Top

Published in:

Open Access 01-03-2022 | Osteoporosis | Original Article

Health-related quality of life of patients with a recent fracture attending a fracture liaison service: a 3-year follow-up study

Authors: N. Li, M. van Oostwaard, J. P. van den Bergh, M. Hiligsmann, A. Boonen, S. M. J. van Kuijk, L. Vranken, S. P. G. Bours, C. E. Wyers

Published in: Osteoporosis International | Issue 3/2022

Abstract

Summary

This study explored the course of health state utility value over 3 years in patients with a recent fracture attending a Fracture Liaison Service and suggested that the overall change in health-related quality of life was not significant, although significant improvements were observed at 6 and 12 months compared to baseline.

Introduction

To estimate the 3-year health-related quality of life (HRQoL) of patients with a recent fracture presenting at a Fracture Liaison Service (FLS) and to explore factors associated with health state utility value (HSUV).

Methods

Patients’ HSUVs were derived from the EQ-5D-5L and SF-6D and calculated at six time points. Multiple imputation was applied for missing data. Linear mixed-effects regression analysis with random intercept and slope was applied to explore the course of HSUV over 3 years. The impact of subsequent fracture and the length of time between FLS visit and patients’ index fracture on HSUV were also investigated. A backward stepwise elimination was applied to identify factors associated with HSUV.

Results

A total of 499 patients were included. The change of EQ-5D HSUV was not significant over 3-year follow-up (P = 0.52), although slightly but significantly higher HSUV was captured at 6 months (mean difference (MD): 0.015, P = 0.02) and 12 months (MD: 0.018, P = 0.01). There was no significant difference in the course of EQ-5D HSUV between fracture locations (P = 0.86). A significant increase in HSUV was only captured for patients had shorter time period (< 107 days) between FLS visit and their index fracture. Suffering a subsequent fracture was associated with significant QoL loss (MD: − 0.078, P < 0.001). Subsequent fracture, previous treatment with anti-osteoporosis medication, a prevalent vertebral fracture (grade 2 or 3), use of a walking aid, previous falls, and higher BMI were negatively associated with mean EQ-5D HSUV over 3 years. Comparable results were found using SF-6D HSUV. The lack of HRQoL data immediately after fracture and selection bias were two main limitations.

Conclusion

The 3-year change in HSUV was not statistically significant, although significant improvements were observed at 6 and 12 months in comparison with baseline. Six factors were negatively associated with EQ-5D HSUV.

Available only for authorised users

Sozen T, Ozisik L, Calik BN (2017) An overview and management of osteoporosis. Eur J Rheumatol 4(1):46–56. https://doi.org/10.5152/eurjrheum.2016.048CrossRefPubMed

Lötters FJB, van den Bergh JP, de Vries F, Rutten-van Mölken MPMH (2016) Current and future incidence and costs of osteoporosis-related fractures in The Netherlands: combining claims data with BMD measurements. Calcif Tissue Int 98(3):235–243. https://doi.org/10.1007/s00223-015-0089-zCrossRefPubMedPubMedCentral

Van Geel TACM, Huntjens KMB, Van Den Bergh JPW, Dinant GJ, Geusens PP (2010) Timing of subsequent fractures after an initial fracture. Curr Osteoporos Rep 8(3):118–122. https://doi.org/10.1007/s11914-010-0023-2

Tran T, Bliuc D, Hansen L et al (2018) Persistence of excess mortality following individual nonhip fractures: a relative survival analysis. J Clin Endocrinol Metab 103(9):3205–3214. https://doi.org/10.1210/jc.2017-02656CrossRefPubMed

McLellan AR, Gallacher SJ, Fraser M, McQuillian C (2003) The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int 14(12):1028–1034. https://doi.org/10.1007/s00198-003-1507-zCrossRefPubMed

Åkesson K, Marsh D, Mitchell PJ et al (2013) Capture the fracture: a best practice framework and global campaign to break the fragility fracture cycle. Osteoporos Int 24(8):2135–2152. https://doi.org/10.1007/s00198-013-2348-zCrossRefPubMedPubMedCentral

Lems WF, Dreinhöfer KE, Bischoff-Ferrari H et al (2017) EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures. Ann Rheum Dis 76(5):802–810. https://doi.org/10.1136/annrheumdis-2016-210289CrossRefPubMed

Eisman JA, Bogoch ER, Dell R et al (2012) Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention. J Bone Miner Res 27(10):2039–2046. https://doi.org/10.1002/jbmr.1698CrossRefPubMed

Svedbom A, Borgström F, Hernlund E et al (2018) Quality of life after hip, vertebral, and distal forearm fragility fractures measured using the EQ-5D-3L, EQ-VAS, and time-trade-off: results from the ICUROS. Qual Life Res 27(3):707–716. https://doi.org/10.1007/s11136-017-1748-5CrossRefPubMed

10.

