Factors associated with the treatment of osteoporosis in Korean postmenopausal women

Factors affecting willingness to get assessed and treated for osteoporosis

Individuals with poor knowledge of osteoporosis and lower socioeconomic status, including being single and having a lower level of annual income, are less likely to be assessed or treated for osteoporosis. Individuals with particular osteoporosis risk factors such as smokers and heavy drinkers are overlooked for diagnosis. Further study is needed to identify and address the existing barriers and to promote osteoporosis management for women with these risk factors.

INTRODUCTION

Despite the negative health consequences of osteoporosis and the availability of effective treatment, a pervasive and persistent prevention care gap for osteoporosis remains present throughout the world. We attempted to identify the factors affecting the willingness of patients to either undergo or avoid assessment and treatment for osteoporosis.

METHODS

A nationwide online survey was conducted in 926 Korean women over age 50. The survey included questions addressing three domains: (1) clinical and socio-demographic characteristics, (2) questions concerning the reasons for undergoing or avoiding osteoporosis assessment or treatment, and (3) knowledge of osteoporosis as measured using the modified Korean version of Facts on Osteoporosis Quiz. The assessed and non-assessed participants were compared in terms of their clinical and socioeconomic statuses, reasons for undergoing or avoiding osteoporosis management, and levels of knowledge of osteoporosis.

RESULTS

The highest-ranked reason for undergoing osteoporosis assessment was fear of osteoporotic fracture, while the highest-ranked reason for avoiding osteoporosis assessment was not feeling a need to get tested for osteoporosis. Participants who sought assessment for osteoporosis were older and more likely to be married, and had greater knowledge of osteoporosis than those who did not seek assessment. The two groups were found to be similar in terms of tobacco use and daily alcohol use. Patients who had been diagnosed with osteoporosis but either did not initiate or discontinued osteoporosis treatment within 1 year were younger and had lower levels of annual income than those who began and continued treatment.

CONCLUSION

Individuals with poor knowledge of osteoporosis and those of lower socioeconomic status, including those who were single and had a lower level of annual income, were less likely to be assessed and treated for osteoporosis. Individuals with particular osteoporosis risk factors such as smokers and heavy drinkers are overlooked for diagnosis. Further study is needed to identify and address the existing barriers and to promote osteoporosis management for women with these risk factors.

The effects of exercise training and type of exercise training on changes in bone mineral denstiy in Korean postmenopausal women: a systematic review

[Purpose]

To systematically review the effects of exercise training and the type of exercise training on changes in bone mineral density (BMD) in Korean postmenopausal women.

[Methods]

Korean studies Information Service System (KISS) and PubMed were searched and 17 randomized control trials were selected. Changes in BMD of lumbar spine (LS), femur neck (FN), Ward’s triangle (WT), and trochanter (Tro) were chosen as major outcomes.

[Results]

Exercise training increased BMD of LS, FN, WT, and Tro. According to the type of exercise training, combined exercise training (aerobic + resistance) showed improvements in BMD of LS, FN, WT, and Tro. However, aerobic exercise training alone and resistance exercise training alone showed inconsistent results.

[Conclusion]

Exercise training can improve the BMD of LS, FN, WT, and Tro in Korean postmenopausal women. The type of exercise training may be a crucial factor for maintaining or improving bone health of this population.

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

Background

The 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.

Methods

After 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.

Results

Doctors 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).

Conclusion

To 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 material

The online version of this article (doi:10.1186/1471-2474-15-334) contains supplementary material, which is available to authorized users.