| Increased risk of hip fracture in the elderly associated with prochlorperazine: is a prescribing cascade contributing? | |
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MedLine Citation:
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PMID: 20623516 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To examine the prescribing of prochlorperazine secondary to the prescribing of a medicine which could lead to symptoms for which prochlorperazine is indicated and commonly used. Given the range of potential hypotensive, sedative, dystonic and other extra-pyramidal side effects associated with prochlorperazine, its association with hip fracture was also examined. METHODS: Prescription/event sequence symmetry analyses were undertaken from 1st January 2003 to 31st December 2006, using administrative claims data from the Department of Veterans' Affairs, Australia. This method assesses asymmetry in the distribution of an incident event (either prescription of another medicine or hospitalization) before and after the initiation of prochlorperazine. Crude and adjusted sequence ratios (ASR) with 95% confidence intervals (CI) were calculated. RESULTS: A total of 34 235 persons with incident use of prochlorperazine were identified during the study period. Statistically significant positive associations were found for a number of commonly used medicines, including cardiovascular medicines, NSAIDs, opioids and sedatives and the subsequent initiation of prochlorperazine that ranged from 1.07 (95%CI 1.01-1.14) for diuretics to 1.50 (95%CI 1.40-1.61) for statins. Prescription event analysis showed a 49% (95%CI 1.19-1.86) increased risk of hospitalisation for hip fracture following dispensing of prochlorperazine. CONCLUSIONS: Prescribers should consider the possible contributing role of newly initiated medicines with the potential to cause of dizziness, and where possible address this through dose reduction or cessation of the medicine, rather than prescribing prochlorperazine. |
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Authors:
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Gillian E Caughey; Elizabeth E Roughead; Nicole Pratt; Sepehr Shakib; Agnes I Vitry; Andrew L Gilbert |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Pharmacoepidemiology and drug safety Volume: 19 ISSN: 1099-1557 ISO Abbreviation: Pharmacoepidemiol Drug Saf Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-02 Completed Date: 2010-12-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9208369 Medline TA: Pharmacoepidemiol Drug Saf Country: England |
Other Details:
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Languages: eng Pagination: 977-82 Citation Subset: IM |
Copyright Information:
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(c) 2010 John Wiley & Sons, Ltd. |
Affiliation:
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Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia. gillian.caughey@unisa.edu.au |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Antiemetics / adverse effects*, therapeutic use Australia / epidemiology Databases, Factual Dizziness / chemically induced, diagnosis, drug therapy Female Hip Fractures / chemically induced* Hospitalization / statistics & numerical data Humans Male Nausea / chemically induced, diagnosis, drug therapy Pharmaceutical Preparations / administration & dosage, adverse effects Physician's Practice Patterns / statistics & numerical data* Prochlorperazine / adverse effects*, therapeutic use Risk Veterans |
| Chemical | |
Reg. No./Substance:
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0/Antiemetics; 0/Pharmaceutical Preparations; 58-38-8/Prochlorperazine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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