other Psychoactive Medicines Concurrently: A Matched Case–Control Study in Australia
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Date
2017
Authors
Leach, M.J.
Pratt, N.L.
Roughead, E.E.
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Journal article
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Drugs - Real World Outcomes, 2017; 4(2):87-96
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Background Few studies have assessed the risk of hip fracture following concurrent use of psychoactive medicines,and none has investigated combinations with selective serotonin reuptake inhibitors (initiation: odds ratio[OR] = 2.7, 95% confidence interval [CI] 2.1, 3.6) and opioids (initiation: OR = 2.3, 95% CI 1.9, 2.9). Combinations associated with an increased odds of hip fracture included addition of benzodiazepines to selective serotonin reuptake inhibitor therapy (OR = 3.0, 95% CI 1.9, 4.8;RERI = 0.9, 95% CI -0.5, 2.3), concurrent use of both opioids and selective serotonin reuptake inhibitors(OR = 2.2, 95% CI 1.9, 2.6; RERI = 0.1, 95% CI -0.3,0.5), addition of opioids to selective serotonin reuptake inhibitor therapy (OR = 3.2, 95% CI 1.8, 5.5; RERI = -0.1, 95% CI -2.0, 1.7), and initiation of both benzodiazepines and selective serotonin reuptake inhibitors(OR = 4.7, 95% CI 1.7, 13; RERI = 1.3, 95% CI -3.8,6.3). The RERI results suggested that the effect of each of these medicine combinations equalled the sum of the effects of individual medicine use.Conclusions In older people, the concurrent use of selective serotonin reuptake inhibitors and other psychoactive medicines increased the risk of hip fracture as much as the sum of the risks owing to individual medicine use. Our results highlight the need for prescribers to consider the sedative burden of medicines in each older patient as well as the potential for an additive risk of hip fracture wheninitiating additional psychoactive therapy.
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Data source: No, By agreement with Australian Government Department of Veterans' Affairs
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Copyright 2017 The Author(s). This is an open access publication. This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the originalauthor(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made (http://creativecommons.org/licenses/by-nc/4.0/)