• Christina Sjöberg and Susanna M Wallerstedt.
• Department of Geriatrics, Sahlgrenska University Hospital, Gothenburg, Sweden.
• J Am Geriatr Soc. 2013 Sep 1; 61 (9): 1464-72.

ObjectivesTo investigate whether medication reviews increase treatment with fracture-preventing drugs and decrease treatment with fall-risk-increasing drugs.DesignRandomized controlled trial (1:1).SettingDepartments of orthopedics, geriatrics, and medicine at Sahlgrenska University Hospital, Gothenburg, Sweden.ParticipantsOne hundred ninety-nine consecutive individuals with hip fracture aged 65 and older.InterventionMedication reviews, based on assessments of risks of falls and fractures, regarding fracture-preventing and fall-risk-increasing drugs, performed by a physician, conveyed orally and in written form to hospital physicians during the hospital stay, and to general practitioners after discharge.MeasurementsPrimary outcomes were changes in treatment with fracture-preventing and fall-risk-increasing drugs 12 months after discharge. Secondary outcomes were falls, fractures, deaths, and physicians' attitudes toward the intervention.ResultsAt admission, 26% of intervention and 29% of control participants were taking fracture-preventing drugs, and 12% and 11%, respectively, were taking bone-active drugs, predominantly bisphosphonates. After 12 months, 77% of intervention and 58% of control participants were taking fracture-preventing drugs (P = .01), and 29% and 15%, respectively, were taking bone-active drugs (P = .04). Mean number of fall-risk-increasing drugs per participants was 3.1 (intervention) and 3.1 (control) at admission and 2.9 (intervention) and 3.1 (control) at 12 months (P = .62). No significant differences in hard endpoints were found. The responding physicians (n = 65) appreciated the intervention; on a scale from 1 (very bad) to 6 (very good), the median rating was 5 (interquartile range (IQR) 4-6) for the oral part and 5 (IQR 4-5.5) for the text part.ConclusionMedication reviews performed and conveyed by a physician increased treatment with fracture-preventing drugs but did not significantly decrease treatment with fall-risk-increasing drugs in older adults with hip fracture. Prescribing physicians appreciated this intervention.© 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

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