nach oben

Erschienen in:

01.12.2013 | Original Article

Fear of falling, fracture history, and comorbidities are associated with health-related quality of life among European and US women with osteoporosis in a large international study

verfasst von: F. Guillemin, L. Martinez, M. Calvert, C. Cooper, T. Ganiats, M. Gitlin, R. Horne, A. Marciniak, J. Pfeilschifter, S. Shepherd, A. Tosteson, S. Wade, D. Macarios, N. Freemantle

Erschienen in: Osteoporosis International | Ausgabe 12/2013

Einloggen, um Zugang zu erhalten

Abstract

Summary

We studied 7,897 women with postmenopausal osteoporosis to assess factors that influence health-related quality of life (HRQoL). An increased number of comorbidities, fear of falling, and previous vertebral fracture were associated with significant reductions in HRQoL. Understanding the factors that affect HRQoL may improve management of these patients.

Introduction

HRQoL is impaired in women treated for postmenopausal osteoporosis (PMO). The objective of this study was to examine the relationship between clinical characteristics, comorbidities, medical history, patient demographics, and HRQoL in women with PMO.

Methods

Baseline data were obtained and combined from two large and similar multinational observational studies: Prospective Observational Scientific Study Investigating Bone Loss Experience in Europe (POSSIBLE EU®) and in the US (POSSIBLE US™) including postmenopausal women in primary care settings initiating or switching bone loss treatment, or who had been on bone loss treatment for some time. HRQoL measured by health utility scores (EQ-5D™) were available for 7,897 women (94 % of study participants). The relationship between HRQoL and baseline clinical characteristics, medical history and patient demographics was assessed using parsimonious, multivariable, mixed-model analyses.

Results

Median health utility score was 0.80 (interquartile range 0.69–1.00). In multivariable analyses, young age, low body mass index, previous vertebral fracture, increased number of comorbidities, high fear of falling, and depression were associated with reduced HRQoL. Regression-based model estimates showed that previous vertebral fracture was associated with lower health utility scores by 0.08 (10.3 %) and demonstrated the impact of multiple comorbidities and of fear of falling on HRQoL.

Conclusions

In this large observational study of women with PMO, there was substantial interindividual variability in HRQoL. An increased number of comorbidities, fear of falling, and previous vertebral fracture were associated with significant reductions in HRQoL.

Nur mit Berechtigung zugänglich

The EQ-5D-3 L version was used in this study.

Kanis JA, Burlet N, Cooper C, Delmas PD, Reginster JY, Borgstrom F, Rizzoli R (2008) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 19:399–428PubMedCrossRef

Lips P, Cooper C, Agnusdei D, Caulin F, Egger P, Johnell O, Kanis JA, Kellingray S, Leplege A, Liberman UA, McCloskey E, Minne H, Reeve J, Reginster JY, Scholz M, Todd C, de Vernejoul MC, Wiklund I (1999) Quality of life in patients with vertebral fractures: validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Working Party for Quality of Life of the European Foundation for Osteoporosis. Osteoporos Int 10:150–160PubMedCrossRef

Adachi JD, Ioannidis G, Olszynski WP, Brown JP, Hanley DA, Sebaldt RJ, Petrie A, Tenenhouse A, Stephenson GF, Papaioannou A, Guyatt GH, Goldsmith CH (2002) The impact of incident vertebral and non-vertebral fractures on health related quality of life in postmenopausal women. BMC Musculoskelet Disord 3:11PubMedCrossRef

Randell AG, Nguyen TV, Bhalerao N, Silverman SL, Sambrook PN, Eisman JA (2000) Deterioration in quality of life following hip fracture: a prospective study. Osteoporos Int 11:460–466PubMedCrossRef

Oleksik A, Lips P, Dawson A, Minshall ME, Shen W, Cooper C, Kanis J (2000) Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res 15:1384–1392PubMedCrossRef

Silverman SL, Minshall ME, Shen W, Harper KD, Xie S (2001) The relationship of health-related quality of life to prevalent and incident vertebral fractures in postmenopausal women with osteoporosis: results from the Multiple Outcomes of Raloxifene Evaluation Study. Arthritis Rheum 44:2611–2619PubMedCrossRef

Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733PubMedCrossRef

Bianchi ML, Orsini MR, Saraifoger S, Ortolani S, Radaelli G, Betti S (2005) Quality of life in post-menopausal osteoporosis. Health Qual Life Outcomes 3:78PubMedCrossRef

Romagnoli E, Carnevale V, Nofroni I, D'Erasmo E, Paglia F, De Geronimo S, Pepe J, Raejntroph N, Maranghi M, Minisola S (2004) Quality of life in ambulatory postmenopausal women: the impact of reduced bone mineral density and subclinical vertebral fractures. Osteoporos Int 15:975–980PubMedCrossRef

10.

Dhillon V, Hurst N, Hannan J, Nuki G (2005) Association of low general health status, measured prospectively by EuroQol EQ5D, with osteoporosis, independent of a history of prior fracture. Osteoporos Int 16:483–489PubMedCrossRef

11.

Salaffi F, Cimmino MA, Malavolta N, Carotti M, Di Matteo L, Scendoni P, Grassi W (2007) The burden of prevalent fractures on health-related quality of life in postmenopausal women with osteoporosis: the IMOF study. J Rheumatol 34:1551–1560PubMed

12.

