A Scoping Review to Assess Risk of Fracture Associated with Anxiolytic Medications DOI Creative Commons
Johnathan Dallman, Levi Aldag, Amanda Klass

и другие.

Kansas Journal of Medicine, Год журнала: 2023, Номер 16(2), С. 222 - 227

Опубликована: Авг. 24, 2023

Introduction. Recent research has focused on evaluating the impact of pharmalogical sources fracture risk. The purpose this study was to review literature anxiolytic medications that may be associated with an increased risk fracture. Methods. A search conducted in MEDLINE and Embase databases identify primary clinical studies patients who sustained a while prescribed were published prior July 2021. Anxiolytics defined by ATC Class N05B, beta blockers, zolpidem included. terms consisted variations following: (“Psychotropic Drugs” or MeSH terms) AND (“Fracture” terms). Results. Of 3,213 studies, 13 (0.4%) met inclusion criteria evaluated. Fractures benzodiazepine reported 12 studies; highest occurred aged 60 years older, RR=2.29, 95% CI (1.48-4.40). N05B showed for those < 55 age differed sex: men RR=5.42, CI(4.86-6.05) women it RR=3.33, (3.03-3.66). Zolpidem also increase risk, CI(1.48-3.56), but only during first 4 weeks treatment. relative 0.77, CI(.72-.83) observed blockers. Conclusions. are mainstay traumatic injuries accompanied economical, physiological, psychological hardship. Fortunately, proper assessment prophylactic measures, can reduced dramatically. Anxiolytic have been described widely such as benzodiazepines 60+ year old patients, (4.86-6.05) 55+ women. Yet, some at low doses, nitrazepam lowered Other medications, decrease risk; however, one each these medications. Ultimately, scoping helped illuminate inconsistency simultaneously illustrating necessary steps guide future research.

Язык: Английский

Performance of a Claims-Based Frailty Proxy Using Varying Frailty Ascertainment Lookback Windows DOI
Emilie D. Duchesneau, Til Stürmer‎, Dae Hyun Kim

и другие.

Medical Care, Год журнала: 2024, Номер 62(5), С. 305 - 313

Опубликована: Март 12, 2024

Background: Frailty is an aging-related syndrome of reduced physiological reserve to maintain homeostasis. The Faurot frailty index has been validated as a Medicare claims-based proxy for predicting using billing information from user-specified ascertainment window. Objectives: We assessed the validity predictor phenotype and 1-year mortality varying windows. Research Design: identified older adults (66+ y) in Round 5 (2015) National Health Aging Trends Study with claims linkage. Gold standard was phenotype. calculated 3, 6, 8, 12 months prior survey or all-available lookback. Model performance each window by quantifying calibration discrimination. Predictive estimating risk differences across strata. Results: Among 4253 adults, 6 8-month windows had best (calibration slopes: 0.88 0.87). All-available lookback discrimination (C-statistic=0.780), but poor calibration. Mortality associations were strongest 3-month monotonically decreased longer Subgroup analyses revealed worse Black Hispanic individuals than counterparts. Conclusions: optimal may depend on clinical context, researchers should consider tradeoffs between discrimination, calibration, mortality. Sensitivity different durations can enhance robustness inferences. needed improve prediction racial ethnic groups.

Язык: Английский

Процитировано

5
Translation of a Claims-Based Frailty Index From the International Classification of Diseases, Ninth Revision, Clinical Modification to the Tenth Revision DOI
Emilie D. Duchesneau, Shahar Shmuel, Keturah R. Faurot

и другие.

American Journal of Epidemiology, Год журнала: 2023, Номер 192(12), С. 2085 - 2093

Опубликована: Июль 11, 2023

Abstract The Faurot frailty index (FFI) is a validated algorithm that uses enrollment and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)–based billing information from Medicare claims data as proxy for frailty. In October 2015, the US health-care system transitioned ICD-9-CM to Tenth (ICD-10-CM). Applying Centers Medicaid Services General Equivalence Mappings, we translated diagnosis-based indicator codes ICD-10-CM, followed by manual review. We used interrupted time-series analysis assess comparability pre- posttransition FFI scores. cohorts beneficiaries enrolled in January 2015–2017 with 8-month look-back periods, estimated associations between 1-year risk aging-related outcomes (mortality, hospitalization, admission skilled nursing facility). Updated indicators had similar prevalences pretransition definitions. median scores interquartile ranges (IQRs) predicted probability were before after Diseases transition (pretransition: median, 0.034 (IQR, 0.02–0.07); posttransition: 0.038 0.02–0.09)). updated was associated increased risks mortality, facility admission, findings era. Studies medical interventions older adults using administrative should use indices, like FFI, mitigate confounding or effect-measure modification

Язык: Английский

Процитировано

8
Using wrist-worn accelerometers to identify the impact of medicines with anticholinergic or sedative properties on sedentary time: A 12-month prospective analysis DOI Creative Commons
Renly Lim, Dorothea Dumuid, Gaynor Parfitt

и другие.

