Quality of life and health care consumption in primary care patients with elevated serum calcium concentrations in - a prospective, case control, study.

Sofia Dalemo,Svante Jansson,Per Hjerpe,Robert Eggertsen,Kristina Bengtsson Boström

doi:10.1186/1471-2296-15-84

Abstract

BackgroundPatients with elevated calcium concentrations have an increased morbidity due to various underlying illnesses. However, there is a lack of studies of quality of life and health care consumption in patients with hypercalcaemia per se. The study aims to investigate quality of life and health care consumption, as measured by, sick leave, drug prescriptions and the number of visits and admissions to health care centres and hospitals, in primary care patients with elevated calcium concentrations.MethodsA prospective, case control, study in primary care centre, in Sweden. Patients with elevated, (n = 127, 28 men), and normal calcium concentrations, (n = 254, 56 men), mean age 61.4 year, were recruited in the study and followed during 10 years. Eighty-six percent of those alive at the time of follow up participated in a follow up visit. The study participants completed a quality of life survey, SF-36, which also were compared with the Swedish SF-36 national normative database.ResultsPatients with elevated calcium concentrations had significantly lower quality of life both compared with the control group (patients with normal calcium concentrations) and compared with age and gender-matched reference material from the Swedish SF-36 national normative database. The group with elevated calcium concentrations had significantly more hospitalisations (p = 0.017), subsequently cancer diagnoses (p < 0.003), sick leave (p = 0.007) and medication (p = 0.002) compared with patients with normal calcium concentrations. Men with elevated calcium concentrations had more contacts with the psychosocial team (p = 0.02) at the health care centre.ConclusionsElevated calcium concentrations are associated with significantly reduced quality of life and increased health care consumption and should therefore be an important warning flag that should alert the physician to further investigate and care for the patient. This is the first study in this field and the results need to be confirmed in further studies.

Highlights

Patients with elevated calcium concentrations have an increased morbidity due to various underlying illnesses
There is a lack of studies of Quality of life (QoL) in patients with hypercalcaemia per se, and it is unknown how this is reflected in health care consumption for this group of patients
There was no difference in marital status, level of education, or employment, number of smokers between patients with elevated and normal calcium concentrations

Summary

Introduction

Patients with elevated calcium concentrations have an increased morbidity due to various underlying illnesses. There is a lack of studies of quality of life and health care consumption in patients with hypercalcaemia per se. The study aims to investigate quality of life and health care consumption, as measured by, sick leave, drug prescriptions and the number of visits and admissions to health care centres and hospitals, in primary care patients with elevated calcium concentrations. The increased calcium screening has resulted in that pHPT patients are diagnosed earlier, when they have milder disease The clinical picture of pHPT, has changed during recent years from critically ill patients to patients with subtle symptoms such as depressed mood, confusion, fatigue, sleep disorders, neuromuscular symptoms or less obvious symptoms mainly diagnosed in primary care [3,4,5]. There is a lack of studies of QoL in patients with hypercalcaemia per se, and it is unknown how this is reflected in health care consumption for this group of patients

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