INCREASED RISK OF SELF-HARM IN PATIENTS WITH OSTEOPOROSIS: A UK POPULATION STUDY

Prior, James; Whittle, Rebecca; Abdul-Sultan, Alyshah; Chew-Graham, Carolyn; Sumathipala, Athula; Sheperd, Tom; Mallen, Christian; Paskins, Zoe

Abstract

Background: Prevention of self-harm, as a key risk factor for suicide, is an international public health priority. The World Health Organization recommends that clinicians should assess the potential for self-harm in patients in high-risk groups e.g. those with chronic pain and depression. Osteoporosis is associated with chronic pain and depression, but the risk of self-harm in osteoporosis has not previously been examined.

Objective: To examine the risk of self-harm in patients with osteoporosis.

Methods: We conducted a retrospective cohort study using data from the UK Clinical Practice Research Datalink (CPRD). Our osteoporosis cohort was defined as those patients with either i) a Read code for osteoporosis or ii) a vertebral fracture Read code and aged ≥50 years. This cohort were identified between 01/01/1990–31/12/2016 and matched to controls without osteoporosis of the same gender and within the same 10-year age category. Incident self-harm was identified by a Read code after the diagnosis of osteoporosis. Characteristics of the sample were initially described and hazard ratios (HR) were obtained from cox-regression analysis to examine the risk of self-harm in patients with osteoporosis compared to matched controls. Analysis was initially unadjusted and then adjusted for age, gender, body mass index, smoking, alcohol, anxiety and depression.

Results: Over the 16-year time-period, 126,316 patients had osteoporosis. These had a mean age of 70.3 years and 84.5% were female. Incidence rates of self-harm in patients with osteoporosis and matched controls were 8.0 and 4.8 per 10,000 person-years respectively. Unadjusted HR (95% confidence interval) for patients with osteoporosis compared to matched controls were 1.67 (1.48-1.88), which decreased when adjusted to 1.46 (1.28, 1.66).

Discussion: Patients with osteoporosis in primary care are at almost 50% greater risk of self-harming compared to matched controls.

Conclusion: Though self-harm in patients with osteoporosis is rare, this group of patients is at greater risk than other matched primary care patients and clinicians need to be aware of the potential for self-harm in this group.

Citation

Prior, J., Whittle, R., Abdul-Sultan, A., Chew-Graham, C., Sumathipala, A., Sheperd, T., …Paskins, Z. (2018, December). INCREASED RISK OF SELF-HARM IN PATIENTS WITH OSTEOPOROSIS: A UK POPULATION STUDY. Poster presented at Osteoporosis Conference 2018, Birmingham, UK

• Presentation Conference Type: Poster
• Conference Name: Osteoporosis Conference 2018
• Conference Location: Birmingham, UK
• Start Date: Dec 2, 2018
• End Date: Dec 4, 2018
• Deposit Date: Jun 23, 2023
• Publisher URL: https://link.springer.com/journal/198/volumes-and-issues/29-2/supplement