title: Health resource utilisation associated with skeletal-related events in patients with bone metastases secondary to solid tumours: regional comparisons in an observational study.
abstract: Skeletal-related events (SREs) including spinal cord compression, pathologic fracture, and radiation or surgery to bone, occur frequently due to bone metastases in advanced cancer. This analysis of a multicentre, observational study was designed to describe cross-regional differences in health resource utilisation (HRU) of SREs in Western Europe and the US. Patients with bone metastases due to breast, lung or prostate cancer, or multiple myeloma who had experienced a SRE within the past 97 days were enrolled. Investigators recorded HRU associated with SREs, including hospitalisation and length of stay (LOS), outpatient visits, procedures and bisphosphonate use. This subanalysis includes 668 patients with solid tumours (US, n = 190 with 354 SREs; EU, n = 478 with 893 SREs). The rate of SREs associated with hospitalisation(s) was higher in the EU vs. the US (30% vs. 15%, P < 0.001) and LOS was longer in the EU [mean (SD) days/SRE: 19.87 (17.31) vs. 10.61 (9.39)]. However, the US was associated with higher rate of SREs with outpatient visits than the EU (88% vs. 74%, P < 0.0001) and more procedures [mean (SD)/SRE: 11.26 (7.94) vs. 6.91 (6.48)]. Bisphosphonates were less often used in the EU (65% vs. 76% of US, P = 0.0033). In patients experiencing SREs due to bone metastases, HRU patterns reflect regional diversity with a substantial burden in both regions.
authors: Medical Oncology Department, Centro Integral Oncologico Clara Campal, Madrid, Spain.
authors: I
authors: I
authors: Duran
authors: Orange Coast Memorial Medical Center, Fountain Valley, CA, USA.
authors: M G
authors: MG
authors: Fink
authors: Bristol Haematology and Oncology Centre, University Hospitals Bristol, Bristol, UK.
authors: A
authors: A
authors: Bahl
authors: Forschungszentrum Ruhr, KliFoCenter GmbH, Witten, Germany.
authors: H
authors: H
authors: Hoefeler
authors: Cancer Specialists of South Texas, Corpus Christi Cancer Center, Corpus Christi, TX, USA.
authors: A
authors: A
authors: Mahmood
authors: Universitätsmedizin Berlin, Charité Campus Benjamin Franklin, Berlin, Germany.
authors: D
authors: D
authors: Lüftner
authors: Kentucky Cancer Clinic, Hazard, KY.
authors: H
authors: H
authors: Ghazal
authors: Biostatistics, Amgen, Inc., Thousand Oaks, CA.
authors: R
authors: R
authors: Wei
authors: Global Health Economics, Amgen Inc., Thousand Oaks, CA, USA.
authors: K C
authors: KC
authors: Chung
authors: Global Health Economics, Amgen Inc., Zug, Switzerland.
authors: G
authors: G
authors: Hechmati
authors: Global Study Management, Amgen Inc., Thousand Oaks, CA.
authors: J
authors: J
authors: Green
authors: Global Health Economics, Amgen Inc., Thousand Oaks, CA, USA.
authors: C
authors: C
authors: Atchison
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000150:complications* / Q000556:secondary / Q000628:therapy; D001943:Breast Neoplasms / Q000473:pathology; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D005598:Fractures, Spontaneous / Q000209:etiology*; D005858:Germany; D006295:Health Resources / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy; D007902:Length of Stay / Q000706:statistics & numerical data; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000473:pathology; D011878:Radiotherapy / Q000706:statistics & numerical data; D013030:Spain; D013117:Spinal Cord Compression / Q000209:etiology*; D006113:United Kingdom; D014481:United States
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates
keywords: Cancer; European; management; palliative care; symptoms