Global Study Shows That Majority Of Women With Osteoporosis Do Not Consider Themselves At Higher Risk For Fractures

Main Category: Menopause
Also Included In: Bones / Orthopaedics;  Women's Health / Gynecology
Article Date: 16 Sep 2008 - 0:00 PDT

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Results from the Global Longitudinal study of Osteoporosis in Women (GLOW) showed that 55 percent of women diagnosed with osteoporosis do not believe they are at a higher risk of fractures than their peers. This latest study from GLOW included more than 60,000 women over age 55 and was presented at the American Society for Bone and Mineral Research (ASBMR) 30th Annual Meeting.

"Many women aren't making the connection between their osteoporosis diagnosis and the serious consequences of the disease, namely the risk of fractures and the disability associated with those fractures," said Ethel Siris, M.D., GLOW investigator and Director of the Toni Stabile Osteoporosis Center of the Columbia University Medical Center, New York-Presbyterian Hospital, New York, New York. "This study underscores the need for physicians to help patients better understand the meaning of an osteoporosis diagnosis, not just from a clinical perspective but also from the perspective of how it could potentially impact their lives."

By definition, osteoporosis causes bones to become fragile and therefore more likely to break. If left untreated, the disease can progress painlessly until a fracture occurs. One in two women over 50 will suffer an osteoporosis related fracture in their remaining lifetime,[1] potentially causing chronic pain, reduced mobility, loss of independence and increased risk of death.[2], [3]

Results from a second GLOW study also presented at ASBMR indicated that experiencing even one fracture after the age of 45 years can reduce a woman's quality of life. This was observed for each of ten different fracture sites evaluated, namely the spine, ankle, arm, collarbone, hip, pelvis, rib, wrist, and upper and lower leg.

"Currently osteoporosis remains under-diagnosed and undertreated," said Cyrus Cooper, M.D., GLOW investigator and Director of the MRC Epidemiology Resource Centre, University of Southampton, and Norman Collison Chair of Musculoskeletal Sciences, University of Oxford, United Kingdom. "We hope that GLOW will highlight the deep impact that a fracture can have on a patient's life and create an awareness among health professionals that preventive therapy should be commenced urgently in patients with osteoporotic fractures."

Study Details

GLOW is a prospective, longitudinal, observational study of women 55 years of age and older who visited a primary care physician during the two years prior to the study. Over 60,000 women have been recruited through over 700 primary care physicians in 17 cities in the United States, Canada, Europe, and Australia. GLOW is gathering information on osteoporosis risk factors, treatment approaches, patient behaviour, and fracture outcomes with an annual patient survey over a 5 year period.

Self-perceived risk of fracture was assessed using a five-point scale ranging from "much lower" to "much higher" risk than other women of the same age. Of 60,112 patients, 11,276 reported an osteoporosis diagnosis.

Data on the occurrence of fracture since the age of 45 years was collected for 10 skeletal sites (spine, ankle, arm, collarbone, hip, pelvis, rib, wrist, and upper and lower leg). Fracture history was correlated to a patient's health-related quality of life as measured by EuroQoL EQ-5D,[4] an instrument that assesses health in the areas of mobility, self-care, usual activities of daily living, pain, and depression. The score is expressed as a health utility score, 1 representing perfect health and 0 representing death. Patients completing all of the EQ-5D questions (56,866) were included in the analysis. Mean EQ-5D scores were significantly higher in women with no fractures versus those with one or multiple fractures since the age of 45 years (0.78 vs. 0.74 and 0.65, respectively). The mean health utility score ranged from 0.76 for women with wrist fractures to 0.64 for women with spinal fractures.

GLOW is supported by an unrestricted educational grant from The Alliance for Better Bone Health (Procter & Gamble Pharmaceuticals and sanofi-aventis) and is being directed by The Center for Outcomes Research, University of Massachusetts Medical School. For more information, visit: http://www.outcomes.org/glow/

About the Center for Outcomes Research (COR)

COR is based at the University of Massachusetts, Worcester, MA, USA. The mission of COR is to collect and evaluate data that reflect real world practices and outcomes and to provide physicians with confidential reports that allow comparison of their practices to evidence based performance standards.

Center for Outcomes Research

References

[1] National Osteoporosis Foundation. Fast facts. Available at: http://www.nof.org/osteoporosis/diseasefacts.htm. Accessed August 26, 2008.

[2] Osteoporosis in the European Community: A call to action. Report by the International Osteoporosis Foundation. © Copyright 1999-2007 IOF. Accessed 06.02.08, available from http://www.iofbonehealth.org/publications/eu-policy-report-of-2001.html

[3] Keene GS, Parker MJ & Pryor GA. Mortality and morbidity after hip fractures. BMJ. 1993 (6914):307;1248-50

[4] EuroQoL Group. EuroQoL - a new facility for the measurement of health-related quality of life. Health Policy 1990; 16:199-208.

Center for Outcomes Research