PP002: Quality of life in bisphosphonates-using patients with the osteonecrosis of the jaws

Abstract

Purpose Osteonecrosis of the jaw (ONJ) is a medical condition frequently associated with intravenous administration of bisphosphonate as chemotherapy in various types of cancers to prevent skeletal metastases. ONJ presents itself as exposed, necrotic bone. The primary aim of this study is to determine the threshold at which ONJ impacts health related quality of life (HRQoL) and modifies bisphosphonate treatment decisions. Material and methods A questionnaire was developed based on CDC’s HRQoL–14 “Healthy Days Measure” and WHOQoL-BREF questionnaires in collaboration with oncology, psychiatry and QoL experts. Subjects were chosen randomly from the clinic’s ONJ patients and 14 were deemed eligible for this survey. Oral health-specific QoL before and after ONJ was determined with the Oral Health Impact Profile (OHIP). OHIP scores were transformed to EQ5D utilities and adjusted for MBC (published utility for MBC = 0.63). Standardized health states for bone cancer and ONJ were used as guidelines. Results The study included 14 patients from the hospital’s Oral and Maxilofacial Surgery Clinic. The mean OHIP was 1.7 pre- ONJ and 8.3 after (0–28 scale). All domains were affected, with overall function and pain having the largest change. A larger OHIP score was linked to a greater number of symptoms. Rank order was appropriate and consistent across instruments. Conclusions Preliminary results suggest that the study design was. Both oral-health specific and global HRQoL instruments determined QoL changes associated with ONJ. Further QoL research may be needed.