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After a Bone Fracture, Check Your Meds

Date: December 15, 2016      Publication: Bottom Line Health      Source:  Jeffrey C. Munson, MD, Dartmouth College      Print:

A broken bone can have devastating consequences for an older person. It can lead to functional decline and loss of independence—even increased risk for death. One of the biggest post-fracture health risks is getting another fracture. But few patients get the right care after a fracture to help them prevent future fractures, a new study finds—and lots of people keep taking meds that increase fracture risk!

THE DRUG CONNECTION

It’s not a secret that many drugs for conditions such as diabetes, depression, high blood pressure, insomnia and even GERD can contribute to increased fracture risk. But breaking a bone should be a loud wake-up call for doctors to reevaluate the meds a patient is taking.

Unfortunately, that isn’t happening. A recent study from the Geisel School of Medicine at Dartmouth College looked at 168,000 Medicare recipients who had had bone fractures and found that four months after their fractures, more than 80% of them were still taking at least one medication known to increase risk for fracture. Even more alarming—more patients increased use of fracture-promoting drugs than decreased such use after their breaks!

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The list of drugs most associated with fracture risk in the study included…

  • Oral steroids
  • Proton pump inhibitors (for peptic ulcers, GERD)
  • Thiazolidinediones (a class of diabetes drug)
  • Diuretics (for high blood pressure)
  • Hypnotics (for insomnia)
  • Selective serotonin reuptake inhibitors (antidepressants)
  • Antipsychotics

Some of these drugs increase fracture risk because they increase the risk of falling—for example, hypnotics, antidepressants and even diuretics can make people dizzy. Others, such as proton pump inhibitors, decrease bone density—weakening bones.

Bottom line: If you have had a fracture, be sure to discuss with your doctor whether any of the medications you are taking might either weaken your bones or make falls more likely. You may be able to take a different class of medication to accomplish the same purpose. You may also want to discuss whether you should take medications for osteoporosis, suggest the study authors.

You can also take steps—literally—to strengthen your bones and help keep you steady on your feet. Weight-bearing exercises, such as walking and lifting weights, can help strengthen your bones, while yoga and tai chi help improve balance—and prevent falls.

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Source: Study titled “Patterns of Prescription Drug Use Before and After Fragility Fracture” by Jeffrey C. Munson, MD, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire, and colleagues, published in JAMA Internal Medicine.

  • Mister Vice

    What good is it to be given a CLASS of medications? I need a list by-name so I can check it against my current prescriptions!