Wolowacz SE, Briggs A, Belozeroff V et al (2016) Estimating health-state utility for economic models in clinical studies: an ISPOR good research practices task force report. Value Heal 19(6):704–719. https://doi.org/10.1016/j.jval.2016.06.001CrossRef

11.

Borgström F, Lekander I, Ivergård M et al (2013) The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) - quality of life during the first 4 months after fracture. Osteoporos Int 24(3):811–823. https://doi.org/10.1007/s00198-012-2240-2CrossRefPubMed

12.

Lesnyak O, Svedbom A, Belova K, et al. (2020) Quality of life after fragility fracture in the Russian Federation: results from the Russian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (ICUROS). Arch Osteoporos 15(1). https://doi.org/10.1007/s11657-020-0699-6

13.

Si L, Winzenberg TM, De Graaff B, Palmer AJ (2014) A systematic review and meta-analysis of utility-based quality of life for osteoporosis-related conditions. Osteoporos Int 25(8):1987–1997. https://doi.org/10.1007/s00198-014-2636-2CrossRefPubMed

14.

Singh S, Whitehurst DG, Funnell L, et al. (2019) Breaking the cycle of recurrent fracture: implementing the first fracture liaison service (FLS) in British Columbia, Canada. Arch Osteoporos 14(1). https://doi.org/10.1007/s11657-019-0662-6

15.

Inderjeeth CA, Raymond WD, Briggs AM, Geelhoed E, Oldham D, Mountain D (2018) Implementation of the Western Australian Osteoporosis Model of Care: a fracture liaison service utilising emergency department information systems to identify patients with fragility fracture to improve current practice and reduce re-fracture rates: a 12-. Osteoporos Int 29(8):1759–1770. https://doi.org/10.1007/s00198-018-4526-5CrossRefPubMed

16.

Adachi JD, Ioannidis G, Berger C et al (2001) The influence of osteoporotic fractures on health-related quality of life in community-dwelling men and women across Canada. Osteoporos Int 12(11):903–908. https://doi.org/10.1007/s001980170017CrossRefPubMed

17.

Jun HJ, Kim KJ, Lee JS, Yang SH (2015) Association between osteoporotic fractures and quality of life based on the Korean Community Health Survey of 2010. J Phys Ther Sci 27(10):3325–3328. https://doi.org/10.1589/jpts.27.3325CrossRefPubMedPubMedCentral

18.

Vranken L, Wyers CE, van Rietbergen B et al (2019) The association between prevalent vertebral fractures and bone quality of the distal radius and distal tibia as measured with HR-pQCT in postmenopausal women with a recent non-vertebral fracture at the Fracture Liaison Service. Osteoporos Int 30(9):1789–1797. https://doi.org/10.1007/s00198-019-05081-9CrossRefPubMedPubMedCentral

19.

Kanis JA, Adachi JD, Cooper C et al (2013) Standardising the descriptive epidemiology of osteoporosis: recommendations from the Epidemiology and Quality of Life Working Group of IOF. Osteoporos Int 24(11):2763–2764. https://doi.org/10.1007/s00198-013-2413-7CrossRefPubMedPubMedCentral

20.

Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8(9):1137–1148. https://doi.org/10.1002/jbmr.5650080915CrossRefPubMed

21.

Versteegh M, Vermeulen MK, Evers MAAS, de Wit GA, Prenger R, Stolk AE (2016) Dutch tariff for the five-level version of EQ-5D. Value Heal 19(4):343–352. https://doi.org/10.1016/j.jval.2016.01.003CrossRef

22.

Brazier J, Roberts J, Deverill M (2002) The estimation of a preference-based measure of health from the SF-36. J Health Econ 21(2):271–292. https://doi.org/10.1016/S0167-6296(01)00130-8CrossRef

23.

