Polypharmacy correlates with increased risk for hip fracture in the elderly

A population-based study

Shih Wei Lai, Kuan Fu Liao, Chien-Chang Liao, Chih Hsin Muo, Chiu Shong Liu, Fung Chang Sung

Research output: Contribution to journalArticle

179 Citations (Scopus)

Abstract

Few studies have addressed the association between polypharmacy and hip fracture using population data. We conducted a population-based case-control study to investigate whether polypharmacy increases the risk for hip fracture in the elderly. We used insurance claims data from the Taiwan Bureau of National Health Insurance, a universal insurance program with a coverage rate of more than 98% of the population in Taiwan. We identified 2328 elderly patients with newly diagnosed hip fracture during the period 2005-2007. We randomly selected 9312 individuals without hip fracture to serve as the control group. Patient characteristics, drugs prescribed by physicians, and all types of hip fracture were ascertained. The odds ratio (OR) of hip fracture in association with the number of medications used per day in previous years was assessed.We found that patients were older than controls, predominantly female, and more likely to use 5 or more drugs (22.2% vs. 9.3%, p <0.0001). The OR of hip fracture increased with the number of medications used per day and with age. Multivariate logistic regression analysis revealed that the overall OR for patients using 10 or more drugs was 8.42 (95% confidence interval [CI], 4.73-15.0) compared with patients who used 0-1 drug per day. However, age-specific analysis revealed that the risk for hip fracture was 23 times greater for patients aged ĝ‰¥85 years who used 10 or more drugs than for those aged 65-74 years who used 0-1 drug after controlling for covariates (OR, 23.0; 95% CI, 3.77-140).We conclude that the risk of hip fracture in older people increases with the number of medications used, especially in women. Age interacts with the daily medications for the risk of hip fracture.

Original languageEnglish
Pages (from-to)295-299
Number of pages5
JournalMedicine (United States)
Volume89
Issue number5
DOIs
Publication statusPublished - 2010
Externally publishedYes

Fingerprint

Polypharmacy
Hip Fractures
Population
Odds Ratio
Pharmaceutical Preparations
Insurance
Taiwan
Confidence Intervals
National Health Programs
Case-Control Studies
Logistic Models
Regression Analysis
Physicians

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Polypharmacy correlates with increased risk for hip fracture in the elderly : A population-based study. / Lai, Shih Wei; Liao, Kuan Fu; Liao, Chien-Chang; Muo, Chih Hsin; Liu, Chiu Shong; Sung, Fung Chang.

In: Medicine (United States), Vol. 89, No. 5, 2010, p. 295-299.

Research output: Contribution to journalArticle

Lai, Shih Wei ; Liao, Kuan Fu ; Liao, Chien-Chang ; Muo, Chih Hsin ; Liu, Chiu Shong ; Sung, Fung Chang. / Polypharmacy correlates with increased risk for hip fracture in the elderly : A population-based study. In: Medicine (United States). 2010 ; Vol. 89, No. 5. pp. 295-299.
@article{ebde83df3bda4f539a41849530251340,
title = "Polypharmacy correlates with increased risk for hip fracture in the elderly: A population-based study",
abstract = "Few studies have addressed the association between polypharmacy and hip fracture using population data. We conducted a population-based case-control study to investigate whether polypharmacy increases the risk for hip fracture in the elderly. We used insurance claims data from the Taiwan Bureau of National Health Insurance, a universal insurance program with a coverage rate of more than 98{\%} of the population in Taiwan. We identified 2328 elderly patients with newly diagnosed hip fracture during the period 2005-2007. We randomly selected 9312 individuals without hip fracture to serve as the control group. Patient characteristics, drugs prescribed by physicians, and all types of hip fracture were ascertained. The odds ratio (OR) of hip fracture in association with the number of medications used per day in previous years was assessed.We found that patients were older than controls, predominantly female, and more likely to use 5 or more drugs (22.2{\%} vs. 9.3{\%}, p <0.0001). The OR of hip fracture increased with the number of medications used per day and with age. Multivariate logistic regression analysis revealed that the overall OR for patients using 10 or more drugs was 8.42 (95{\%} confidence interval [CI], 4.73-15.0) compared with patients who used 0-1 drug per day. However, age-specific analysis revealed that the risk for hip fracture was 23 times greater for patients aged ĝ‰¥85 years who used 10 or more drugs than for those aged 65-74 years who used 0-1 drug after controlling for covariates (OR, 23.0; 95{\%} CI, 3.77-140).We conclude that the risk of hip fracture in older people increases with the number of medications used, especially in women. Age interacts with the daily medications for the risk of hip fracture.",
author = "Lai, {Shih Wei} and Liao, {Kuan Fu} and Chien-Chang Liao and Muo, {Chih Hsin} and Liu, {Chiu Shong} and Sung, {Fung Chang}",
year = "2010",
doi = "10.1097/MD.0b013e3181f15efc",
language = "English",
volume = "89",
pages = "295--299",
journal = "Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Polypharmacy correlates with increased risk for hip fracture in the elderly

