Association of low general health status, measured prospectively by Euroqol EQ5D, with osteoporosis, independent of a history of prior fracture
Association of low general health status, measured prospectively by Euroqol EQ5D, with osteoporosis, independent of a history of prior fracture
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DOI：
10.1007/s00198-004-1705-3
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发表时间：
2005-05-01
影响因子：
4
通讯作者：
Nuki, G
中科院分区：
文献类型：
--
作者：
Dhillon, V;Hurst, N;Nuki, G
目的：目前还没有研究在转诊进行骨量测量的患者中前瞻性测量一般健康相关生活质量（HR-QOL）。本研究的目的是检查之间的关系HR-QOL，测量DXA扫描前进行，和骨密度（BMD）。与年龄和性别匹配的一般人群的HR-QOL进行了比较。设计图：HR-QOL问卷由进入随机、前瞻性、平行组试验的患者完成，以评估直接访问DXA扫描（DADS）与转诊给医院顾问的影响，由全科医生（GP）进行临床决策（Dhillon et al.，Osteoporos Int 14：326-333，2003）。在随机化和DXA扫描之前完成HR-QOL问卷。参与者：325例患者，来自爱丁堡市18个代表性的全科诊所，共77例。患者由他们的全科医生转介，他们可以获得关于确定骨质疏松症高危患者的国家指南。结果测量：使用Euroqol（EQ 5D）测量一般HR-QOL。这提供了五个维度的自我报告问题的概况（EQ 5D（概况）），健康效用（EQ 5D（效用））和视觉模拟全球自测健康评估（EQ 5D（vas））。结果如下：与一般人群相比，骨质疏松症患者自我报告的EQ 5D（特征）问题的比值比（OR）高于无骨质疏松症患者。骨质疏松症患者EQ 5D（效用）的校正均值（SD）显著低于非骨质疏松症患者（0.65 [0.28] vs 0.76 [0.27]; p < 0.01），但随着年龄的增长，差异逐渐缩小。与无骨质疏松症患者相比，骨质疏松症患者的EQ 5D（vas）经校正的平均值（SD）显著降低（68 [20] vs 76 [16]; p < 0.01）。有骨折史的患者与无骨折史的患者相比，没有这种差异。结论：与年龄匹配的女性普通人群相比，骨质疏松症女性患者的一般HR-QOL降低，无论既往骨折史如何。骨质疏松症和HR-QOL之间的因果关系（如有）尚不清楚。需要进一步的研究来确定这种关系，并确定骨质疏松症的治疗是否对HR-QOL有独立于骨折风险的有益影响。
Objectives: There have been no studies of generic health-related quality of life (HR-QOL) measured prospectively, in patients referred for bone mass measurement. The aim of this study was to examine the relationship between HR-QOL, measured before DXA scanning was undertaken, and bone mineral density (BMD). Comparison of HR-QOL with the age- and sex-matched general population was also made. Design: HR-QOL questionnaires were completed by patients who were being entered into a randomized, prospective, parallel group trial to assess the impact of direct access DXA scanning (DADS) versus referral to a hospital consultant, upon clinical decision making by general practitioners (GPs) (Dhillon et al., Osteoporos Int 14:326-333, 2003). HR-QOL questionnaires were completed prior to both randomization and DXA scanning. Participants: 325 patients from18 representative general practices of a total of 77 in the city of Edinburgh. Patients had been referred by their GPs who had access to national guidelines on the identification of patients at high risk of osteoporosis. Outcome measures: Generic HR-QOL was measured using Euroqol (EQ5D). This provides a profile of self-reported problems in five dimensions (EQ5D(profile)), health utility (EQ5D(utility)), and a visual analogue global self-rated health assessment (EQ5D(vas)). Results: Odds ratios (ORs) for any self-reported problems on EQ5D(profile) were higher in patients with osteoporosis than those without, and compared with the general population. Age-adjusted mean (SD) EQ5D(utility) was significantly lower in patients with osteoporosis than in those without (0.65 [0.28] vs 0.76 [0.27]; p < 0.01), but the difference lessened with advancing age. Age-adjusted mean (SD) EQ5D(vas) was significantly reduced in patients with compared with no osteoporosis (68 [20] vs 76 [16]; p < 0.01). There were no such differences in patients with a history of prior fracture compared with those without a history of prior fracture. Conclusions: Female patients with osteoporosis have reduced generic HR-QOL compared with the age-matched female general population, irrespective of a history of prior fracture. The causal relationship between osteoporosis and HR-QOL, if any, is unclear. Further studies are needed to define this relationship and to determine whether treatment of osteoporosis has a beneficial effect on HR-QOL independent of fracture risk.