title: Older adults' medication use 6 months before and after hip fracture: a population-based cohort study.
abstract: OBJECTIVE
  To study changes in use of fall-risk increasing drugs (FRIDs) and bone density-related medication in participants with hip fracture before and after the fracture and to analyze differences between five healthcare districts.
  
  
  METHODS
  Population-based cohort study.
  
  
  METHODS
  Data retrieved from two national databases
  
  
  METHODS
  All 2,043 people with hip fracture aged 60 and older in a Swedish county in 2006.
  
  
  METHODS
  Changes in FRIDs and bone-active medications prescribed within 6 months before and 6 months after hip fracture and differences between health care districts.
  
  
  RESULTS
  Before hip fracture, 1,308 participants (67.7%) received any FRIDs or combinations; after fracture, 97.7% were treated. Polypharmacy (≥5 drugs) increased 39.3%, excessive polypharmacy (≥10 drugs) increased 36.4%, and use of three or more psychotropic drugs increased 8.6%. After fracture, the use of all analyzed drugs including psychotropic, cardiovascular, opioid, and anticholinergic drugs increased significantly (P<.001). Treatment with calcium and vitamin D increased from 9% before to 27.7% after and with bisphosphonates from 3.5% to 7.6%. Variations in postfracture prescribing between the five health care districts were observed regarding opioids (range 85-64%), bisphosphonates (range 20-4%), and calcium and vitamin D (72-13%) (P<.001, for all comparisons).
  
  
  CONCLUSIONS
  Two-thirds of participants with hip fracture were prescribed FRIDs before fracture, and the number increased significantly after fracture. Significant variations between healthcare districts in treating osteoporosis and pain were evident; geriatric support could be a contributing factor to the greater treatment in two districts.
authors.affiliation: Division of Geriatric Medicine, Department of Health Sciences, Lund University, Lund, Sweden. annikakragh@gmail.com
authors.forename: Annika
authors.initials: A
authors.lastname: Kragh
authors.forename: Sölve
authors.initials: S
authors.lastname: Elmståhl
authors.forename: Isam
authors.initials: I
authors.lastname: Atroshi
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000627:therapeutic use; D016009:Chi-Square Distribution; D015331:Cohort Studies; D004164:Diphosphonates / Q000627:therapeutic use; D004358:Drug Therapy / Q000706:statistics & numerical data; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006620:Hip Fractures / Q000139:chemically induced* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012306:Risk; D013548:Sweden / Q000453:epidemiology; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D004164:Diphosphonates; D014807:Vitamin D; D002118:Calcium