A Survey of Osteoporosis in Thailand
Narong Bunyaratavej MD*, Suppasin Soontrapa MD**, Thawee Songpatanasilp MD***, Taninnit Leerapun MD****
Affiliation : * Department of Orthopedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Department of Orthopedic Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand *** Department of Orthopedics, Pramongkutklao Hospital, Bangkok, Thailand **** Maharaj Nakorn Chiang Mai Hospital,Chaing Mai, Thailand
This survey of osteoporotic opinion was conducted to150 Thai physicians in every part of the country with 10 questionnaires. The details of the questions concentrated on the osteoporosis in the aspects of diagnosis, management, methods of assessment, common medicine for treatment. The most responder specialty was Orthopedist (79%), others were Gynecologist (3%), Rheumatologist (5%), Internist (5%), the others (7%) respectively. The diagnosis of osteoporosis used Dual-energy X-ray absorptiometry (DXA), (81%) in the case of this equipment as well as other methods (16%) are available. The per cent of other methods are X-ray, clinical symptoms, microdensitometry, QUS, biochemical bone markers and others: 30,23,13,5,3 and 6 respectively. About twenty-five percent of physicians took responses to 21-100 cases per month while two per cent of responders had more than 100 cases per month. The most common three ranking kinds of criteria were used for initiating medication for the treatment of osteoporosis that had low bone mineral density, signs of vertebral fracture, and menopause which they considered as the importance of prophylactic medication for patients. The continuation of medication depends on the following factors: experience of serious side effect (62%), affordable expense (53%) and stable bone mass (52%). The desirable features of anti-osteoporosis agents are stopped fracture, increasing BMD, cost effectiveness, side effect, stopped bone resorption, pain relieve and drug compliance respectively. Calcium is most commonly prescribed on condition that premenopausal and postmenopausal women have without fracture or with fracture: patients are elderly and treated with the prolonged steroid application. Bisphosphonates are widely used in case of fracture in every group. Alfacalcidol, vitamin D analog is the third prescription in the above conditions. Bisphosphonate,Calcium and Alfacacidol are the common kinds of combination under the above conditions. In addition, these kinds of drugs are commonly used for continuation after the remission therapy.
Keywords : Absorptiometry, Photon, Biological markers, Bone density, Osteoporosis, Ultrasonography
