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Sleep medications linked to hip fractures in seniors

Nursing home residents who take a class of sleep medications that includes Lunesta and Ambien may be at higher risk for hip fractures compared with those who do not take these nonbenzodiazepine hypnotic drugs, according to a Harvard Medical School study.

The study involved more than 15,000 nursing home residents who were on average 81 years old and were documented by Medicare to have had a hip fracture between July 2007 and December 2008. Nearly 11 percent of the residents with hip fractures took these drugs.

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Residents who took the prescription sleep medications were 66 percent more likely to sustain a hip fracture than those who did not. The risk was greater among new users of the medications and those suffering mild to moderate mental and physical decline.

Those who took the medication for less than two months were more than twice as likely to fracture their hip, the study found.

Nonbenzodiazepenes have been known to alter memory, attention, and balance, which may be why there is a greater risk of physical injury when taking the medication, the researchers wrote.

Based on the findings, nursing home staff should try to treat sleep problems using nondrug strategies first, such as increased daytime activity and discouraging daytime napping, according to the researchers.

BOTTOM LINE: Nursing home residents who take nonbenzodiazepine hypnotic sleep medications may be at higher risk for hip fractures.

CAUTIONS: The study found an association between sleep medications and the risk of fractures, but could not prove that the drugs cause fractures.

WHERE TO FIND IT: JAMA Internal Medicine, March 4

Electronic alerts of
test results overlooked

An overload of alerts generated by an electronic health records system may have caused some physicians to overlook important abnormal test results, a study found.

Researchers at the Veterans Affairs Medical Center in Houston surveyed more than 2,500 VA primary care physicians in 2010 about the usefulness of the electronic alerts. Nearly one-third of the physicians reported missing notifications of test results. The physicians reported receiving a median of 63 alerts a day, and nearly 87 percent thought the number of notifications was excessive. Nearly 70 percent indicated they were not able to manage all the alerts they received.

The so-called information overload for physicians, as well as the difficulty some physicians find in using the electronic health record system, may put patients’ safety at risk, the researchers wrote.

BOTTOM LINE: An overload of alerts generated by an electronic health records system may cause some physicians to overlook important abnormal test results.

CAUTIONS: The study relied on self-reported answers from physicians and may underestimate or overestimate the number of alerts. Researchers did not examine whether missed alerts harmed patient care.

WHERE TO FIND IT: JAMA Internal Medicine, March 4

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