Influence of potentially inappropriate medications on activities of daily living for patients with osteoporotic vertebral compression fractures: A retrospective cohort study

Purpose Potentially inappropriate medications (PIMs) are a major concern in geriatric care. Osteoporotic vertebral compression fractures (OVCFs) are more common among the elderly, who are more likely to receive long-term analgesics for pain and additional medications for complications, but no studies have examined the effects of PIMs on OVCFs. The purpose of our study was to clarify the association between PIMs and activities of daily living (ADL) among patients with OVCFs. Methods The subjects were 170 patients aged 65 years or older with OVCFs treated conservatively who underwent rehabilitation between October 2014 and August 2019. Patients' clinical information, including age, sex, body mass index, total number of drugs used for treatment at admission, number and type of PIMs used at admission, bone mineral density, use of drugs for osteoporosis, fracture type, comorbidity severity, nutritional status, Barthel Index (BI), presence and extent of lower back pain, and length of hospital stay were examined retrospectively. The possible association between these clinical factors and the BI and use of PIMs was assessed. Results Ninety-seven patients (57.1%) were prescribed PIMs at admission. Mean BI at discharge was significantly lower among patients receiving PIMS (70 points vs. 83 points; p < 0.001). Multivariate analysis for BI gain after propensity score matching showed that the number of PIMs and BI at admission affected the BI gain. Conclusion The use of PIMs hindered the improvement in ADL. Our results demonstrate the importance of appropriate drug control for patients with OVCFs.