title: Quality of life and health care consumption in primary care patients with elevated serum calcium concentrations in - a prospective, case control, study.
abstract: BACKGROUND
  Patients with elevated calcium concentrations have an increased morbidity due to various underlying illnesses. However, there is a lack of studies of quality of life and health care consumption in patients with hypercalcaemia per se. The study aims to investigate quality of life and health care consumption, as measured by, sick leave, drug prescriptions and the number of visits and admissions to health care centres and hospitals, in primary care patients with elevated calcium concentrations.
  
  
  METHODS
  A prospective, case control, study in primary care centre, in Sweden. Patients with elevated, (n=127, 28 men), and normal calcium concentrations, (n=254, 56 men), mean age 61.4 year, were recruited in the study and followed during 10 years. Eighty-six percent of those alive at the time of follow up participated in a follow up visit. The study participants completed a quality of life survey, SF-36, which also were compared with the Swedish SF-36 national normative database.
  
  
  RESULTS
  Patients with elevated calcium concentrations had significantly lower quality of life both compared with the control group (patients with normal calcium concentrations) and compared with age and gender-matched reference material from the Swedish SF-36 national normative database. The group with elevated calcium concentrations had significantly more hospitalisations (p=0.017), subsequently cancer diagnoses (p<0.003), sick leave (p=0.007) and medication (p=0.002) compared with patients with normal calcium concentrations. Men with elevated calcium concentrations had more contacts with the psychosocial team (p=0.02) at the health care centre.
  
  
  CONCLUSIONS
  Elevated calcium concentrations are associated with significantly reduced quality of life and increased health care consumption and should therefore be an important warning flag that should alert the physician to further investigate and care for the patient. This is the first study in this field and the results need to be confirmed in further studies.
authors.affiliation: Institute of Medicine/Department of Public Health and Community/Primary Health Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. sofia.dalemo@vgregion.se.
authors.forename: Sofia
authors.initials: S
authors.lastname: Dalemo
authors.forename: Robert
authors.initials: R
authors.lastname: Eggertsen
authors.forename: Per
authors.initials: P
authors.lastname: Hjerpe
authors.forename: Svante
authors.initials: S
authors.lastname: Jansson
authors.forename: Kristina Bengtsson
authors.initials: KB
authors.lastname: Boström
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology