title: Trends of benzodiazepine prescribing and the risk of hip fracture in elderly patients in Taiwan: A population-based study.
abstract: Abstract Objective. The aim of this study was to explore the trends of prescribing potentially inappropriate benzodiazepine use (PIBU) and the risk of fractures in an elderly population in Taiwan. Methods. Retrospective administrative database analysis was conducted. Outpatient claim data were retrieved from the Longitudinal Health Insurance Database (LHID) between 2000 and 2003, which contains all inpatient and outpatient medical claims of approximately 23 million patients in Taiwan. All patients with the diagnosis of hip fractures (ICD codes) were identified from the database. The inappropriate use for the elderly was defined as a prescription with the dose of short- and long-acting BZD according to the 2003 version of Beers' criteria. Multiple logistic regressions were used to determine the association of PIBU with fractures. Results. A total of 62,023 elderly patients aged ≧65 years were retrieved from the database. The proportion of elderly patients taking short-and long-acting benzodiazepines declined significantly from 28.1 to 25% and 19.5 to 14.5% from 2000 to 2003, respectively (P<0.001). After adjustment for age, sex, co-morbidity, other medications in one prescription and all of the covariates, the risk of hip fractures (∼50%) was still statistically significant (adjusted OR in the four years studied: 1.57, 1.38, 1.68, 1.45) for elderly patients taking benzodiazepines in Taiwan. Conclusion. These findings suggest that the inappropriate use of benzodiazepine may be associated with the risk of fractures. Physicians should prescribe benzodiazepines appropriately for the elderly to minimize the risk of hip fractures.
authors.affiliation: Department of Pharmacy, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Agnes L F
authors.initials: AL
authors.lastname: Chan
authors.forename: Shun-Jin
authors.initials: SJ
authors.lastname: Lin
keywords: Beer criteria; Benzodiazepines; Taiwan; elderly; fractures; pharmacoepidemiology