OBJECTIVES : Osteoporosis causes substantial morbidity and mortality in the US. Data are limited regarding the burden of osteoporosis and related fractures. The objective of this study was to evaluate burden of illness in patients diagnosed with osteoporosis including the impact of fractures.

METHODS : Data were taken from the 2016 Adelphi US Osteoporosis Disease Specific Programme, a cross-sectional survey of physicians and their osteoporotic patients. Patient-reported outcomes (PROs) include health status as measured by European Quality of Life 5 Domains (EQ-5D) and visual analogue scale (VAS); health related quality of life (HRQoL) was assessed using the Osteoporosis Assessment Questionnaire (OPAQ) which includes physical, emotional, and symptom domain scores. Analysis of variance was used to evaluate the association between PROs and the number and site of fractures. Multivariate analyses were conducted using linear regression.

RESULTS : Physicians provided patient records for 1848 osteoporotic patients. A total of 981 (53.1%) completed the patient survey (Female: 899 [91.6%]; ≥65: 644 [65.6%]). Number of fractures significantly affected all PROs (p<0.01), with an increased number of fractures resulting in reduced health status and poorer HRQoL. In patients with a fracture, most recent fracture site was found to significantly affect PROs (p<0.01), with hip and spine fractures being associated with the greatest reduction in health status and HRQoL.

Regression analyses indicated number of fractures, age, BMI, and Charlson Comorbidity Index (CCI) are associated with lower HRQoL (p<0.05). Fracture site, CCI, gender (health status only) and age (OPAQ physical domain only) are associated with PROs in patients who have experienced a fracture (p<0.05). Interactions between age and gender are not significant in any model.

CONCLUSIONS : Occurrence of an osteoporotic fracture is associated with lower HRQoL and lower health state, which vary with age and comorbidities. Development and evaluation of interventions to reduce osteoporosis disease burden are warranted.