Functional recovery in hip fracture patients: the role of pharmacotherapy

Aging Clin Exp Res. 2020 Jan;32(1):49-57. doi: 10.1007/s40520-019-01175-w. Epub 2019 Mar 21.

Abstract

Background and aim: The aim of this prospective observational cohort study was to verify the relationship between number of drugs used and functional outcome in hip fracture patients undergoing rehabilitation.

Methods: This study was conducted on 139 patients with hip fracture who underwent a rehabilitation program. Efficiency rate in the Functional Independence Measure (FIM) and Berg Balance Scale (BBS), and length of stay (LOS) were the outcome measures.

Results: At the end of rehabilitation, 66.1% of patients showed an increase in number of drugs used, while 33.9% used the same or lower number of drugs than at admission. At the end of rehabilitation patients with increased pharmacotherapy took a higher total number of drug classes (p = 0.001), had longer LOS (p = 0.009) and lower Berg efficiency (p = 0.048) than patients with the same or lower pharmacotherapy. The number of drugs used at discharge was an independent determinant of LOS (beta = 0.19, p = 0.022) and FIM efficiency (beta = - 0.20, p = 0.025). Age was a determinant of LOS (beta = 0.17, p = 0.044) and BBS efficiency (beta = - 0.23, p = 0.009), while CIRS severity was a determinant of BBS efficiency only (beta = - 0.22, p = 0.016).

Discussion: Findings of study indicate that in hip fracture patients, the number of drugs prescribed at discharge is an important indicator of LOS and rehabilitation efficiency.

Conclusions: These findings can help the physician to better plan the rehabilitation of hip fracture patients who require polypharmacy.

Keywords: Drugs; Hip fracture; Outcome; Rehabilitation.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Drug Prescriptions / statistics & numerical data
  • Female
  • Hip Fractures / drug therapy
  • Hip Fractures / rehabilitation*
  • Humans
  • Length of Stay / statistics & numerical data*
  • Male
  • Physical Therapy Modalities / organization & administration
  • Polypharmacy*
  • Prospective Studies
  • Recovery of Function / drug effects*
  • Treatment Outcome