Mangen MJJ, Bolkenbaas M, Huijts SM, van Werkhoven CH, Bonten MJM, de Wit GA (2017) Quality of life in community-dwelling Dutch elderly measured by EQ-5D-3L. Health Qual Life Outcomes 15(1):1–6. https://doi.org/10.1186/s12955-016-0577-5CrossRef

24.

Fischer K, Trombik M, Freystätter G, Egli A, Theiler R, Bischoff-Ferrari HA (2019) Timeline of functional recovery after hip fracture in seniors aged 65 and older: a prospective observational analysis. Osteoporos Int 30(7):1371–1381. https://doi.org/10.1007/s00198-019-04944-5CrossRefPubMed

25.

Adachi JD, Adami S, Gehlbach S et al (2010) Impact of prevalent fractures on quality of life: baseline results from the global longitudinal study of osteoporosis in women. Mayo Clin Proc 85(9):806–813. https://doi.org/10.4065/mcp.2010.0082CrossRefPubMedPubMedCentral

26.

Jinbayashi H, Aoyagi K, Ross PD, Ito M, Shindo H, Takemoto T (2002) Prevalence of vertebral deformity and its associations with physical impairment among Japanese women: the Hizen-Oshima study. Osteoporos Int 13(9):723–730. https://doi.org/10.1007/s001980200099CrossRefPubMed

27.

Bliuc D, Alarkawi D, Nguyen TV, Eisman JA, Center JR (2015) Risk of subsequent fractures and mortality in elderly women and men with fragility fractures with and without osteoporotic bone density: the dubbo osteoporosis epidemiology study. J Bone Miner Res 30(4):637–646. https://doi.org/10.1002/jbmr.2393CrossRefPubMed

28.

Inose H, Kato T, Ichimura S, et al. (2021) Risk factors for subsequent vertebral fracture after acute osteoporotic vertebral fractures. Eur Spine J (0123456789). https://doi.org/10.1007/s00586-021-06741-3

29.

Shah A, Wu F, Jones G, Cicuttini F, Toh LS, Laslett LL. The association between incident vertebral deformities , health-related quality of life and functional impairment : a 10 . 7-year cohort study. Published online 2021.

30.

Yeam CT, Chia S, Tan HCC, Kwan YH, Fong W, Seng JJB (2018) A systematic review of factors affecting medication adherence among patients with osteoporosis. Osteoporos Int 29(12):2623–2637. https://doi.org/10.1007/s00198-018-4759-3CrossRefPubMed

31.

Gonnelli S, Caffarelli C, Nuti R (2014) Obesity and fracture risk. Clin Cases Miner Bone Metab 11(1):9–14. https://doi.org/10.11138/ccmbm/2014.11.1.009CrossRefPubMedPubMedCentral

32.

Yan LL, Daviglus ML, Liu K et al (2004) BMI and health-related quality of life in adults 65 years and older. Obes Res 12(1):69–76. https://doi.org/10.1038/oby.2004.10CrossRefPubMed

33.

Sayah F Al, Qiu W, Xie F, Johnson JA. Comparative performance of the EQ-5D-5L and SF-6D index scores in adults with type 2 diabetes. Qual Life Res. 2017;26(8):2057-2066. https://doi.org/10.1007/s11136-017-1559-8

Title: Health-related quality of life of patients with a recent fracture attending a fracture liaison service: a 3-year follow-up study
Authors: N. Li
M. van Oostwaard
J. P. van den Bergh
M. Hiligsmann
A. Boonen
S. M. J. van Kuijk
L. Vranken
S. P. G. Bours
C. E. Wyers
Publication date: 01-03-2022
Publisher: Springer London
Keywords: Osteoporosis
Osteoporosis
Published in: Osteoporosis International / Issue 3/2022
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-021-06204-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Health-related quality of life of patients with a recent fracture attending a fracture liaison service: a 3-year follow-up study

Abstract

Summary

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2022

Evaluation of estimated glomerular function (eGFR) versus creatinine clearance (CrCl) to predict acute kidney injury when using zoledronate for the treatment of osteoporosis

Association between body mass index, bone bending strength, and BMD in young sedentary women

Epidemiology and reporting of osteoporotic vertebral fractures in patients with long-term hospital records based on routine clinical CT imaging

The use of oral glucocorticoids and the risk of major osteoporotic fracture in patients with myasthenia gravis

Gait speed and spasticity are independently associated with estimated failure load in the distal tibia after stroke: an HR-pQCT study

Low serum osteocalcin levels are associated with diabetes mellitus in glucocorticoid treated patients