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, Freemantle N
Université de Lorraine, Université Paris Descartes, EA 4360 Apemac, Nancy, France,
Osteoporos Int. 2013 Dec;24(12):3001-10. doi: 10.1007/s00198-013-2408-4. Epub 2013 Jun 11.
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.
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.
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.
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.
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.
我们研究了7897名绝经后骨质疏松症女性，以评估影响健康相关生活质量（HRQoL）的因素。合并症数量增加、害怕跌倒和既往椎体骨折与HRQoL显著降低相关。了解影响HRQoL的因素可能会改善这些患者的管理。
接受绝经后骨质疏松症（PMO）治疗的女性的HRQoL受损。本研究的目的是探讨PMO女性的临床特征、合并症、病史、患者人口统计学与HRQoL之间的关系。
从两项大型且相似的跨国观察性研究中获取并合并基线数据：欧洲前瞻性观察性科学研究调查骨质流失经历（POSSIBLE EU®）和美国的（POSSIBLE US™），包括在初级保健机构开始或转换骨质流失治疗、或已接受骨质流失治疗一段时间的绝经后女性。7897名女性（占研究参与者的94%）可获得通过健康效用评分（EQ-5D™）测量的HRQoL。使用简约的多变量混合模型分析评估HRQoL与基线临床特征、病史和患者人口统计学之间的关系。
健康效用评分中位数为0.80（四分位间距0.69 - 1.00）。在多变量分析中，年轻、低体重指数、既往椎体骨折、合并症数量增加、高度害怕跌倒和抑郁与HRQoL降低相关。基于回归的模型估计显示，既往椎体骨折与健康效用评分降低0.08（10.3%）相关，并证明了多种合并症和害怕跌倒对HRQoL的影响。
在这项对PMO女性的大型观察性研究中，HRQoL存在很大的个体间差异。合并症数量增加、害怕跌倒和既往椎体骨折与HRQoL显著降低相关。
