Ha Yong-Chan, Lee Young-Kyun, Lim Yong-Taik, Jang Sun-Mee, Shin Chan Soo
Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
J Bone Metab. 2014 May;21(2):143-9. doi: 10.11005/jbm.2014.21.2.143. Epub 2014 May 31.
In management of osteoporosis, several concerns here have been raised. The current issue included the utilization of dual energy X-ray absorptiometry (DXA) and fracture-risk assessment (FRAX), screening of vitamin D deficiency and secondary osteoporosis, and long-term use of bisphosphonate and calcium supplements. There was no study on physicians' attitude on these current issues in Korea. Therefore, we investigated the physicians' attitude on these issues by survey.
We administered a 30-item questionnaire to all members of Korean Society for Bone and Mineral Research by email survey form. One hundred participants answered the questionnaire. The questionnaire included the questions about the physicians' attitude to current issues and the barriers to osteoporosis treatment in Korea.
Most physicians used bone densitometry devices (99%) and, central DXA was the most accessible device (95%). Eighty-eight percent were aware of FRAX®, but among them, only 19.3% used it. The main reason for not using FRAX® was the lack of time in their proactive (76%). Screening for vitamin D status and secondary osteoporosis was performed by 59% and 52% of the respondents, respectively. The lack of awareness among patients and high costs of medication were perceived as the most important barriers to osteoporosis management in Korea.
This study provides physicians' perspective to the current issue for diagnostic and treatment of osteoporosis in Korea. To further improve osteoporosis management, educational programs for patients and doctors, and the improvement of reimbursement system should be considered in Korea.
在骨质疏松症的管理方面，引发了一些问题。当前的问题包括双能X线吸收法（DXA）和骨折风险评估（FRAX）的应用、维生素D缺乏症和继发性骨质疏松症的筛查，以及双膦酸盐和钙补充剂的长期使用。在韩国，尚未有关于医生对这些当前问题态度的研究。因此，我们通过调查来探究医生对这些问题的态度。
我们通过电子邮件调查问卷的形式，向韩国骨与矿物质研究学会的所有成员发放了一份包含30个条目的问卷。100名参与者回答了问卷。问卷包括关于医生对当前问题的态度以及韩国骨质疏松症治疗障碍的问题。
大多数医生使用骨密度测量设备（99%），其中中央DXA是最容易获取的设备（95%）。88%的医生知晓FRAX®，但其中只有19.3%的医生使用它。不使用FRAX®的主要原因是主动使用时缺乏时间（76%）。分别有59%和52%的受访者进行了维生素D状态和继发性骨质疏松症的筛查。患者缺乏认知和药物成本高被认为是韩国骨质疏松症管理的最重要障碍。
本研究为韩国骨质疏松症诊断和治疗的当前问题提供了医生的观点。为进一步改善骨质疏松症管理，韩国应考虑为患者和医生开展教育项目，并改善报销制度。
