Study suggests hip fractures not caused by benzodiazepine use after all

BOSTON--Benzodiazepine use was not shown to be associated with hip fractures after all, according to a new study from the Department of Ambulatory Care and Prevention (of Harvard Medical School and Harvard Pilgrim Health Care). Previous epidemiological studies suggesting an association have been used to support legislation and policy decisions that limit access to these drugs among the elderly. These policies may need to be reexamined based on these new findings, which are being published in the Jan. 16 Annals of Internal Medicine.

Benzodiazepines are sedative drugs prescribed for anxiety, sleep, and seizure disorders. Concerns about abuse, misuse, and adverse effects of these drugs--including hip fractures among the elderly--have prompted state and national policies intended to regulate access to them. Since January 2006, benzodiazepines have been excluded from coverage through the Medicare Part D drug benefit.

Hip fractures are the most serious individual and public health risks attributed to benzodiazepines because they often lead to disability and death among the elderly. An expected benefit of limiting access to these drugs is a decrease in the incidence of falls and resulting hip fractures. However, no data exist to demonstrate this policy effect.

Anita Wagner, PharmD, MPH, DrPH, lead author of the study and assistant professor of ambulatory care and prevention in the Department of Ambulatory Care and Prevention (DACP) of Harvard Medical School and Harvard Pilgrim Health Care, and colleagues studied whether a state policy that drastically decreased use of benzodiazepines resulted in fewer hip fractures among the elderly. They looked for changes in hip fracture rates in a stable population of more than 90,000 Medicaid recipients age 65 and older before and after a policy was implemented in New York in 1989 requiring benzodiazepine prescribing on triplicate forms. Since then, all physicians in the state are required to obtain, pay f

Contact: Leah Gourley
Harvard Medical School

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