In a recent commentary, gerontologists call on clinicians to coordinate care among orthopedics, rehabilitation services, and primary care physicians to re-evaluate patients’ medication use following a fracture, to help reduce the risk of secondary falls and fractures.
This commentary appears in JAMA Internal Medicine, alongside research from Jeffrey C. Munson, MD, MCSE, and his research team that suggests that few changes are made to patients’ prescription medications in the 4 months following a fracture.
“The findings of Munson et al suggests that far too often clinicians fail to perform a thoughtful medication review for patients with a fracture,” states corresponding author Sarah D. Berry, MD, MPH, assistant professor of medicine in the Division of Gerontology in the Department of Medicine at Beth Israel Deaconess Medical Center and Harvard Medical School (HMS), as well as assistant scientist II at the Hebrew SeniorLife Institute for Aging Research, in the commentary.
“It’s imperative that researchers and clinicians work together to narrow this treatment gap and reduce secondary fractures and their devastating consequences,” she adds, according to a media release from Beth Israel Deaconess Medical Center.
In their commentary, Berry and co-author Douglas P. Kiel, MD, MPH, professor of medicine in the Department of Medicine at BIDMC and HMS, and senior scientist and director of the Musculoskeletal Research Center at the Hebrew SeniorLife Institute of Aging Research, suggest the following approach for clinicians considering medications for post-fracture patients:
First, per the release, they suggest that clinicians should consider discontinuing the use of medications that may lead to the increased risk of falls or fractures, such as psychotropic medications (ie, sleep aids, sedatives, and antidepressants) that could cause dizziness or loss of balance.
Second, they suggest that physicians should prescribe medications that are known to prevent the likelihood of fractures.
“Most clinicians wouldn’t dispute the importance of medication review for patients following a fracture but the question is who should do it,” Berry says, per the release. “We challenge all clinicians to work together to reduce the use of drugs linked to falls and fractures and to treat patients with drugs that can prevent subsequent fractures.”
“We also encourage patients who have experienced a fall or fracture to initiate a discussion with their doctors about the risks and benefits of medications associated with falls and bone loss,” Berry concludes.
[Source(s): Beth Israel Deaconess Medical Center, Newswise]