Use of hypnotic-sedative medication and risk of falls and fractures in adults: A self-controlled case series study
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Use of hypnotic-sedative medication and risk of falls and fractures in adults : A self-controlled case series study. / Rozing, Maarten Pieter; Wium-Andersen, Marie Kim; Wium-Andersen, Ida Kim; Jørgensen, Terese Sara Høj; Jørgensen, Martin Balslev; Osler, Merete.
I: Acta Psychiatrica Scandinavica, Bind 148, Nr. 5, 2023.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Use of hypnotic-sedative medication and risk of falls and fractures in adults
T2 - A self-controlled case series study
AU - Rozing, Maarten Pieter
AU - Wium-Andersen, Marie Kim
AU - Wium-Andersen, Ida Kim
AU - Jørgensen, Terese Sara Høj
AU - Jørgensen, Martin Balslev
AU - Osler, Merete
N1 - Publisher Copyright: © 2023 The Authors. Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.
PY - 2023
Y1 - 2023
N2 - Objective: To evaluate the risk of falls and fractures in users of benzodiazepines, Z-drugs, or melatonin. Methods: We followed 699,335 adults with a purchase of benzodiazepines, Z-drugs, or melatonin in the Danish National Prescription Registry between 2003 and 2016 for falls and fractures in the Danish National Patient Registry between 2000 and 2018. A self-controlled case-series analysis and conditional Poisson regression were used to derive incidence rate ratios (IRR) of falls and fractures during six predefined periods. Results: In total 62,105 and 36,808 adults, respectively, experienced a fall or fracture. For older adults, the risk of falls was highest during the 3-month pre-treatment period (IRRmen+70, 4.22 (95% confidence interval, 3.53–5.05), IRRwomen + 70, 3.03 (2.59–3.55)) compared to the baseline (>1 year before initiation). The risk continued to be higher in the later treatment periods. Contrarily, in men and women aged 40–69 years, the risk was only higher in the 3-month pre-treatment period. The incidence of falls among young men and women was slightly lower after initiation of sedating medication (treatment period, IRRmen15–39, 0.66 (0.50–0.86), IRRwomen15–39, 0.65 (0.51–0.83)). Analyses with fractures as outcome yielded similar results. Conclusions: Although falls and fractures occur more often in persons using sedative-hypnotic medication, the higher risk of falls and fractures in the pre-treatment period relative to the period directly after treatment, suggests that this association is better explained by other factors that elicited the prescription of this medication rather than the adverse effects of the sedative-hypnotic medication.
AB - Objective: To evaluate the risk of falls and fractures in users of benzodiazepines, Z-drugs, or melatonin. Methods: We followed 699,335 adults with a purchase of benzodiazepines, Z-drugs, or melatonin in the Danish National Prescription Registry between 2003 and 2016 for falls and fractures in the Danish National Patient Registry between 2000 and 2018. A self-controlled case-series analysis and conditional Poisson regression were used to derive incidence rate ratios (IRR) of falls and fractures during six predefined periods. Results: In total 62,105 and 36,808 adults, respectively, experienced a fall or fracture. For older adults, the risk of falls was highest during the 3-month pre-treatment period (IRRmen+70, 4.22 (95% confidence interval, 3.53–5.05), IRRwomen + 70, 3.03 (2.59–3.55)) compared to the baseline (>1 year before initiation). The risk continued to be higher in the later treatment periods. Contrarily, in men and women aged 40–69 years, the risk was only higher in the 3-month pre-treatment period. The incidence of falls among young men and women was slightly lower after initiation of sedating medication (treatment period, IRRmen15–39, 0.66 (0.50–0.86), IRRwomen15–39, 0.65 (0.51–0.83)). Analyses with fractures as outcome yielded similar results. Conclusions: Although falls and fractures occur more often in persons using sedative-hypnotic medication, the higher risk of falls and fractures in the pre-treatment period relative to the period directly after treatment, suggests that this association is better explained by other factors that elicited the prescription of this medication rather than the adverse effects of the sedative-hypnotic medication.
KW - benzodiazepines
KW - fall
KW - fracture
KW - melatonin
KW - sedative-hypnotic medication
KW - self-controlled design
KW - Z-drugs
U2 - 10.1111/acps.13610
DO - 10.1111/acps.13610
M3 - Journal article
C2 - 37665682
AN - SCOPUS:85169703330
VL - 148
JO - Acta Psychiatrica Scandinavica
JF - Acta Psychiatrica Scandinavica
SN - 0001-690X
IS - 5
ER -
ID: 367698588