Disability-adjusted-life-years losses in postmenopausal women with osteoporosis: a burden of illness study

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• 作者：Josep Darbà ; Lisette Kaskens ; Nuria Pérez-álvarez ; Santiago Palacios…
• 关键词：Disability ; adjusted life year ; Burden of illness ; Osteoporosis ; Menopause ; Disability weights ; Drug ; based therapy ; Osteoporotic risk fracture factors
• 刊名：BMC Public Health
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：15
• 期：1
• 全文大小：390 KB
• 参考文献：Clinician’s Guide to Prevention and Treatment of Osteoporosis. National Osteoporosis Foundation, Washington, DC
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• 刊物主题：Public Health; Medicine/Public Health, general; Epidemiology; Environmental Health; Biostatistics; Vaccine;
• 出版者：BioMed Central
• ISSN：1471-2458

文摘

Background To estimate the disability-adjusted life years (DALY) in a nationwide representative sample of postmenopausal women with osteoporosis. The effects of drug-based therapy and risk factors for osteoporotic bone fractures on DALY losses were also explored. Methods DALY were estimated based on participant’s clinical characteristics and Health-Related Quality-of-Life (HRQoL) data obtained from a cross-sectional, epidemiological one-visit study (the GINERISK study). The study enrolled postmenopausal women (at least 12-months after their last menstrual period) with osteoporosis, above 18-years old, who attended Spanish outpatient Gynaecology clinics. HRQoL was assessed using the generic SF-12v2 questionnaire, which was used to derive disutility values. Mortality rates were extracted from the Spanish national statistics database. Factors explored to be associated with DALY losses were examined using ANOVA, ANCOVA and MANCOVA models. Results DALY could be computed in 2,782 (67%) out of 4,157 postmenopausal women, with a mean (95% CI) age of 61.0 (60.7-61.2) years. Overall individual undiscounted DALY per woman were 6.1 (5.9-6.2), resulting to be significantly higher in women with severe osteoporosis with prior bone fracture; 7.8 (7.2-8.4) compared to osteoporotic women [5.8 (5.6-6.0)] or postmenopausal women with a BMD-??2.5?T-score that received a drug-based therapy [6.2 (5.8-6.5)]; F--7.0 (P--.01). Models explaining the variation in the levels of health based on the use of a selective estrogen receptor modulator (SERM) or possession of risk factors for osteoporotic BF were found (P--.05). Conclusions DALY losses were considerable amongst postmenopausal women with osteoporosis. Not having a prior bone fracture, being older, using a SERM and having less osteoporotic risk factors were all linked to less DALY losses.