Maturitas, Год журнала: 2023, Номер 172, С. 9 - 14

Опубликована: Март 30, 2023

Studies have shown that use of medicines with sedative or anticholinergic properties is associated a decline in physical function; however, the effects not been quantified, and it known how which specific movements are affected. This prospective study quantified impact change load over time on 24-hour activity composition.This used data collected from randomised trial assessing an ongoing pharmacist service residential aged care. The composition sleep, sedentary behaviour, light-intensity activity, moderate to vigorous was derived accelerometry bands. Mixed effect linear models were regress multivariate outcome medication at baseline 12 months. A fixed interaction between stage included test for differing two stages.Data 183 85 participants available months respectively. There statistically significant point (sedative F = 7.2, p < 0.001 3.2, 0.02). increase 2 4 12-month period average daily behaviour by estimated 24 min.As increased, there time. Our findings suggest wearable bands possible tool monitoring function medicines.The ReMInDAR registered Australian New Zealand Trials Registry ACTRN12618000766213.

Язык: Английский

Процитировано

7
Evaluating the use of methods to mitigate bias from non‐transient medications in the case‐crossover design: A systematic review DOI Creative Commons
Hsiao‐Ching Huang,

Wen‐Chin Li,

Mina Tadrous

и другие.

Pharmacoepidemiology and Drug Safety, Год журнала: 2023, Номер 32(9), С. 939 - 950

Опубликована: Июнь 7, 2023

The case-crossover design is a self-controlled study used to compare exposure immediately preceding an event occurrence with in earlier control periods. most suitable for transient exposures order avoid biases that can be problematic when using the non-transient (i.e., chronic) exposures. Our goal was conduct systematic review of studies and its variants (case-time-control case-case-time-control) analysis choices by medication type.We conducted search identify recent case-crossover, case-time-control, case-case-time-control focused on Articles indexed MEDLINE EMBASE these designs were published between January 2015 December 2021 English language identified. Reviews, methodological studies, commentaries, articles without medications as interest, no available full text excluded. Study characteristics including design, outcome, risk window, reporting discordant pairs, inclusion sensitivity analyses summarized overall type. We further evaluated implementation recommended methods account introduced among exposure.Of 2036 initially identified, 114 included. common (88%), followed case-time-control (17%), (3%). Fifty-three percent included only medications, 35% 12% both. Across years, proportion evaluating ranged from 30% 2018 69% 2017. found 41% did not apply any more than half which authors previous publication history studies.Using evaluate remains pharmacoepidemiology. Researchers should appropriate opting use

Язык: Английский

Процитировано

3
Antipsychotic medication use and fracture: a case–control study DOI Creative Commons
Behnaz Azimi Manavi, Amanda L. Stuart, Julie A. Pasco

и другие.

Scientific Reports, Год журнала: 2023, Номер 13(1)

Опубликована: Авг. 22, 2023

It has been reported that antipsychotic use is associated with lower bone mineral density and quality. We aimed to determine whether fracture risk in a population-based sample of adults living the Barwon Statistical Division, south-eastern Australia. In this case-control study, 1458 participants (51.8% women) radiologically confirmed between June 1st 2012 May 31st 2013 (cases) were compared 1795 (46.5% without (controls) for same time period. Medication use, medical history lifestyle factors documented by self-report. Multivariable binary logistic regression was used explore associations following adjustment possible confounders. women, identified 20 755 (2.6%) cases 10 834 (1.2%) controls (p = 0.034) men, 13 703 (1.8%) 5 961 (0.5%) 0.010). Following adjustments, 3.0-fold increased men 2.3-fold women. Patterns persisted after exclusion non-fragility fractures self-reported schizophrenia. While future research exploring underlying mechanisms needed, regular monitoring health users suggested.

Язык: Английский

Процитировано

3
Anticholinergics and falls in older adults DOI

Xiang Jiang Xu,

Maw Pin Tan

Expert Review of Clinical Pharmacology, Год журнала: 2022, Номер 15(3), С. 285 - 294

Опубликована: Март 4, 2022

The use of medications with anticholinergic (ACh) properties is associated numerous adverse effects especially in older adults. Emerging evidence suggests the presence long-term ACh use.Our article presents an overview and falls individuals including examination emerging on cumulative exposure short-term risk. databases CINAHL, MEDLINE, EMBASE, Web Science were searched for articles published from January 2002 to December 2021.Anticholinergic side include muscle weakness, blurred vision, mental confusion which are likely lead increased Many commonly used such as beta-blockers, calcium-channel blockers, antihistamines now known have mild properties. With polypharmacy considered unavoidable patients, multiple drugs may also relationship between be irreversible extend beyond period drug use, due cognitive physical deconditioning following initial drugs. Future studies accurate quantification measurement actual outcomes urgently required.

