Greater Number of Narcotic Analgesic Prescriptions for Osteoarthritis Is Associated with Falls and Fractures in Elderly Adults

摘要: OBJECTIVES: To evaluate the changes in types of medications prescribed for pain before and after withdrawal certain selective cyclooxygenase 2 (COX-2) inhibitors 2004 to determine whether there was an association with fall events elderly adults a diagnosis osteoarthritis (OA). DESIGN: A nested case-control design using electronic medical records compiled between 2001 2009. SETTING: Electronic care provided integrated health system rural Pennsylvania over 9-year period (2001-09), midpoint which rofecoxib valdecoxib were pulled from market. PARTICIPANTS: Thirteen thousand three hundred fifty-four individuals aged 65 89 OA. MEASUREMENTS: The incidence falls fractures examined relation analgesics prescribed: narcotics, COX-2 inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs). comparison sample who did not matched 3:1 those fell according age, sex, comorbidity. RESULTS: Narcotic analgesic prescriptions associated significantly greater risk fractures. likelihood experiencing fall/fracture higher participants narcotic than inhibitor (odds ratio (OR) = 3.3, 95% confidence interval (CI) 2.5-4.3) or NSAID (OR 4.1, CI 3.7-4.5). CONCLUSION: Use is OA, observation that suggests current guidelines treatment pain, include first-line prescription should be reevaluated. Language: en