Impact of Osteoporotic Fractures on Work: Data From a Fracture Liaisons Service
Condition: Osteoporotic Fractures
MeSH terms: Fractures, Bone; Osteoporotic Fractures
Study type: Observational

Summary: 
      Osteoporosis is a bone disease characterized by a decrease in bone density with deterioration
      of the micro-architecture and the appearance of bone fragility, responsible for an increased
      risk of fractures. The most common osteoporotic fractures are spinal, wrist and femoral neck
      fractures. Osteoporosis affects 22.7% of women and 6.9% of men in France. Each year, around
      8.9 million fragility fractures are identified worldwide, with an incidence in France in 2017
      of 382,000 patients in France in 2017.

      The economic impact, the functional consequences and the quality of life of patients with
      osteoporosis, fracture or not, have been widely described in the literature in recent years.
      There is indeed a great alteration in the mobility, functional capacities and overall quality
      of life of these patients, measured by composite scores such as Short Form-36 (SF-36),
      EuroQol 5 Dimensions (EQ-5D) , the Health-related quality of life (HRQoL), or more
      specifically for osteoporosis, osteoporososis quality of life questionnaire (OQLQ) or its
      shortened version OLQ, the osteoporosis assessment questionnaire (OPAQ), the Quality of life
      questionnaire of the European Foundation for Osteoporosis (QUALEFFO) (specific for vertebral
      fractures), etc.

      However, few studies have focused on the repercussions of osteoporotic fractures at work,
      because this pathology affects more elderly subjects (> 65 years old) and therefore retirees.
    

Detailed description: 
      New osteoporosis management programs have emerged in recent years, in order to improve the
      management of this pathology by linking the specialties concerned. Among them, La Filière
      Fracture (in Anglo-Saxon: Fractures Liaisons Services: FLS) of the Paris Saint-Joseph
      Hospital Group (GHPSJ), created in 2015, aims to follow up patients consulting the GHPSJ for
      an osteoporotic fracture of spinal location. , the upper end of the femur or the lower end of
      the radius.

      Since the creation of the sector, 2,486 patients have been recruited; it was found that in
      529 of these patients (or 21.3%), the osteoporotic fracture occurred at an age of less than
      65 years.

      The impact on the work of an osteoporotic fracture has been little studied in the literature:
      a study focused specifically on fractures of the upper extremity of the femur, and found, in
      291 patients under 65 years recruited between 2009 and 2013, a 65% return to work rate at 12
      months, or around a third of patients who have not returned to professional activity at one
      year. A study published in 2016 assessed return to work delay and factors associated with
      return to work in 275 patients with fragility fractures in Canada; 88% had returned to work
      with an average absenteeism period of 20.5 days. The average duration of presenteeism
      (presence at work but with reduced productivity due to the fracture) was 2.9 hours in 4
      weeks. Another Japanese study found a risk ratio of 4 (p <0.001) to greater absenteeism in
      patients with several osteoporotic fractures, with no difference found in terms of
      productivity at work compared to patients with a history of a single fracture or without
      history of osteoporotic fracture. The female sex, the need for surgical management, the
      existence of work with the need to carry heavy loads were associated with a prolonged return
      to work time.

      The objective here is to assess the occupational impact of osteoporotic fractures occurring
      in active patients under 65 years of age, and to look for factors predicting a return to work
      within 3 months after the fracture.
    

Intervention name(s): No intervention
Intervention type(s): Other
Intervention description(s): All patients treated between 01/01/2017 and 12/31/2018 in the Fracture sector will be screened through the computerized medical file. For patients who meet all the eligibility criteria, the information note, study questionnaire and a stamped envelope will be sent to them by post. Without feedback from him within 30 days of this submission, the patient is considered not to have objected to the study. The patient's information as well as his non-objection will be recorded in his medical file.
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        All patients treated between 01/01/2017 and 31/12/2018 in the Fracture sector will be
        screened through the computerized medical file
      
Keywords: osteoporotic fractures; work; quality of life