Association between the awareness of osteoporosis and the quality of care for bone health among Korean women with osteoporosis

Abstract

BackgroundThe prevalence of osteoporosis is increasing and is a socio-economic burden worldwide. Although screening tests for osteoporosis in Korea are easily accessible, this condition remains undertreated. Evaluating post-diagnostic behavior changes may be helpful for improving the quality of care for bone health in osteoporotic patients.MethodsAfter reviewing the Fourth Korean National Health and Nutrition Examination Survey 2008–2009, 1,114 women with osteoporosis aged >50 years were included in this cross-sectional study. Factors related to bone health were categorized into the following groups: (1) behavioral health (smoking, alcohol consumption, and physical activity); (2) measured factors (lean body mass [kg], appendicular skeletal muscle mass [kg], and serum vitamin D level [nmol/L]); and (3) nutritional factors (calcium intake, vitamin/mineral supplementation, and healthy supplementary food). Logistic regression analysis and analysis of covariance was conducted after adjusting for age, education, income, residential area, height, weight, and self-perceived health using a weighted method.ResultsDoctors diagnosed 39.5% of patients with osteoporosis, and these patients were compared with the control group. The awareness group, who had been diagnosed with osteoporosis by a doctor, had a lower proportion of smokers and higher serum vitamin D level than the control group, who had never been diagnosed with osteoporosis. No other associations were found for quality of bone health care variables. The awareness group had higher odds ratios of vitamin/mineral replacement and healthy supplementary food but no other differences were observed, indicating the patients’ beliefs in bone health care do not follow the recommended clinical guidelines (e.g. higher physical activity, lower alcohol consumption).ConclusionTo improve the quality of care for bone health in osteoporotic patients, an initial step should be the development of post-diagnostic procedures such as patient counseling and education through a multi-team care approach.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-334) contains supplementary material, which is available to authorized users.

Factors associated with bone mineral density in adults: a cross-sectional population-based study

“…With respect to behavioral factors in addition to PA, there is strong evidence that excessive alcohol consumption and smoking has a negative influence on bone metabolism (13)(14) . Regarding smoking, we found that smokers and former smokers in our study had lower BMD means than non-smokers, although these differences were not significant.…”

“…In view of this epidemiological situation, the identification of factors associated with bone health is fundamental to combat the progression of osteometabolic diseases. In this sense, studies have shown that age and gender (5)(6)(8)(9)(10) , use of medications and hormones (11)(12) , body composition (6)(7)(8)(9)(10) , behavioral and environmental aspects (13)(14) , and food consumption (15) are factors associated with bone metabolism. However, few studies have been conducted with adults of both genders (4,16) , and the existing studies assess risk factors in isolation (5,15) .…”

Care coordination in bone health screening between individual behaviors and health care services among Korean-American women across three age groups

“…The Peri-M (aged 45-55 years) women's awareness was higher (59%) than the Post-M (age 65+, 19.0%) women, so the screening behaviors were inconsistent with the studies conducted in Korea regarding awareness of osteoporosis of women aged 50 years or older in that they did not differ with age or bone condition (Kim et al, 2012;Shin, Kang, Lee, & Park, 2014). This can be explained as the transitional menopausal status in the Peri-M group might have taken it upon themselves to seek screening.…”

Pop‐up messages in order communication systems can increase awareness of osteoporosis among physicians and improve osteoporosis treatment

“…[23,24] Likewise, our pop-up messages were informative and effective for increasing the awareness of orthopaedic surgeons regarding osteoporosis. Shin et al have emphasized that post-diagnostic care should start with discontinuation of alcohol and initiation of physical exercise, [1] and osteoporosis medications and exercise programmes might be crucial for reducing morbidity and mortality after osteoporotic hip and spine fractures. Bogoch et al [25] described four categories of barriers to osteoporosis treatment: patients, physicians, orthopaedic surgeons and medical care systems.…”

“…Osteoporotic hip and spine fractures are the clinical manifestation of osteoporosis and have become a socio-economic burden throughout the world. [1,2] These fractures are associated with a high mortality rate and low quality of life, [2,3] although several studies have demonstrated that appropriate osteoporosis treatment after hip or fragility fractures reduces the risks of subsequent fracture and mortality. [4][5][6] However, secondary fracture can occur after osteoporotic hip or spine fractures, which create increases of 5% in the risk of subsequent hip fracture within 1 year, 17-21% in the risk of any fracture within 16-21 months and 29% in the risk of subsequent hip fracture within 20 years.…”