Medication Review After a Fracture Lacking

Findings from a recent study suggest that a fragility fracture among Medicare beneficiaries may present an opportunity for physicians to manage high-risk drugs.

Medicare beneficiaries and older patients face a high risk for experiencing fragility fractures, and that risk increases if they have previously experienced 1 or more fractures.

Included in a study published by JAMA Internal Medicine, were 168,133 community-dwelling Medicare beneficiaries who survived a fragility fracture of the hip, shoulder, or wrist. Approximately 84.2% of patients included were women, with an average age of 80-years-old.

Researchers analyzed Medicare Part D claims to find the amount of prescription fills for 21 classes medications associated with increased fracture risk. Drugs included are known to increase fall risk, decrease bone density, or increase fracture risk through an unclear mechanism.

They discovered that three-quarters of patients were taking 1 or more non-opiate drug associated with increased fracture risk in the 4 months preceding the event. However, only approximately 7% of patients discontinued the use of the drug after the fracture.

The researchers reported that the decrease was offset by new users, and there was no change in proportion of beneficiaries taking the medications.

Researchers believe that the time after a fracture may be an opportunity for providers to review medications for high-risk patients.

Researchers do caution that some medications cannot be discontinued after fractures due to their critical indications, and a clear method to improve prescribing practices could potentially be discovered with additional research.