Abstract: Prospective Evaluation of Preferences and Quality of Life in Women with Hip Fractures

Prospective Evaluation of Preferences and Quality of Life in Women with Hip Fractures

ANN B. CRANNEY, DOUGLAS COYLE, WILMA M. HOPMAN, VALERIE HUM, BARBARA POWER, and PETER S. TUGWELL

ABSTRACT.

Objective. Hip fractures are a major cause of morbidity for older women, which result in impaired health related quality of life (HRQOL). Few studies have prospectively evaluated the effect of hip fractures in women on HRQOL with different health state preference measures. We compared how 4 different preference measures change in women post-hip fracture and evaluated the responsiveness of the preference measures. We also compared HRQOL in women with recent hip fractures to a control sample at baseline and to normative Canadian data at followup.

Methods. Health status measures [the Medical Outcomes Study Short Form-36 (SF-36)] and preferences (direct and indirect) of women over age 50 years with hip fractures were measured at baseline and at 3 and 9 months. Baseline preferences [Health Utilities Index (HUI), Feeling Thermometer, Standard Gamble, and SF-36] were obtained from women without hip fractures for comparison. Independent sample t tests were used to compare baseline scores of fracture and nonfracture controls. Correlations between preference and health status measures were assessed and repeated measures ANOVA was used to assess change in health status and preferences over time.

Results. Health status and preference measures were lower in women with hip fractures in comparison to nonfracture controls. After 9 months, the SF-36, HUI, Feeling Thermometer, and SF-6D scores improved significantly. Values for the SF-36 remained lower than an age-matched normative sample. The HUI and SF-6D were sensitive to change over time, but the Standard Gamble was not.

Conclusion. HRQOL and preference measures improve over time in women with recent hip fractures, with the majority of the change occurring in the initial 3 months. Our results suggest that the HUI and SF-6D are valid measures to assess change over time post-hip fracture. (J Rheumatol 2005;32:2393-9)

Key Indexing Terms:

HEALTH RELATED QUALITY OF LIFE
HIP FRACTURES
OSTEOPOROSIS

From the Ottawa Health Research Institute, Ottawa; Clinical Research Centre, Kingston General Hospital, Kingston; Department of Community Health and Epidemiology, Queen's University, Kingston; Division of Geriatric Medicine, University of Ottawa, Ottawa; and University of Ottawa Population Health Institute, Ottawa, Ontario, Canada.

Supported by a grant from the Bickell Foundation.

A.B. Cranney, MB, BCh, FRCPC, MSc; D. Coyle, PhD; V. Hum, BSc, Ottawa Health Research Institute; W.M. Hopman, MA, Clinical Research Centre, Kingston General Hospital; B. Power, MD, FRCPC, Division of Geriatric Medicine, University of Ottawa; P.S. Tugwell, MD, FRCPC, MSc, University of Ottawa Population Health Institute.

Address reprint requests to Dr. A. Cranney, Clinical Epidemiology Program, Ottawa Health Research Institute, 1053 Carling Avenue, C402, Ottawa, Ontario K1Y 4E9, Canada. E-mail: ancranney@ohri.ca

Accepted for publication June 9, 2005.