Starfield B (2006) Threads and yarns: weaving the tapestry of comorbidity. Ann Fam Med 4:101–103PubMedCrossRef

13.

Fortin M, Lapointe L, Hudon C, Vanasse A, Ntetu AL, Maltais D (2004) Multimorbidity and quality of life in primary care: a systematic review. Health Qual Life Outcomes 2:51PubMedCrossRef

14.

Fortin M, Bravo G, Hudon C, Lapointe L, Almirall J, Dubois MF, Vanasse A (2006) Relationship between multimorbidity and health-related quality of life of patients in primary care. Qual Life Res 15:83–91PubMedCrossRef

15.

van den Akker M, Buntinx F, Metsemakers JF, Roos S, Knottnerus JA (1998) Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol 51:367–375PubMedCrossRef

16.

Salkeld G, Cameron ID, Cumming RG, Easter S, Seymour J, Kurrle SE, Quine S (2000) Quality of life related to fear of falling and hip fracture in older women: a time trade off study. BMJ 320:341–346PubMedCrossRef

17.

Suzuki M, Ohyama N, Yamada K, Kanamori M (2002) The relationship between fear of falling, activities of daily living and quality of life among elderly individuals. Nurs Health Sci 4:155–161PubMedCrossRef

18.

Freemantle N, Cooper C, Roux C, Díez-Pérez A, Guillemin F, Jonsson B, Ortolani S, Pfeilschifter J, Horne R, Kakad S, Shepherd S, Möller G, Marciniak A, Martinez L (2010) Baseline observations from the POSSIBLE EU study: characteristics of postmenopausal women receiving bone loss medications. Arch Osteoporos 5:61–72PubMedCrossRef

19.

Barrett-Connor E, Ensrud K, Tosteson AN, Varon SF, Anthony M, Daizadeh N, Wade S (2009) Design of the POSSIBLE US™ study: postmenopausal women's compliance and persistence with osteoporosis medications. Osteoporos Int 20:463–472PubMedCrossRef

20.

EuroQoL EQ-5D™ (2010) EuroQol group. http://www.euroqol.org/ Accessed 13 July 2012

21.

Silverman SL (2000) The Osteoporosis Assessment Questionnaire (OPAQ): a reliable and valid disease-targeted measure of health-related quality of life (HRQOL) in osteoporosis. Qual Life Res 9:767–774CrossRef

22.

Dolan P (1997) Modeling valuations for EuroQol health states. Med Care 35:1095–1108PubMedCrossRef

23.

Harrell FE Jr, Lee KL, Mark DB (1996) Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med 15:361–387PubMedCrossRef

24.

Akaike H (1974) A new look at the statistical model identification. IEEE Trans Automat Contr 19:716–723CrossRef

25.

Shaw JW, Johnson JA, Coons SJ (2005) US valuation of the EQ-5D health states: development and testing of the D1 valuation model. Med Care 43:203–220PubMedCrossRef

26.

Kind P, Hardman G, Macran S (1999) UK population norms for EQ-5D. Discussion paper 172. York: University of York Centre for Health Economics. http://www.york.ac.uk/media/che/documents/papers/discussionpapers/CHE%20Discussion%20Paper%20172.pdf. Accessed 13 July 2012

27.

Lips P, van Schoor NM (2005) Quality of life in patients with osteoporosis. Osteoporos Int 16:447–455PubMedCrossRef

28.

Coelho R, Silva C, Maia A, Prata J, Barros H (1999) Bone mineral density and depression: a community study in women. J Psychosom Res 46:29–35PubMedCrossRef

29.

Peasgood T, Herrmann K, Kanis JA, Brazier JE (2009) An updated systematic review of health state utility values for osteoporosis related conditions. Osteoporos Int 20:853–868PubMedCrossRef

30.

Bharmal M, Thomas J 3rd (2006) Comparing the EQ-5D and the SF-6D descriptive systems to assess their ceiling effects in the US general population. Value Health 9:262–271PubMedCrossRef

Titel: Fear of falling, fracture history, and comorbidities are associated with health-related quality of life among European and US women with osteoporosis in a large international study
verfasst von: F. Guillemin
L. Martinez
M. Calvert
C. Cooper
T. Ganiats
M. Gitlin
R. Horne
A. Marciniak
J. Pfeilschifter
S. Shepherd
A. Tosteson
S. Wade
D. Macarios
N. Freemantle
Publikationsdatum: 01.12.2013
Verlag: Springer London
Erschienen in: Osteoporosis International / Ausgabe 12/2013
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-013-2408-4

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Knie-TEP: Kein Vorteil durch antibiotikahaltigen Knochenzement

29.05.2024 Periprothetische Infektionen Nachrichten

Zur Zementierung einer Knie-TEP wird in Deutschland zu über 98% Knochenzement verwendet, der mit einem Antibiotikum beladen ist. Ob er wirklich besser ist als Zement ohne Antibiotikum, kann laut Registerdaten bezweifelt werden.

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Fear of falling, fracture history, and comorbidities are associated with health-related quality of life among European and US women with osteoporosis in a large international study