Article date: July 2017
By: Ragnhild Birkeland Waade, Espen Molden, Mette Irene Martinsen, Monica Hermann, Anette Hylen Ranhoff in Volume 83, Issue 7, pages 1397-1404
Aims
To determine use of psychotropic drugs and weak opioids in hip fracture patients by analysing plasma samples at admission, and compare detected drug frequencies with prescription registry data and drug records.
Methods
Plasma from 250 hip fracture patients aged ≥65 years sampled at hospital admission were analysed by ultra‐performance liquid chromatography–tandem mass spectrometry methods for detection of psychotropic drugs and weak opioid analgesics (alcohol also determined). Odds ratios for drugs detected in plasma of hip fracture patients vs. prescription frequencies of the same drugs in an age‐, time‐ and region‐matched reference population were calculated. Moreover, recorded and measured drugs were compared.
Results
Psychotropic drugs and/or weak opioid analgesics were detected in 158 (63%) of the patients (median age 84 years; 76% females), while alcohol was found in 19 patients (7.6%). The occurrence of diazepam (odds ratio 1.6; 95% confidence interval 1.1–2.4), nitrazepam (2.3; 1.3–4.1), selective serotonin reuptake inhibitors (1.9; 1.3–2.9) and mirtazapine (2.3; 1.2–4.3) was significantly higher in plasma samples of hip fracture patients than in prescription data from the reference population. Poor consistency between recorded and measured drugs was disclosed for z‐hypnotics and benzodiazepines; e.g. diazepam was detected in 29 (11.6%), but only recorded in six (2.4%) of the patients.
Conclusions
Plasma analysis shows that use of antidepressants and benzodiazepines in hip fracture patients is significantly more frequent than respective prescription frequencies in the general elderly population. Moreover, consistency between recorded and actual use of psychotropic fall‐risk drugs is poor at hospital admission of hip fracture patients.
DOI: 10.1111/bcp.13244
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