T2 - A population-based study

AU - Lai, Shih Wei

AU - Liao, Kuan Fu

AU - Liao, Chien-Chang

AU - Muo, Chih Hsin

AU - Liu, Chiu Shong

AU - Sung, Fung Chang

PY - 2010

Y1 - 2010

N2 - Few studies have addressed the association between polypharmacy and hip fracture using population data. We conducted a population-based case-control study to investigate whether polypharmacy increases the risk for hip fracture in the elderly. We used insurance claims data from the Taiwan Bureau of National Health Insurance, a universal insurance program with a coverage rate of more than 98% of the population in Taiwan. We identified 2328 elderly patients with newly diagnosed hip fracture during the period 2005-2007. We randomly selected 9312 individuals without hip fracture to serve as the control group. Patient characteristics, drugs prescribed by physicians, and all types of hip fracture were ascertained. The odds ratio (OR) of hip fracture in association with the number of medications used per day in previous years was assessed.We found that patients were older than controls, predominantly female, and more likely to use 5 or more drugs (22.2% vs. 9.3%, p <0.0001). The OR of hip fracture increased with the number of medications used per day and with age. Multivariate logistic regression analysis revealed that the overall OR for patients using 10 or more drugs was 8.42 (95% confidence interval [CI], 4.73-15.0) compared with patients who used 0-1 drug per day. However, age-specific analysis revealed that the risk for hip fracture was 23 times greater for patients aged ĝ‰¥85 years who used 10 or more drugs than for those aged 65-74 years who used 0-1 drug after controlling for covariates (OR, 23.0; 95% CI, 3.77-140).We conclude that the risk of hip fracture in older people increases with the number of medications used, especially in women. Age interacts with the daily medications for the risk of hip fracture.

AB - Few studies have addressed the association between polypharmacy and hip fracture using population data. We conducted a population-based case-control study to investigate whether polypharmacy increases the risk for hip fracture in the elderly. We used insurance claims data from the Taiwan Bureau of National Health Insurance, a universal insurance program with a coverage rate of more than 98% of the population in Taiwan. We identified 2328 elderly patients with newly diagnosed hip fracture during the period 2005-2007. We randomly selected 9312 individuals without hip fracture to serve as the control group. Patient characteristics, drugs prescribed by physicians, and all types of hip fracture were ascertained. The odds ratio (OR) of hip fracture in association with the number of medications used per day in previous years was assessed.We found that patients were older than controls, predominantly female, and more likely to use 5 or more drugs (22.2% vs. 9.3%, p <0.0001). The OR of hip fracture increased with the number of medications used per day and with age. Multivariate logistic regression analysis revealed that the overall OR for patients using 10 or more drugs was 8.42 (95% confidence interval [CI], 4.73-15.0) compared with patients who used 0-1 drug per day. However, age-specific analysis revealed that the risk for hip fracture was 23 times greater for patients aged ĝ‰¥85 years who used 10 or more drugs than for those aged 65-74 years who used 0-1 drug after controlling for covariates (OR, 23.0; 95% CI, 3.77-140).We conclude that the risk of hip fracture in older people increases with the number of medications used, especially in women. Age interacts with the daily medications for the risk of hip fracture.

UR - http://www.scopus.com/inward/record.url?scp=77957270714&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77957270714&partnerID=8YFLogxK

U2 - 10.1097/MD.0b013e3181f15efc

DO - 10.1097/MD.0b013e3181f15efc

M3 - Article

VL - 89

SP - 295

EP - 299

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

SN - 0025-7974

IS - 5

ER -