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KMID : 1120320170030000078
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Osteoporosis and Sarcopenia
2017 Volume.3 No. 0 p.78 ~ p.78
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Pharmacologic treatment improved mortality and quality of life in osteoporotic hip fracture without increasing cost: 12 months follow-up
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Phruetthiphat Ong-Art
Tutaworn Teerapat
Songpatanasilp Thawee
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Abstract
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Background: Osteoporotic hip fracture is an important cause of mortality and morbidity among the elderly patients. The effect of osteoporotic treatment on mortality has not been carefully evaluated in real-life.
Objective: To assess the effect of pharmacologic osteoporosis treatment on mortality and quality of life in osteoporotic hip fracture as well as evaluate the cost per quality adjusted life year (QALY) between patients who received pharmacologic osteoporosis treatment (treatment group) and who did not receive anti-osteoporotic drug (non-treatment group).
Methods: A prospective-cohort study was conducted from November 1st, 2012 to January 31st, 2015. All new osteoporotic hip fracture patients were enrolled and followed at 3, 6 and 12 months. Pharmacologic osteoporosis treatments include Alendronate, Risedronate, Ibandronate, Zoledronic acid, Strontium and Teriparatide depended on physician decision. In every follow up, demographic data, quality of life was measured by using EQ-5D questionnaire and the cost was collected. The predictive factors for mortality were evaluated by univariate and multivariate analyses. The cost utility was calculated.
Results: A total of 143 patients, 76 patients were in treatment group and 67 were in non-treatment group. Ten patients died. Treatment group had less mortality (2.63% vs 11.94%, p=0.046) and has better function at 12 months assessed by EQ-5D questionnaire than non-treatment group (0.53 + 0.13 vs 0.45 + 0.15, p=0.033). The predictive factors for mortality were cardiovascular diseases and not receiving osteoporosis treatment (odd ratio and 95% confidence interval were 11.2, 2.6-51.3 and 5.9, 1.1-33.3, respectively). According to incremental cost effectiveness ratio analysis, osteoporosis treatment required 86,536baht for 1 unit of QALY.
Discussion: Patients with cardiovascular problem were highest mortality even though they were received anti- osteoporotic drug because they mainly deceased from their major cardiovascular complications. Conversely, non-treatment group (approximately six times mortality rate) may be caused by sequential complication from hip fracture.
Conclusion: Osteoporosis treatment significantly decreased mortality in osteoporotic hip fracture and also improved quality of life after treatment.
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KEYWORD
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Osteoporosis, Osteoporotic hip fracture, Mortality, quality of life, Cost utility, QALY, ICER
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