Effects of medication reviews performed by a physician on treatment with fracture-preventing and fall-risk-increasing drugs in older adults with hip fracture-a randomized controlled study
| Autor: | Christina Sjöberg, Susanna M. Wallerstedt |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Osteoporosis Poison control Risk Assessment law.invention Randomized controlled trial law Interquartile range Intervention (counseling) Physicians Injury prevention Medicine Humans Prospective Studies Aged Geriatrics Aged 80 and over Sweden Hip fracture Bone Density Conservation Agents Diphosphonates business.industry Hip Fractures Incidence Length of Stay medicine.disease Prognosis Physical therapy Accidental Falls Female Geriatrics and Gerontology business Follow-Up Studies |
| Zdroj: | Journal of the American Geriatrics Society. 61(9) |
| ISSN: | 1532-5415 |
| Popis: | OBJECTIVES: To investigate whether medication reviews increase treatment with fracture-preventing drugs and decrease treatment with fall-risk-increasing drugs. DESIGN: Randomized controlled trial (1:1). SETTING: Departments of orthopedics, geriatrics, and medicine at Sahlgrenska University Hospital, Gothenburg, Sweden. PARTICIPANTS: One hundred ninety-nine consecutive individuals with hip fracture aged 65 and older. INTERVENTION: Medication reviews, based on assessments of risks of falls and fractures, regarding fracture-preventing and fall-risk-increasing drugs, performed by a physician, conveyed orally and in written form to hospital physicians during the hospital stay, and to general practitioners after discharge. MEASUREMENTS: Primary outcomes were changes in treatment with fracture-preventing and fall-risk-increasing drugs 12 months after discharge. Secondary outcomes were falls, fractures, deaths, and physicians' attitudes toward the intervention. RESULTS: At admission, 26% of intervention and 29% of control participants were taking fracture-preventing drugs, and 12% and 11%, respectively, were taking bone-active drugs, predominantly bisphosphonates. After 12 months, 77% of intervention and 58% of control participants were taking fracture-preventing drugs (P = .01), and 29% and 15%, respectively, were taking bone-active drugs (P = .04). Mean number of fall-risk-increasing drugs per participants was 3.1 (intervention) and 3.1 (control) at admission and 2.9 (intervention) and 3.1 (control) at 12 months (P = .62). No significant differences in hard endpoints were found. The responding physicians (n = 65) appreciated the intervention; on a scale from 1 (very bad) to 6 (very good), the median rating was 5 (interquartile range (IQR) 4-6) for the oral part and 5 (IQR 4-5.5) for the text part. CONCLUSION: Medication reviews performed and conveyed by a physician increased treatment with fracture-preventing drugs but did not significantly decrease treatment with fall-risk-increasing drugs in older adults with hip fracture. Prescribing physicians appreciated this intervention. Language: en |
| Databáze: | OpenAIRE |
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