Warning: Sleeping Pills and Antihypertensive Medications Increase Risk of Hip Fractures

The nation’s nursing homes house a large number of senior citizens who require constant care and attention. Nursing home authorities therefore have to be extra cautious in order to protect these vulnerable residents from potential dangers, including slip and falls.

It is estimated that more than one out of every three American adults 65 years and above suffer falls each year. In fact, among older adults, falls are the major cause of injury deaths, and the main reason for non-fatal injuries and hospital admissions.

Statistics also show that women are more likely to suffer hip fractures – almost 80% of the total number. The incidence of hip fractures increases with age, for both men and women. Seniors 85 years and older have a 10-15 times greater risk of hip fractures than their slightly younger counterparts.

The use of tranquilizers, anti-anxiety drugs and sleeping pills need to be reviewed, particularly in light of recent studies that point to their possible negative side effects. These medications have been found to increase the risk of falls. This is why nursing homes need to monitor their elderly inmates more closely to prevent incidents such as falls and resulting hip fractures.

Sleeping pills may do more harm than good for some patients. Researchers say that elderly nursing home residents taking certain hypnotics such as Sonata, Ambien, and Lunesta stand a 70 percent higher risk of hip fractures. The risk is even higher among new users of these drugs. Our dangerous drug lawyers at Pintas & Mullins Law Firm share the concerns of nursing home residents and their families about this increased hip fracture risk.

Usage of these hypnotic drugs steadily increased in nursing homes around the country after Medicare Part D restricted them from mandatory coverage in 2006. They were initially thought to be safer than traditional insomnia drugs that increased fall risks in older patients.

However, according to a Massachusetts medical center physician, a study involving more than one million Medicare patients taking Ambien, Sonata, or Lunesta showed an increased hip fracture risk. The risk was especially high for new users.

Given the uncertainty regarding the best methods to treat sleeplessness in the nursing home environment and identify high risk patients, the study looked at more than 26,000 patients who stayed in nursing homes for at least 6 months before suffering a hip fracture. Of these, just over 900 were given a non-benzodiazepine drug. About 20 percent of the patients had slight functional impairment and 60 percent had slight or no cognitive impairment.

As predicted, the maximum risk was observed among new users, patients with urinary continence, those with functional and cognitive impairment, and those requiring bed rails to be held back.

Researchers also determined that the possibility of developing a fracture was greater in patients with no or slight cognitive impairment, compared to those with considerable cognitive impairment. With respect to functional status, patients with slight to medium impairment stood a higher risk than those with serious impairment.

This study shows that sleeping pills should have more restrictive policies, particularly when prescribed to older patients. Furthermore, nursing home patients who are being treated for insomnia with these pills need to be closely monitored for osteoporosis and falls, especially those with mild cognitive impairment and new users.

Antihypertensive medications are also linked to hip fractures among elderly individuals, as a recent report shows. The risk is maximum during the initial 45 days after starting the medication, with those taking angiotensin II converting-enzyme inhibitors and beta-adrenergic blockers at a greater risk. The data was collected from 300, 000 plus newly treated, community-dwelling individuals around 81 years of age. Among these people, 1463 sustained hip fractures during the observation period of 450 days.

Earlier research had indicated that initiating antihypertensive treatment increased the risk for falls among the elderly population. However, the researchers said that the risk for hip fractures was not known. Patients taking two types of medications were particularly at risk — 58% for beta-adrenergic blockers and 53% for angiotensin II converting-enzyme inhibitors. The researchers said that more in-depth study was required regarding this trend.

Pharmaceutical litigation attorneys at Pintas & Mullins Law Firm are closely following this development because it is of great significance to elderly hypertensive patients staying in nursing homes. Nursing homes also should take note of this recent development in pharmaceutical research to ensure maximum safety for their residents.

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