title: Osteoporosis management and the utilization of FRAX®: a survey amongst health care professionals of the Asia-Pacific.
abstract: This survey investigated osteoporosis management practices in the Asia-Pacific region. While access to anti-osteoporotic medication is reasonable, screening for secondary contributors is performed insufficiently. FRAX® is well-known, but not used by many physicians. High costs of medication and unawareness about the disease are the biggest barriers to osteoporosis care.
  
  
  OBJECTIVE
  Osteoporosis is an increasing burden amongst countries of the Asia-Pacific. The fracture risk assessment tool FRAX® has recently been introduced in some Asian countries. This study aimed to identify attitudes about osteoporosis management in general and the utilization of FRAX® in particular amongst physicians in the Asia-Pacific region.
  
  
  METHODS
  A 26-item questionnaire was distributed to the participants of the first Asian regional osteoporosis meeting of the IOF in 2010. In total, 247 valid questionnaires representing 17 countries from the Asia-Pacific region were analyzed.
  
  
  RESULTS
  Most physicians make use of bone densitometry devices (94 %) and have access to at least one type of anti-osteoporotic medication (100 %). Central dual-energy X-ray absorptiometry was the most accessible device (87 %). Oral bisphosphonates were the only medication that was available to health care professionals in all surveyed Asia-Pacific countries. Seventy-six percent were aware of FRAX®; however, among these only 62 % used it. The main reason for not using FRAX® was the lack of country-specific models (46 %). Screening for secondary osteoporosis was performed by 36 % of the respondents. The high costs of medication and lack of awareness amongst physicians and patients about the disease were perceived as the most important barriers to osteoporosis care.
  
  
  CONCLUSIONS
  More FRAX® models should be established and implemented into the local guidelines. The necessity of screening for secondary contributors to osteoporosis should be emphasized, as easily treatable causes might be identified. To further improve osteoporosis diagnosis and treatment, the awareness of osteoporosis among doctors as well as patients needs to be raised.
authors.affiliation: Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Outram Road, 169608, Singapore, Singapore. daniela.korthoewer@campus.lmu.de
authors.forename: Daniela
authors.initials: D
authors.lastname: Korthoewer
authors.forename: Manju
authors.initials: M
authors.lastname: Chandran
mesh_terms: D000328:Adult; D000368:Aged; D001208:Asia; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D003720:Densitometry / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology; D010139:Pacific Islands; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011859:Radiography; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D050071:Bone Density Conservation Agents