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Osteoporosis International
Published in: Osteoporosis International 1/2014

01-01-2014 | Original Article

Disease-specific perception of fracture risk and incident fracture rates: GLOW cohort study

Authors: C. L. Gregson, E. M. Dennison, J. E. Compston, S. Adami, J. D. Adachi, F. A. Anderson Jr, S. Boonen, R. Chapurlat, A. Díez-Pérez, S. L. Greenspan, F. H. Hooven, A. Z. LaCroix, J. W. Nieves, J. C. Netelenbos, J. Pfeilschifter, M. Rossini, C. Roux, K. G. Saag, S. Silverman, E. S. Siris, N. B. Watts, A. Wyman, C. Cooper, for the GLOW Investigators

Published in: Osteoporosis International | Issue 1/2014

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Abstract

Summary

Accurate patient risk perception of adverse health events promotes greater autonomy over, and motivation towards, health-related lifestyles.

Introduction

We compared self-perceived fracture risk and 3-year incident fracture rates in postmenopausal women with a range of morbidities in the Global Longitudinal study of Osteoporosis in Women (GLOW).

Methods

GLOW is an international cohort study involving 723 physician practices across ten countries (Europe, North America, Australasia); 60,393 women aged ≥55 years completed baseline questionnaires detailing medical history and self-perceived fracture risk. Annual follow-up determined self-reported incident fractures.

Results

In total 2,945/43,832 (6.8 %) sustained an incident fracture over 3 years. All morbidities were associated with increased fracture rates, particularly Parkinson's disease (hazard ratio [HR]; 95 % confidence interval [CI], 3.89; 2.78–5.44), multiple sclerosis (2.70; 1.90–3.83), cerebrovascular events (2.02; 1.67–2.46), and rheumatoid arthritis (2.15; 1.53–3.04) (all p < 0.001). Most individuals perceived their fracture risk as similar to (46 %) or lower than (36 %) women of the same age. While increased self-perceived fracture risk was strongly associated with incident fracture rates, only 29 % experiencing a fracture perceived their risk as increased. Under-appreciation of fracture risk occurred for all morbidities, including neurological disease, where women with low self-perceived fracture risk had a fracture HR 2.39 (CI 1.74–3.29) compared with women without morbidities.

