Osteoporosis is a common chronic disease in aging populations with an increasing incidence worldwide [1]. Since baby boomers in Korea are aging, issues related to bone health and chronic conditions have not only become medical problems, but also a socio-economic burden [2]. Despite the increase in its significance, osteoporosis is widely recognized as a preventable and treatable disease; therefore, an appropriate detection and management system that includes lifestyle modifications may minimize the burden on public health resources worldwide. Although clinical guidelines recommend cessation of tobacco use, avoidance of excessive alcohol intake, participation in regular exercise, and an adequate intake of calcium and vitamin D for maintaining bone health [3], several studies have shown that osteoporosis patients do not follow the recommended clinical guidelines after diagnosis of the disease [4].
In Korea, the national health care system enables people to easily access medical institutions where they can undergo dual energy x-ray absorptiometry (DEXA) scans to screen for low bone mineral density (BMD), which can indicate osteoporosis [5]. However, there is a lack of standardized post-diagnostic and follow-up care, which consequently results in the undertreatment of osteoporosis [6,7]. Moreover, there is a lack of studies reporting on the compliance of clinical guidelines for bone health behavior following a diagnosis of osteoporosis in Korea. Understanding which bone health behaviors are well performed or not may be helpful in the implementation of education or intervention programs to improve the bone health status of osteoporosis patients. Therefore, we analyzed the quality of care for bone health in relation to patients’ awareness of their disease using data from the Fourth Korean National Health and Nutrition Examination Survey 2008–2009 (KNHANES IV).