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The impact of incident fractures on health-related quality of life: 5 years of data from the Canadian Multicentre Osteoporosis Study

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Abstract

Summary

Using prospective data from the Canadian Multicentre Osteoporosis Study (CaMos), we compared health utilities index (HUI) scores after 5 years of follow-up among participants (50 years and older) with and without incident clinical fractures. Incident fractures had a negative impact on HUI scores over time.

Introduction

This study examined change in health-related quality of life (HRQL) in those with and without incident clinical fractures as measured by the HUI.

Methods

The study cohort was 4,820 women and 1,783 men (50 years and older) from the CaMos. The HUI was administered at baseline and year 5. Participants were sub-divided into incident fracture groups (hip, rib, spine, forearm, pelvis, other) and were compared with those without these fractures. The effects of both time and fracture type on HUI scores were examined in multivariable regression analyses.

Results

Men and women with hip fractures, compared to those without, had lower HUI measures that ranged from −0.05 to −0.25. Both women and men with spine fractures had significant deficits on the pain attributes (−0.07 to −0.12). In women, self-care (−0.06), mobility and ambulation (−0.05) were also negatively impacted. Women with rib fractures had deficits similar to women with spine fractures, and these effects persisted over time. In men, rib fractures did not significantly affect HUI scores. Pelvic and forearm fractures did not substantially influence HUI scores.

Conclusion

The HUI was a sensitive measure of HRQL change over time. These results will inform economic analyses evaluating osteoporosis therapies.

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Conflicts of interest

Alexandra Papaioannou, MD, FRCPC, MSc

Consulting and Advisory Role: Amgen, Eli Lilly, Merck Frosst, Novartis, Proctor and Gamble, sanofi-aventis, Servier

Clinical Trials: Amgen, Eli Lilly, Merck, Novartis, Proctor and Gamble, sanofi-aventis

Jacques P. Brown, MD, FRCPC has received honoraria for lecturing, consultancies, grants and research support for clinical trials: Abbott, Alpharx, Amgen, Arthrolab, sanofi-aventis Canada, Boehringer Ingelheim/Roche, Bristol-Myers Squibb, Celltech, Eli Lilly Canada, Genizon, Glaxosmithkline, Merck Frosst, Nicox, Novartis, NPS Pharma, Pfizer, Proctor and Gamble, Quintiles, Rhône-Poulenc Rorer, Servier, Wyeth, Zelos

Robert G. Josse, MB, FRCPC

Advisory boards, honoraria, research grants: Lilly, Proctor and Gamble/sanofi-aventis, Merck, Novartis, Servier, GlaxoSmithKline, Amgen, Wyeth

Emmanuel Papadimitropoulos, PhD is an employee of Eli Lilly and Company in the Research and Development division.

Stephanie M Kaiser, MD, FRCPC

Advisory Boards: Amgen, Eli Lilly, Novartis, Wyeth-Ayerst, Servier

Speaker for: Amgen, Eli Lilly, Novartis, Merck, Procter and Gamble/sanofi-aventis, AstraZeneca, Servier

David Goltzman, MD, FRCPC

Consulting Role: Lilly, Novartis, sanofi-aventis, Proctor and Gamble, Servier

Wojciech P. Olszynski, MD, FRCPC

Consulting Role: Abbott Laboratories, Limited; Merck Frosst Canada Ltd.; Amgen Canada Inc.; Novartis Pharmaceutical Canada Inc.; Aventis Pharma Inc.; Pfizer Canada Inc.; Boehringer Ingelheim (Canada) Ltd.; Procter and Gamble Pharmaceutical Canada, Inc.; Eli Lilly Canada Inc.; Sanofi-Synthelabo Canada Inc.; Genzyme Canada Inc.; Schering Canada Inc.; GlaxoSmithKline Inc.; Servier Canada Inc.; Hoffmann-LaRoche Limited; Solvay Pharma Inc.; Janssen-Ortho Inc./Ortho-Biotech; Wyeth Canada

Jonathan D. Adachi, MD, FRCPC

Consulting Role: Amgen; Astra Zeneca, Eli Lilly; GlaxoSmithKline; Merck Frosst; Novartis; Proctor and Gamble; Roche; sanofi-aventis; Servier

Clinical Trials: Eli Lilly; GlaxoSmithKline; Merck; Novartis; Pfizer; Proctor and Gamble; sanofi-aventis; Servier; Wyeth-Ayerst

Courtney C. Kennedy, MSc; George Ioannidis, MSc; Anna M. Sawka MD, FRCPC, PhD; Wilma M. Hopman, MSc; Laura Pickard MSc; Tassos Anastassiades, MD; Alan Tenenhouse, MD; Jerilynn C. Prior MD: No competing interests to declare.

Author information

Authors and Affiliations

  1. McMaster University, Hamilton Health Sciences—Chedoke Site, Building 74, 1200 Main Street West, Hamilton, ON, Canada, L8N 3Z5

    A. Papaioannou

  2. McMaster University, Hamilton, ON, Canada

    A. Papaioannou, C. C. Kennedy, G. Ioannidis, L. Pickard & J. D. Adachi

  3. St. Joseph’s Hospital, Hamilton, ON, Canada

    G. Ioannidis, L. Pickard & J. D. Adachi

  4. University of Toronto, Toronto, ON, Canada

    A. Sawka, R. G. Josse & M. Papadimitropoulos

  5. Queen’s University, Kingston, ON, Canada

    W. M. Hopman & T. Anastassiades

  6. Laval University, Sainte-Foy, QC, Canada

    J. P. Brown

  7. Dalhousie University, Halifax, ON, Canada

    S. Kaiser

  8. McGill University, Montreal, QC, Canada

    D. Goltzman & A. Tenenhouse

  9. Eli Lilly and Company, Toronto, ON, Canada

    M. Papadimitropoulos

  10. University of British Columbia, Vancouver, Canada

    J. C. Prior

  11. University of Saskatchewan, Saskatoon, SK, Canada

    W. P. Olszynski

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  1. A. Papaioannou
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  2. C. C. Kennedy
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  9. S. Kaiser
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  11. D. Goltzman
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  12. M. Papadimitropoulos
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  13. A. Tenenhouse
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  14. J. C. Prior
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  15. W. P. Olszynski
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  16. J. D. Adachi
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for the CaMos Study Group

Corresponding author

Correspondence to A. Papaioannou.

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Papaioannou, A., Kennedy, C.C., Ioannidis, G. et al. The impact of incident fractures on health-related quality of life: 5 years of data from the Canadian Multicentre Osteoporosis Study. Osteoporos Int 20, 703–714 (2009). https://doi.org/10.1007/s00198-008-0743-7

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  • DOI: https://doi.org/10.1007/s00198-008-0743-7

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