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KMID : 1022920220100010031
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Journal of Korean Academy of Social & Managed Care Pharmacy
2022 Volume.10 No. 1 p.31 ~ p.36
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Association Between the Use of Sedative-Hypnotic Drugs and Fractures in Korean Elderly Population
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Jang Yoon-Wook
Han Eun-A
Choi Jae-Woo
Kang Hye-Young
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Abstract
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OBJECTIVE To investigate association between the use of sedative-hypnotics and fractures in the Korean elderly population.
METHODS We used 2016 Health Insurance Review and Assessment Service-the Adult Patient Sample (HIRA-APS) data, which was extracted from 20% of the elderly patients over 65 years old. We excluded individuals diagnosed with fractures, osteoporosis, or car accidents during a wash-out period (i.e., January - March). Then, patients with at least one claim record with prescribed sedative-hypnotics from April through December were defined as those treated with sedative-hypnotics. If there was at least one claim record with a diagnosis of fracture during the same time period, then we
defined a fracture incidence.
RESULTS A multivariate logistic regression analysis result showed that the elderly prescribed with sedative-hypnotics had a significantly higher risk of fractures by 1.337 times (adjusted odds ratio (aOR)=1.337, 95% confidence interval (CI): 1.316-1.358). Also, the risk of fractures significantly increased as the number of sedative-hypnotics prescribed increased (aOR of taking one sedative-hypnotics vs. none: 1.255 (95% CI: 1.233-1.278), aOR of two sedativehypnotics: 1.464 (95% CI: 1.425-1.504), and aOR of three or more sedative-hypnotics: 1.720 (95% CI: 1.652-1.790).
CONCLUSION A significant association between the use of sedative-hypnotics and the risk of fractures and its dose-response relationship among Korean elderly population were confirmed based on a nationally representative data of HIRA-APS. Our results suggest careful use of sedative-hypnotics to treat elderly population. Especially, when it is necessary to prescribe multiple sedative-hypnotics for the elderly, a close monitoring should be accompanied to prevent fractures.
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KEYWORD
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claims data, elderly, fracture, sedative-hypnotic
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