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No Link Seen Between Benzodiazepines, Hip Fracture

Researchers suggest that federal and state restrictions on use may be unwarranted

THURSDAY, Jan. 18 (HealthDay News) -- Contrary to previous research, benzodiazepines may not increase the risk of hip fracture, and lawmakers should reconsider federal and state restrictions that limit the use of benzodiazepines in elderly patients as a way to reduce fractures, according to a report published in the Jan. 16 issue of the Annals of Internal Medicine.

Anita Wagner, Pharm.D., M.P.H., Dr.PH., of Harvard Medical School and Harvard Pilgrim Health Care in Boston, and colleagues studied benzodiazepine prescriptions and hip fractures in 51,529 New York Medicaid enrollees during the 12 months before and 21 months after New York adopted a triplicate-form prescription policy in 1989. As a control, they also studied 42,029 Medicaid enrollees in New Jersey, which has a less restrictive policy.

The researchers found that New York's triplicate prescription policy immediately resulted in decreases in benzodiazepine use in women (60.3 percent) and men (58.5 percent), while use in New Jersey remained stable. But the investigators found that age- and eligibility category-adjusted hazard ratios for hip fracture did not change in either state. The hazard ratio changed from 1.2 to 1.1 among female benzodiazepine users and from 1.3 to 1.1 among female non-users, and from 0.8 to 1.1 among male users and from 1.1 to 1.3 among male non-users.

"Policies that lead to substantial reductions in the use of benzodiazepines among elderly persons do not necessarily lead to decreased incidence of hip fracture," the authors conclude. "Limitations on coverage of benzodiazepines under Medicare Part D may not achieve this widely assumed clinical benefit."

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