OBJECTIVES: To evaluate the changes in types of medications prescribed for pain before and after withdrawal of certain selective cyclooxygenase 2 (COX-2) inhibitors in 2004 and to determine whether there was an association with fall events in elderly adults with a diagnosis of osteoarthritis (OA). DESIGN: A nested case-control design using electronic medical records compiled between 2001 and 2009. SETTING: Electronic medical records for care provided in an integrated health system in rural Pennsylvania over a 9-year period (2001-09), the midpoint of which rofecoxib and valdecoxib were pulled from the market. PARTICIPANTS: Thirteen thousand three hundred fifty-four individuals aged 65 to 89 with a diagnosis of OA. MEASUREMENTS: The incidence of falls and fractures was examined in relation to analgesics prescribed: narcotics, COX-2 inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs). The comparison sample of individuals who did not fall was matched 3:1 with those who fell according to age, sex, and comorbidity. RESULTS: Narcotic analgesic prescriptions were associated with a significantly greater risk of falls and fractures. The likelihood of experiencing a fall/fracture was higher in participants prescribed narcotic analgesics than those prescribed a COX-2 inhibitor (odds ratio (OR) = 3.3, 95% confidence interval (CI) = 2.5-4.3) or NSAID (OR = 4.1, 95% CI = 3.7-4.5). CONCLUSION: Use of narcotic analgesics is associated with risk of falls and fractures in elderly adults with OA, an observation that suggests that the current guidelines for the treatment of pain, which include first-line prescription of narcotics, should be reevaluated.
OBJECTIVES: To evaluate the changes in types of medications prescribed for pain before and after withdrawal of certain selective cyclooxygenase 2 (COX-2) inhibitors in 2004 and to determine whether there was an association with fall events in elderly adults with a diagnosis of osteoarthritis (OA). DESIGN: A nested case-control design using electronic medical records compiled between 2001 and 2009. SETTING: Electronic medical records for care provided in an integrated health system in rural Pennsylvania over a 9-year period (2001-09), the midpoint of which rofecoxib and valdecoxib were pulled from the market. PARTICIPANTS: Thirteen thousand three hundred fifty-four individuals aged 65 to 89 with a diagnosis of OA. MEASUREMENTS: The incidence of falls and fractures was examined in relation to analgesics prescribed: narcotics, COX-2 inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs). The comparison sample of individuals who did not fall was matched 3:1 with those who fell according to age, sex, and comorbidity. RESULTS: Narcotic analgesic prescriptions were associated with a significantly greater risk of falls and fractures. The likelihood of experiencing a fall/fracture was higher in participants prescribed narcotic analgesics than those prescribed a COX-2 inhibitor (odds ratio (OR) = 3.3, 95% confidence interval (CI) = 2.5-4.3) or NSAID (OR = 4.1, 95% CI = 3.7-4.5). CONCLUSION: Use of narcotic analgesics is associated with risk of falls and fractures in elderly adults with OA, an observation that suggests that the current guidelines for the treatment of pain, which include first-line prescription of narcotics, should be reevaluated.
Authors: Kristine E Ensrud; Terri L Blackwell; Carol M Mangione; Paula J Bowman; Mary A Whooley; Douglas C Bauer; Ann V Schwartz; Joseph T Hanlon; Michael C Nevitt Journal: J Am Geriatr Soc Date: 2002-10 Impact factor: 5.562
Authors: Bradley T Kerridge; Tulshi D Saha; S Patricia Chou; Haitao Zhang; Jeesun Jung; W June Ruan; Sharon M Smith; Boji Huang; Deborah S Hasin Journal: Drug Alcohol Depend Date: 2015-09-02 Impact factor: 4.492
Authors: Adam L Doré; Yvonne M Golightly; Vicki S Mercer; Xiaoyan A Shi; Jordan B Renner; Joanne M Jordan; Amanda E Nelson Journal: Arthritis Care Res (Hoboken) Date: 2015-05 Impact factor: 4.794
Authors: Laura S Gold; Ryan N Hansen; Andrew L Avins; Zoya Bauer; Bryan A Comstock; Richard A Deyo; Patrick J Heagerty; Sean D Rundell; Pradeep Suri; Judith A Turner; Jeffrey G Jarvik Journal: Clin J Pain Date: 2018-04 Impact factor: 3.442
Authors: Aymen Ali Al-Qurain; Lemlem G Gebremichael; Muhammad Suleman Khan; Desmond B Williams; Lorraine Mackenzie; Craig Phillips; Patrick Russell; Michael S Roberts; Michael D Wiese Journal: Drugs Aging Date: 2020-04 Impact factor: 3.923
Authors: Sarah Schear; Kanan Patel; Lisa X Deng; Christine Miaskowski; Ingrid Maravilla; Sarah K Garrigues; Nicole Thompson; Andrew D Auerbach; Christine S Ritchie Journal: J Palliat Med Date: 2019-11-05 Impact factor: 2.947