Drugs with anticholinergic potential and risk of falls with hip fracture in the elderly: A case-control study

[Speaker] Jorge E Machado-Alba:1
[Co-author] Manuel E Machado-Duque:1, Juan P Castano-Montoya:1, Diego A Medina-Morales:1, Alejandro Castro-Rodriguez:1, Alexandra Gonzalez-Montoya:1
1:Grupo de Investigacion en Farmacoepidemiologia y Farmacovigilancia, Universidad Tecnologica de Pereira. Asociacion Colombiana de Farmacologia. , Colombia

Background: Studies have shown an association between the use of drugs with anticholinergic potential and falls with hip fracture. To determine the association between the use of anticholinergic drugs and the risk of hip fracture in a population older than 60 years.
Methods: A case-control study in patients over 60 years of age with a diagnosis of hip fracture. Two controls were obtained per case. All drugs dispensed during the previous 30 days were identified. Sociodemographic, clinical, pharmacological (drugs according to the anticholinergic risk scale [ARS]), polypharmacy variables were analyzed. Measurements: Fall with hip fracture and type of drug according to the ARS.
Results: A total of 300 patients with hip fracture and 600 controls were included. The mean age was 81.6 (SD:8.9 years), with female predominance (71.3%). The use of drugs with low ARS scores in the month prior to the fall did not result in a significant increase in fracture risk, but in those who received drugs with moderate (OR:1.97, 95%CI:1.19-3.27) or high scores (OR:1.83, 95%CI:1.13-2.96), there was an increased probability of fracture. The drugs associated with increased risk were proton pump inhibitors (OR:1.58, 95%CI:1.08-2.32), systemic corticosteroids (OR:1.81, 95%CI:1.01-3.24), and conventional antipsychotics (OR:3.30, 95%CI:1.13-9.63).
Conclusions: There was an association between the use of drugs with anticholinergic properties and the risk of hip fracture in elderly patients, and it was possible to establish the level of risk. It is necessary to define policies in public health and to strengthen medical training programs, seeking the appropriate prescription of drugs in the geriatric population.

Figure 1. Multivariate analysis between the score of the ARS and the risk of hip fracture in adults older than 60 years, Colombia 2015.

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