title: Determinants of health-related quality of life in women with vertebral fractures.
abstract: Health-related quality of life (HRQL) is an important consideration in the management of patients with vertebral fractures. The purpose of this study was to examine patient-related factors that contribute to HRQL after vertebral fractures, including co-morbidities, medications, fracture history, family disease history, demographics, exercise, education and living environment. A total of 1,129 post-menopausal women (mean age 67.2, SD 11.9 years) was studied from the Canadian Database of Osteoporosis and Osteopenia (CANDOO). HRQL was measured using the mini-osteoporosis quality of life questionnaire (mini-OQLQ). Separate multivariable linear regression analyses [parameter estimates and corresponding 95% confidence intervals (CI)] were performed for each of the five mini-OQLQ domains: symptoms, physical functioning, emotional functioning, activities of daily living and leisure domains. A strong positive association was found between HRQL and post-secondary education, a family history of osteoporosis, working and thiazide therapy. Exercise improved HRQL; however, several hours a week were required to be meaningful. Living in long-term care had the most marked negative effect on HRQL. Smoking, past surgery of the hip or spine, sedatives, anticonvulsants, atherosclerotic disease and hypertension were also associated with a substantially decreased HRQL across several domains. Calcium channel-blockers, chemotherapy, corticosteroids, diabetes, migraines, the number of non-vertebral fractures and falls had a negative impact on selected domains. We demonstrated that several modifiable factors influence HRQL in patients with vertebral fractures, and physicians should be aware of these and other markers of reduced HRQL to enhance patient care.
authors.affiliation: Department of Medicine, McMaster University, Hamilton, Ontario, Canada. papaioannou@hhsc.ca
authors.forename: Alexandra
authors.initials: A
authors.lastname: Papaioannou
authors.forename: Courtney C
authors.initials: CC
authors.lastname: Kennedy
authors.forename: George
authors.initials: G
authors.lastname: Ioannidis
authors.forename: Jacques P
authors.initials: JP
authors.lastname: Brown
authors.forename: Anjali
authors.initials: A
authors.lastname: Pathak
authors.forename: David A
authors.initials: DA
authors.lastname: Hanley
authors.forename: Robert G
authors.initials: RG
authors.lastname: Josse
authors.forename: Rolf J
authors.initials: RJ
authors.lastname: Sebaldt
authors.forename: Wojciech P
authors.initials: WP
authors.lastname: Olszynski
authors.forename: Alan
authors.initials: A
authors.lastname: Tenenhouse
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Murray
authors.forename: Annie
authors.initials: A
authors.lastname: Petrie
authors.forename: Charles H
authors.initials: CH
authors.lastname: Goldsmith
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Adachi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001416:Back Pain / Q000209:etiology; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002170:Canada; D002318:Cardiovascular Diseases / Q000150:complications / Q000523:psychology; D016208:Databases, Factual; D004522:Educational Status; D004644:Emotions; D015914:Estrogen Replacement Therapy; D005260:Female; D005598:Fractures, Spontaneous / Q000150:complications; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications; D011788:Quality of Life; D012907:Smoking / Q000009:adverse effects; D016103:Spinal Fractures / Q000150:complications / Q000235:genetics / Q000523:psychology*; D011795:Surveys and Questionnaires; D049971:Thiazides / Q000627:therapeutic use
chemical_list: D002121:Calcium Channel Blockers; D049971:Thiazides