Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb;25(1):177-190.
doi: 10.1111/hex.13361. Epub 2021 Sep 27.

Perspectives of patients with depression and chronic pain about bone health after a fragility fracture: A qualitative study

Joanna E M Sale  1   2   3 , Monique Gignac  4 , Lucy Frankel  1 , Stephen Thielke  5 , Earl Bogoch  6   7 , Victoria Elliot-Gibson  1 , Gillian Hawker  2   8 , Larry Funnell  9
Affiliations

Perspectives of patients with depression and chronic pain about bone health after a fragility fracture: A qualitative study

Joanna E M Sale et al. Health Expect. 2022 Feb.

Abstract

Background: Compromised bone health is often associated with depression and chronic pain.

Objective: To examine: (1) the experience of existing depression and chronic nonfracture pain in patients with a fragility fracture; and (2) the effects of the fracture on depression and pain.

Design: A phenomenological study guided by Giorgi's analytical procedures.

Setting and participants: Fracture patients who reported taking prescription medication for one or more comorbidities, excluding compromised bone health.

Main variables studied: Patients were interviewed within 6 weeks of their fracture, and 1 year later. Interview questions addressed the recent fracture and patients' experience with bone health and their other health conditions, such as depression and chronic pain, including the medications taken for these conditions.

Results: Twenty-six patients (5 men, 21 women) aged 45-84 years old with hip (n = 5) and nonhip (n = 21) fractures were recruited. Twenty-one participants reported depression and/or chronic nonfracture pain, of which seven reported having both depression and chronic pain. Two themes were consistent, based on our analysis: (1) depression and chronic pain overshadowed attention to bone health; and (2) the fracture exacerbated reported experiences of existing depression and chronic pain.

Conclusion: Experiences with depression and pain take priority over bone health and may worsen as a result of the fracture. Health care providers treating fragility fractures might ask patients about depression and pain and take appropriate steps to address patients' more general emotional and physical state.

Patient contribution: A patient representative was involved in the study conception, data interpretation and manuscript writing.

Keywords: bone health; chronic pain; depression; fragility fracture; patient perspective.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there are no conflict of interests.

References

    1. Wu Q, Liu B, Tonmoy S. Depression and risk of fractures and bone loss: an updated meta‐analysis of prospective studies. Osteoporos Int. 2018;29(6):1303‐1312. - PubMed
    1. Huang AR, Mallet L, Rochefort CM, Eguale T, Buckeridge DL, Tamblyn R. Medication‐related falls in the elderly: causative factors and preventive strategies. Drugs Aging. 2012;29(5):359‐376. - PubMed
    1. American Geriatrics Society Beers Criteria® Update Expert Panel . American Geriatrics Society 2019 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67(4):647‐694. - PubMed
    1. Mazziotti G, Canalis E, Giustina A. Drug‐induced osteoporosis: mechanisms and clinical implications. Am J Med. 2010;123:877‐884. - PubMed
    1. Chang CY, Chen WL, Liou YF. Increased risk of major depression in the three years following a femoral neck fracture—a national population‐based follow‐up study. PLoS One. 2014;9(3):e89867. - PMC - PubMed

Publication types

Grants and funding