Conclusions

Postmenopausal women with morbidities tend to under-appreciate their risk, including in the context of neurological diseases, where fracture rates were highest in this cohort. This has important implications for health education, particularly among women with Parkinson's disease, multiple sclerosis, or cerebrovascular disease.
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Literature
1.
Beaglehole R, Bonita R, Horton R et al (2011) Priority actions for the non-communicable disease crisis. Lancet 377:1438–1447PubMedCrossRef
2.
3.
van Staa TP, Dennison EM, Leufkens HG, Cooper C (2001) Epidemiology of fractures in England and Wales. Bone 29:517–522PubMedCrossRef
4.
Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767PubMedCrossRef
5.
Chen JS, Hogan C, Lyubomirsky G, Sambrook PN (2011) Women with cardiovascular disease have increased risk of osteoporotic fracture. Calcif Tissue Int 88:9–15PubMedCrossRef
6.
Drake MT, Murad MH, Mauck KF et al (2012) Clinical review. Risk factors for low bone mass-related fractures in men: a systematic review and meta-analysis. J Clin Endocrinol Metab 97:1861–1870PubMedCrossRef
7.
Janghorbani M, Van Dam RM, Willett WC, Hu FB (2007) Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture. Am J Epidemiol 166:495–505PubMedCrossRef
8.
Vestergaard P (2007) Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes–a meta-analysis. Osteoporos Int 18:427–444PubMedCrossRef
9.
Loke YK, Cavallazzi R, Singh S (2011) Risk of fractures with inhaled corticosteroids in COPD: systematic review and meta-analysis of randomised controlled trials and observational studies. Thorax 66:699–708PubMedCrossRef
10.
David C, Confavreux CB, Mehsen N, Paccou J, Leboime A, Legrand E (2010) Severity of osteoporosis: what is the impact of co-morbidities? Joint Bone Spine 77(Suppl 2):S103–S106PubMedCrossRef
11.
Bazelier MT, van Staa TP, Uitdehaag BM, Cooper C, Leufkens HG, Vestergaard P, Herings RM, de Vries F (2012) Risk of fractures in patients with multiple sclerosis: a population-based cohort study. Neurology 78:1967–1973PubMedCrossRef
12.
Dennison EM, Compston JE, Flahive J et al (2012) Effect of co-morbidities on fracture risk: findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW). Bone 50:1288–1293PubMedCrossRef
13.
Cline RR, Farley JF, Hansen RA, Schommer JC (2005) Osteoporosis beliefs and antiresorptive medication use. Maturitas 50:196–208PubMedCrossRef
14.
Gerend MA, Aiken LS, West SG, Erchull MJ (2004) Beyond medical risk: investigating the psychological factors underlying women's perceptions of susceptibility to breast cancer, heart disease, and osteoporosis. Health Psychol 23:247–258PubMedCrossRef
15.
Cooper V, Moyle GJ, Fisher M, Reilly G, Ewan J, Liu HC, Horne R (2011) Beliefs about antiretroviral therapy, treatment adherence and quality of life in a 48-week randomised study of continuation of zidovudine/lamivudine or switch to tenofovir DF/emtricitabine, each with efavirenz. AIDS Care 23:705–713PubMedCrossRef
16.
Horne R, Clatworthy J, Hankins M (2010) High adherence and concordance within a clinical trial of antihypertensives. Chronic Illn 6:243–251PubMedCrossRef
17.
Kucukarslan SN (2012) A review of published studies of patients' illness perceptions and medication adherence: lessons learned and future directions. Res Social Adm Pharm 8:371–382PubMedCrossRef
18.
Siris ES, Gehlbach S, Adachi JD et al (2011) Failure to perceive increased risk of fracture in women 55 years and older: the Global Longitudinal Study of Osteoporosis in Women (GLOW). Osteoporos Int 22:27–35PubMedCentralPubMedCrossRef
19.
Hooven FH, Adachi JD, Adami S et al (2009) The Global Longitudinal Study of Osteoporosis in Women (GLOW): rationale and study design. Osteoporos Int 20:1107–1116PubMedCentralPubMedCrossRef
20.
Ware JE, Kosinski M, Dewey JE (2000) How to Score Version 2 of the SF-36 Health Survey. Quality Metric, Incorporated, Lincoln, RI
21.
Gerend MA, Erchull MJ, Aiken LS, Maner JK (2006) Reasons and risk: factors underlying women's perceptions of susceptibility to osteoporosis. Maturitas 55:227–237PubMedCrossRef
22.
Phillipov G, Phillips PJ, Leach G, Taylor AW (1998) Public perceptions and self-reported prevalence of osteoporosis in South Australia. Osteoporos Int 8:552–556PubMedCrossRef
23.
Giangregorio L, Papaioannou A, Thabane L, DeBeer J, Cranney A, Dolovich L, Adili A, Adachi JD (2008) Do patients perceive a link between a fragility fracture and osteoporosis? BMC Musculoskelet Disord 9:38PubMedCentralPubMedCrossRef
24.
Taylor BC, Schreiner PJ, Stone KL, Fink HA, Cummings SR, Nevitt MC, Bowman PJ, Ensrud KE (2004) Long-term prediction of incident hip fracture risk in elderly white women: study of osteoporotic fractures. J Am Geriatr Soc 52:1479–1486PubMedCrossRef
