Association of drug combination with fracture
| Model 1*: multivariable analysis | Model 2†: IPTW propensity score analysis | ||
| HR (95% CI) | HR (95% CI) | ||
| Drug combination‡ | Benzo/opioid | REF | REF |
| 3+combo | 1.30 (0.97 to 1.74) | 1.12 (0.82 to 1.53) | |
| Benzo+GABA | 0.76 (0.59 to 0.98) | 0.82 (0.62 to 1.09) | |
| Benzo+SSRI or SNRI | 0.73 (0.52 to 1.02) | 0.75 (0.53 to 1.06) | |
| GABA +SSRI or SNRI | 1.05 (0.81 to 1.36) | 1.09 (0.83 to 1.43) | |
| Opioid +GABA | 1.19 (0.94 to 1.49) | 1.15 (0.90 to 1.45) | |
| Opioid +SSRI or SNRI | 1.12 (0.88 to 1.44) | 1.17 (0.89 to 1.53) | |
| Sex | Male | REF | |
| Female | 0.85 (0.70 to 1.02) | ||
| Age | 65–74 | REF | |
| 75–84 | 1.23 (1.03 to 1.46) | ||
| 85+ | 1.22 (0.98 to 1.53) | ||
| Race | White | REF | |
| Black | 0.97 (0.67 to 1.40) | ||
| Hispanic | 0.76 (0.50 to 1.15) | ||
| Other | 1.29 (0.84 to 1.99) | ||
| Region | WE | REF | |
| MW | 0.69 (0.54 to 0.87) | ||
| NE | 0.99 (0.78 to 1.24) | ||
| SO | 0.77 (0.63 to 0.94) | ||
| Original entitlement | Disabled/ESRD | REF | |
| Old age | 1.06 (0.89 to 1.26) | ||
| Medicaid dual eligibility | No | REF | |
| Yes | 0.85 (0.72 to 1.01) | ||
| History of fracture | 5.18 (4.36 to 6.15) | ||
| History of hospitalisation | 1.40 (1.18 to 1.66) | ||
| Chronic conditions (HR is for yes vs no) | Alcohol use disorders | 1.03 (0.76 to 1.41) | |
| Alzheimer/dementia | 1.27 (1.08 to 1.51) | ||
| Arthritis | 0.83 (0.67 to 1.03) | ||
| Asthma | 1.04 (0.86 to 1.26) | ||
| Cancer | 1.27 (1.08 to 1.49) | ||
| CKD | 1.32 (1.13 to 1.55) | ||
| COPD | 1.15 (0.97 to 1.36) | ||
| Depression | 0.90 (0.77 to 1.06) | ||
| Diabetes | 1.01 (0.81 to 1.26) | ||
| Drug use disorder | 1.35 (1.03 to 1.77) | ||
| Epilepsy | 0.92 (0.79 to 1.08) | ||
| Hearing impairment | 1.06 (0.85 to 1.32) | ||
| Hip/pelvic fracture | 0.90 (0.66 to 1.21) | ||
| Liver disease | 1.18 (0.93 to 1.49) | ||
| Migraine/headache | 1.01 (0.79 to 1.30) | ||
| Mobility impairment | 0.97 (0.74 to 1.27) | ||
| Obesity | 0.91 (0.77 to 1.08) | ||
| Osteoporosis | 1.18 (0.99 to 1.40) | ||
| Spine injury | 0.95 (0.79 to 1.15) | ||
| Vision impairment | 1.15 (0.87 to 1.53) |
*The multivariable analysis was adjusted for demographic variables, history of fracture, history of hospitalisation and chronic conditions.
†Inverse probability of treatment weighting with propensity score.
‡The p value for the overall drug combination variable is 0.0008 for the fracture models.
CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; ESRD, end-stage renal disease; GABA, gabapentinoid; IPTW, inverse probability of treatment weighting; MW, Midwest; NE, Northeast; REF, reference group; SNRI, serotonin–norepinephrine reuptake inhibitor; SO, South; SSRI, selective serotonin reuptake inhibitor; WE, West.