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Study suggests hip fractures not caused by benzodiazepine use after all

or, and use serially-numbered triplicate forms to prescribe benzodiazepines. Pharmacists forward one copy of the prescription to state health authorities for surveillance, allowing for monitoring of each physician's prescribing, each pharmacy's dispensing, and each patient's receipt of benzodiazepines.

The policy resulted in an immediate 60 percent reduction in benzodiazepine use among women and 58 percent among men. The neighboring demographically-similar state New Jersey did not regulate benzodiazepine prescribing and benzodiazepine use did not change. Incidence of hip fracture before and after the policy change was similar.

"The policy drastically decreased use of benzodiazepines in New York and we did not see any decline in hip fracture rates compared to New Jersey; in fact, we seem to see an increase in New York over New Jersey," says Wagner.

There are several possible explanations for the study results. Most plausible, however, are biases in the previous studies that found a relationship between these drugs and hip fractures.

"It is very challenging to answer the question whether or not benzodiazepines cause hip fractures. People who get benzodiazepines, such as chronically ill elderly patients with dementia, have conditions, like dementia, that can cause hip fractures--and their hip fractures may not be due to their benzodiazepines," says Wagner.

"The challenge of disentangling the effects of benzodiazepines from other causes of hip fractures in the elderly is especially concerning when study results are used to guide policies that restrict access to medicines for huge populations," says senior author Stephen Soumerai, ScD, professor of ambulatory care and prevention at DACP.

Policy makers may expect that reducing access to benzodiazepines under Medicare Part D and other policies will decrease hip fracture risk. "Our study suggests that these expectations are not justified," says Soumerai.


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Contact: Leah Gourley
public_affairs@hms.harvard.edu
617-432-0442
Harvard Medical School
15-Jan-2007


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