title: Association between the awareness of osteoporosis and the quality of care for bone health among Korean women with osteoporosis.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.forename: Hyun-Young
authors.initials: HY
authors.lastname: Shin
authors.forename: Hee Cheol
authors.initials: HC
authors.lastname: Kang
authors.forename: Kiheon
authors.initials: K
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. smpark.snuh@gmail.com.
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Park
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000208:ethnology*; D001364:Awareness; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D009749:Nutrition Surveys / Q000379:methods; D010024:Osteoporosis / Q000208:ethnology* / Q000517:prevention & control; D011787:Quality of Health Care / Q000592:standards; D056910:Republic of Korea / Q000208:ethnology