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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

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
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
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.
0937-941X
3001-3010
Guillemin, F.
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Martinez, L.
98bfed28-f5e9-4441-b268-6936c2b64834
Calvert, M.
f7173f4e-db7d-4d50-90be-71ae71ea7d44
Cooper, C.
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Ganiats, T.
9bf39540-9515-4be3-a08a-2cecf167bcb3
Gitlin, M.
56659348-ca04-4ceb-b4aa-5768172a4ef6
Horne, R.
57310a70-7989-45dd-8478-6a478e33ea28
Marciniak, A.
7eea38fb-e680-4db6-b41f-dd3a0973d8f2
Pfeilschifter, J.
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Shepherd, S.
dc74e030-85a8-45ab-91cc-23d74909a944
Tosteson, A.
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Wade, S.
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Macarios, D.
57f84ea7-19f1-4ffb-8235-a6209c90784d
Freemantle, N.
76c59b7f-991b-4b1b-9ecc-c1ba3e282fb5
Guillemin, F.
4b8e048f-bef0-4ecb-8cd6-662608ecff46
Martinez, L.
98bfed28-f5e9-4441-b268-6936c2b64834
Calvert, M.
f7173f4e-db7d-4d50-90be-71ae71ea7d44
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Ganiats, T.
9bf39540-9515-4be3-a08a-2cecf167bcb3
Gitlin, M.
56659348-ca04-4ceb-b4aa-5768172a4ef6
Horne, R.
57310a70-7989-45dd-8478-6a478e33ea28
Marciniak, A.
7eea38fb-e680-4db6-b41f-dd3a0973d8f2
Pfeilschifter, J.
39a39944-567b-47d5-8973-630dcd32b2cc
Shepherd, S.
dc74e030-85a8-45ab-91cc-23d74909a944
Tosteson, A.
1d7b9e9a-c19a-433a-8e79-f24a4fbf4a43
Wade, S.
32a83c28-5029-4810-a7fb-4c3d8474d55b
Macarios, D.
57f84ea7-19f1-4ffb-8235-a6209c90784d
Freemantle, N.
76c59b7f-991b-4b1b-9ecc-c1ba3e282fb5

Guillemin, F., Martinez, L., Calvert, M., Cooper, C., Ganiats, T., Gitlin, M., Horne, R., Marciniak, A., Pfeilschifter, J., Shepherd, S., Tosteson, A., Wade, S., Macarios, D. and Freemantle, N. (2013) 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. Osteoporosis International, 24 (12), 3001-3010. (doi:10.1007/s00198-013-2408-4.). (PMID:23754200)

Record type: Article

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.

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More information

Published date: December 2013
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 360436
URI: http://eprints.soton.ac.uk/id/eprint/360436
ISSN: 0937-941X
PURE UUID: beea416f-b3ba-42c4-9ea8-63c38dafbe43
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 09 Dec 2013 15:26
Last modified: 05 Nov 2019 01:59

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Contributors

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

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