Osteoporos Sarcopenia.  2016 Mar;2(1):45-52.

Perception of severe osteoporosis amongst medical doctors in South Korea: Awareness, impact, and treatment

Affiliations
  • 1Department of Orthopaedics, Ilsan Paik Hospital of Inje University, Goyang, South Korea.
  • 2Department of Orthopaedic Surgery, Guri Hospital, Hanyang University College of Medicine, Gyeonggi-do, South Korea.
  • 3Department of Orthopaedic Surgery, KonKuk University Medical Center, KonKuk University School of Medicine, Seoul, South Korea.
  • 4Lilly Korea Ltd, Seoul, South Korea.
  • 5Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea. yschung@ajou.ac.kr

Abstract


OBJECTIVES
Little is currently known about the issues surrounding management and treatment of severe osteoporosis in South Korea. Our objective was to assess doctors' views on the perception, diagnosis, and treatment of severe osteoporosis.
METHODS
Face-to-face interviews were conducted (16 February-13 March 2015) with 100 doctors (specialists in orthopedic surgery, endocrinology, neurosurgery, family medicine, or rheumatology) who treated ≥5 severe osteoporosis (T-score ≤ -2.5, plus fracture) patients per month. Respondent demographic characteristics, their perception of severe osteoporosis, its impact and treatment, and their views on current practice and unmet needs were assessed.
RESULTS
Of 416 doctors approached, 100 completed the survey (24% response rate). Most doctors (90%) specialized in orthopedic surgery, endocrinology, or neurosurgery. When diagnosing severe osteoporosis, most doctors (79%) considered both bone mineral density and fracture. Almost all doctors (≥91%) ranked disease impact and seriousness highly, but much fewer (≤25%) doctors thought society agreed. Most doctors (89%) had concerns with current treatments, switching treatments because of the efficacy and safety of bisphosphonates (>89%), the efficacy of selective estrogen receptor modulators (>71%), and the high cost of parathyroid hormone (>73%). Parathyroid hormone was ranked highest for efficacy and was preferentially prescribed to severe osteoporosis patients (mean 32.2% of prescriptions) compared with osteoporosis patients overall (3.7%). "Limitations with reimbursement" was the most commonly cited (76%) unmet need.
CONCLUSIONS
There are concerns with the safety, efficacy, and affordability of current treatments for severe osteoporosis in South Korea, as well as a perceived lack of disease awareness amongst patients and doctors.

Keyword

Bisphosphonates; Korea; Osteoporosis; SERMs; Teriparatide

MeSH Terms

Bone Density
Diagnosis
Diphosphonates
Endocrinology
Humans
Korea*
Neurosurgery
Orthopedics
Osteoporosis*
Parathyroid Hormone
Selective Estrogen Receptor Modulators
Surveys and Questionnaires
Teriparatide
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