Язык: Английский

Процитировано

5
Sedative-hypnotics and osteoporotic fractures: A systematic review of observational studies with over six million individuals DOI

Chong Xu,

Janice Ching Nam Leung,

Jiaying Shi

и другие.

Sleep Medicine Reviews, Год журнала: 2023, Номер 73, С. 101866 - 101866

Опубликована: Окт. 23, 2023

Язык: Английский

Процитировано

2
A Prescribing Cascade of Proton Pump Inhibitors Following Anticholinergic Medications in Older Adults With Dementia DOI Creative Commons
Shanna Trenaman,

Austin Harding,

Susan K. Bowles

и другие.

Frontiers in Pharmacology, Год журнала: 2022, Номер 13

Опубликована: Июнь 22, 2022

Introduction: Prescribing cascade refers to use of a medication treat drug-related adverse event. cascades increase use, cost, and risk events. Objective: Our objective was administrative health data identify whether medications from the anticholinergic cognitive burden scale associated with proton pump inhibitor (PPI) prescribing consistent in older adults dementia. Method: The cohort comprised Nova Scotia Seniors’ Pharmacare beneficiaries identified have dementia dispensation recorded between 1 April 2010, or entry 31 March 2015. Anticholinergic (ACB) were abstracted. A look back period 365 days if PPI had been dispensed preceding dispensation. initiation within 30, 60, 90, 180 assessed. Demographic description those PPIs reported. Risk factors for investigated logistic regression Cox proportional hazards modelling including sex-stratified analysis. Results: We 28,952 prescription data. frequently 63.4% at least one an medication. defined as up 180-days inititation dispensation, occurred 1,845 (incidence 6.4%). Multivariate showed experiencing after initiating any younger (OR 0.98, 95%CI [0.97–0.98]), less likely live urban location 0.82, [0.74–0.91]), be men 0.74, [0.67–0.82]). demonstrated increased starting when ACB (HR 1.38, [1.29–1.58]). Discussion: Regression suggested that cohort. identification this population Program using highlights how routinely collected can used cascades.

Язык: Английский

Процитировано

3
Association between Central Nervous System Drugs and Femoral Fracture Risk in Japanese Individuals ≥80 Years Old: A Case-crossover Study DOI Open Access

Haruhiko Fukada,

Shuko Nojiri, Takuya Uematsu

и другие.

Internal Medicine, Год журнала: 2024, Номер unknown

Опубликована: Янв. 1, 2024

Objectives To assess the association between concomitant use of central nervous system drugs and femoral fracture risk in individuals ≥80 years old Japan.

Язык: Английский

Процитировано

0
A Scoping Review to Assess Risk of Fracture Associated with Anxiolytic Medications DOI Creative Commons
Johnathan Dallman, Levi Aldag, Amanda Klass

и другие.

Kansas Journal of Medicine, Год журнала: 2023, Номер 16(2), С. 222 - 227

Опубликована: Авг. 24, 2023

Introduction. Recent research has focused on evaluating the impact of pharmalogical sources fracture risk. The purpose this study was to review literature anxiolytic medications that may be associated with an increased risk fracture. Methods. A search conducted in MEDLINE and Embase databases identify primary clinical studies patients who sustained a while prescribed were published prior July 2021. Anxiolytics defined by ATC Class N05B, beta blockers, zolpidem included. terms consisted variations following: (“Psychotropic Drugs” or MeSH terms) AND (“Fracture” terms). Results. Of 3,213 studies, 13 (0.4%) met inclusion criteria evaluated. Fractures benzodiazepine reported 12 studies; highest occurred aged 60 years older, RR=2.29, 95% CI (1.48-4.40). N05B showed for those < 55 age differed sex: men RR=5.42, CI(4.86-6.05) women it RR=3.33, (3.03-3.66). Zolpidem also increase risk, CI(1.48-3.56), but only during first 4 weeks treatment. relative 0.77, CI(.72-.83) observed blockers. Conclusions. are mainstay traumatic injuries accompanied economical, physiological, psychological hardship. Fortunately, proper assessment prophylactic measures, can reduced dramatically. Anxiolytic have been described widely such as benzodiazepines 60+ year old patients, (4.86-6.05) 55+ women. Yet, some at low doses, nitrazepam lowered Other medications, decrease risk; however, one each these medications. Ultimately, scoping helped illuminate inconsistency simultaneously illustrating necessary steps guide future research.

Язык: Английский

Процитировано

1