25.
26.
Invernizzi M, Carda S, Viscontini GS, Cisari C (2009) Osteoporosis in Parkinson's disease. Parkinsonism Relat Disord 15:339–346PubMedCrossRef
27.
28.
Goodin DS, Frohman EM, Garmany GP Jr, Halper J, Likosky WH, Lublin FD, Silberberg DH, Stuart WH, van den Noort S (2002) Disease modifying therapies in multiple sclerosis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the MS Council for Clinical Practice Guidelines. Neurology 58:169–178PubMedCrossRef
29.
Thurman DJ, Stevens JA, Rao JK (2008) Practice parameter: assessing patients in a neurology practice for risk of falls (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 70:473–479PubMedCrossRef
30.
Zesiewicz TA, Sullivan KL, Arnulf I, Chaudhuri KR, Morgan JC, Gronseth GS, Miyasaki J, Iverson DJ, Weiner WJ (2010) Practice Parameter: treatment of nonmotor symptoms of Parkinson disease: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 74:924–931PubMedCrossRef
31.
Grimes D, Gordon J, Snelgrove B et al (2012) Canadian guidelines on Parkinson's disease. Can J Neurol Sci 39:S1–S30PubMed
32.
33.
34.
35.
36.
(2002) Guidelines for the management of rheumatoid arthritis: 2002 Update. Arthritis Rheum 46:328–346
37.
(2003) American Gastroenterological Association medical position statement: guidelines on osteoporosis in gastrointestinal diseases. Gastroenterology 124: 791–794
38.
39.
40.
Mowat C, Cole A, Windsor A et al (2011) Guidelines for the management of inflammatory bowel disease in adults. Gut 60:571–607PubMedCrossRef
41.
42.
43.
44.
Kasje WN, Denig P, De Graeff PA, Haaijer-Ruskamp FM (2004) Physicians' views on joint treatment guidelines for primary and secondary care. Int J Qual Health Care 16:229–236PubMedCrossRef
45.
Kvamme OJ, Olesen F, Samuelson M (2001) Improving the interface between primary and secondary care: a statement from the European Working Party on Quality in Family Practice (EQuiP). Qual Health Care 10:33–39PubMedCentralPubMedCrossRef
46.
Giangregorio L, Dolovich L, Cranney A, Adili A, Debeer J, Papaioannou A, Thabane L, Adachi JD (2009) Osteoporosis risk perceptions among patients who have sustained a fragility fracture. Patient Educ Couns 74:213–220PubMedCrossRef
47.
de Groot V, Beckerman H, Lankhorst GJ, Bouter LM (2003) How to measure comorbidity. A critical review of available methods. J Clin Epidemiol 56:221–229PubMedCrossRef
48.
Stockwell T, Donath S, Cooper-Stanbury M, Chikritzhs T, Catalano P, Mateo C (2004) Under-reporting of alcohol consumption in household surveys: a comparison of quantity-frequency, graduated-frequency and recent recall. Addiction 99:1024–1033PubMedCrossRef
49.
Hundrup YA, Høidrup S, Obel EB, Rasmussen NK (2004) The validity of self-reported fractures among Danish female nurses: comparison with fractures registered in the Danish National Hospital Register. Scandinavian Journal of Public Health 32:136–143PubMedCrossRef
50.
Chen Z, Kooperberg C, Pettinger MB, Bassford T, Cauley JA, LaCroix AZ, Lewis CE, Kipersztok S, Borne C, Jackson RD (2004) Validity of self-report for fractures among a multiethnic cohort of postmenopausal women: results from the Women's Health Initiative observational study and clinical trials. Menopause 11:264–274PubMedCrossRef
51.
Rosati G (2001) The prevalence of multiple sclerosis in the world: an update. Neurol Sci 22:117–139PubMedCrossRef
52.
Carmona L, Villaverde V, Hernandez-Garcia C, Ballina J, Gabriel R, Laffon A (2002) The prevalence of rheumatoid arthritis in the general population of Spain. Rheumatology (Oxford) 41:88–95CrossRef
53.
Cimmino MA, Parisi M, Moggiana G, Mela GS, Accardo S (1998) Prevalence of rheumatoid arthritis in Italy: the Chiavari Study. Ann Rheum Dis 57:315–318PubMedCrossRef
54.
55.
Gabriel SE, Crowson CS, O'Fallon WM (1999) The epidemiology of rheumatoid arthritis in Rochester, Minnesota, 1955–1985. Arthritis Rheum 42:415–420PubMedCrossRef
56.
Guo F, He D, Zhang W, Walton RG (2012) Trends in prevalence, awareness, management, and control of hypertension among United States adults, 1999 to 2010. J Am Coll Cardiol 60:599–606PubMedCrossRef
Metadata
Title
Disease-specific perception of fracture risk and incident fracture rates: GLOW cohort study
Authors
C. L. Gregson
E. M. Dennison
J. E. Compston
S. Adami
J. D. Adachi
F. A. Anderson Jr
S. Boonen
R. Chapurlat
A. Díez-Pérez
S. L. Greenspan
F. H. Hooven
A. Z. LaCroix
J. W. Nieves
J. C. Netelenbos
J. Pfeilschifter
M. Rossini
C. Roux
K. G. Saag
S. Silverman
E. S. Siris
N. B. Watts
A. Wyman
C. Cooper
for the GLOW Investigators
Publication date
01-01-2014
Publisher
Springer London
Published in
Osteoporosis International / Issue 1/2014
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-013-2438-y

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