• Korean Journal of Schizophrenia Research
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• v.24 no.1
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• pp.36-43
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• 2021

Objectives: Despite the high discontinuation rate of clozapine in refractory schizophrenia, there is limited evidence regarding the suggested treatment after clozapine discontinuation. Methods: The medical records of 37 patients who discontinued clozapine were retrospectively reviewed. The prescription patterns of antipsychotics, mood stabilizers, and antidepressants were compared at three points before and after clozapine treatment and at the most recent visit. Results: After clozapine discontinuation, 75.6% of the subjects were receiving antipsychotic polypharmacy, and 32.4% were taking more than 3 antipsychotics. The frequently used antipsychotics were olanzapine (21.5%), quetiapine (21.5%), and paliperidone (12.7%). The rates of augmentation with mood stabilizers and antidepressants were 43.2% and 29.7%, respectively. Furthermore, valproate was the most commonly used mood stabilizer (87.5%). Conclusion: Antipsychotic polypharmacy and augmentation are inevitable in schizophrenia patients for whom clozapine has been discontinued. Further research is required to improve the outcomes of polypharmacy and augmentation in schizophrenia patients.

• Korean Journal of Schizophrenia Research
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• v.22 no.1
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• pp.1-7
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• 2019

Objectives: Clozapine is the drug of choice in treatment-resistant schizophrenia. However, its use is often delayed and a significant proportion of clozapine treated patients fails to respond and experience potentially dangerous side-effects. The aim of this retrospective study was to describe the clinical characteristics of patients started on clozapine and the rate and reason of discontinuation of clozapine. Methods: Medical records of 83 patients started on clozapine during the period of 2012-2016 were reviewed. Results: Clozapine started on patients in chronic phase; the mean age of start was 38.1 years old and the mean number of psychiatric admission was 6.5. A majority (80.7%) of the patients had been subjected to antipsychotic polypharmacy prior to clozapine and most (61.5%) of them were being treated with polypharmacy including clozapine. Overall, 39 (47.0%) subjects had continued clozapine whereas 15 (18.1%) discontinued it; 29 (34.9%) were lost to follow-up. The most common reason for discontinuation was side-effects (n=13) including six life-threatening cases, most of which occurred within 6 months of its start. Conclusion: This study demonstrated that there is some evidence of delays to clozapine use, high rates of polypharmacy and significant rate of discontinuation during the early phase of clozapine treatment.

• Proceedings of the Korea Information Processing Society Conference
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• 2014.04a
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• pp.932-933
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• 2014

최근에는 의료 빅데이터 분야에서 의료기기, 의료전문가로부터 생성 또는 감지되는 사운드 생체신호(심장박동, 호흡, 맥박, 진맥) 데이터의 특징을 디지털 데이터로 추출하여 패턴 데이터로 변환한 후, 이를 빅데이터 분석 플랫폼 기반으로 분석하여 진료, 처방, 예방 등에 유용한 정보를 생성하는 모델 구축 연구가 활성화되고 있다. 본 논문에서는 사운드 생체신호 특징을 디지털 데이터로 추출하여 (주)리아컴즈 NeoQubit 빅데이터 플렛폼을 기반으로 패턴 데이터를 분석하고 예측할 수 있는 모델을 제시한다.

• Proceedings of the Korea Information Processing Society Conference
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• 2009.04a
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• pp.555-557
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• 2009

최근 의료 패러다임은 치료에서 예방과 관리의 개념으로 변화하고 있다. 특히 우리나라 성인 인구 중 20~30%에서 발견되는 만성질환은 예방과 관리가 더욱 필요한 성인병이다. 본 논문에서는 만성 질환 중 지속적인 치료와 예방 그리고 관리가 필요한 고혈압 환자들을 관리하기 위하여 생체 데이터, 검진 데이터, 문진 데이터, 생활 습관 등을 이용하여 순차패턴 방법을 적용한 고혈압 환자에 대한 약제 처방 시스템과 연관규칙을 적용하여 고혈압 환자들에게 24시간 관리가 가능하도록 하는 고혈압 환자 관리 시스템을 개발한다.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.51-58
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• 2018

Objectives : We aimed to investigate the discontinuation rate and reasons of doxepin base prescription pattern in insomnia outpatients of psychiatry department of a university hospital. Methods : 534 patients prescribed doxepin were screened. 201 patients were included and reviewed for their medical records retrospectively. The discontinuation rate and reasons of doxepin after 2 months of prescription were investigated. Patients were divided into three groups according to the prescription patterns. The initial group, prescribed doxepin as the first hypnotic, the add-on group, prescribed doxepin while maintaining existing hypnotics, and the switching group, prescribed doxepin after discontinuation of existing hypnotics. Results : The discontinuation rate after 2 months of prescription of doxepin was 56.2%. There were significant differences in the discontinuation rate among three groups. The initial group had the highest while the add-on group had the lowest (p=0.018). In reasons for discontinuation of doxepin among three groups, lack of efficacy (p<0.001) and adverse events (p<0.001) were significantly higher in the add-on group. In the initial group, patient's refusal (p=0.022) and unknown or loss to follow up (p<0.001) were significantly higher. Conclusions : The results of this study suggested that add-on is superior than switching method and gradual reduction of existing hypnotics is necessary to maintain doxepin treatment and prevent adverse events. Additional large scale prospective studies are needed to evaluate various factors and risks of discontinuation of doxepin.

• Proceedings of the Korean Society of Computer Information Conference
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• 2014.07a
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• pp.403-404
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• 2014

원 업무 효율성을 높이기 위해 최근 다양한 병원 정보 시스템들이 도입되어 왔다. 이러한 시스템들을 통해 병원에서는 다양한 데이터를 전자적인 형태로 기록하고 공유하고 있으나, 이러한 데이터들은 일반적으로 간단한 통계량을 집계하는 데에만 사용되고 있어, 보다 체계적인 방법으로 병원 운영 관리에 유용한 숨겨진 지식이나 패턴을 추출하는 방법이 필요하다. 이에 본 논문에서는 기존 병원 정보 시스템들에 의해 축적되어진 환자 이력 데이터를 분석하여 임상 서비스 프로세스 모형을 추출하는 방법을 제안한다. 환자 이력 데이터는 검사나 처방 등을 실시한 기록을 포함하는데, 일반적으로 구조가 복잡하고 데이터 소스가 분산되어 있어 단순한 방법으로 분석하는 것이 까다롭다. 따라서, 본 논문에서는 먼저 단순한 형태의 프로세스 모형을 생성하고 이를 확장해나가는 단계적인 분석 방법을 소개한다. 이러한 목적을 위해 적절한 데이터 전처리, 데이터 마이닝, 프로세스 마이닝 기법 등이 활용되었으며, 제안하는 방법을 실제 류머티스과 환자 이력 데이터에 적용하여 임상 서비스 프로세스 모형을 추출할 수 있었다.

• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.238-244
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• 2016

Background: Mupirocin, a topical antimicrobial agent has been used for patients with methicillin-resistant Staphylococcus aureus and recently mupirocin resistance was issued in some studies. The objective of this study was to analyze prescription patterns of topical mupirocin, to evaluate appropriateness of prescriptions in the ambulatory setting, and to compare frequency of mupirocin usage in South Korea with that in United States. Methods: Topical mupirocin prescription patterns (the number of prescription and a prescription period), and appropriateness of prescription (including a prescription rate over 10 days, a repeat prescription rate within 30 days and a prescription rate within labeled indications) were analyzed using the 2012 Health Insurance and Review and Assessment service-National Patient Sample dataset of South Korea. The National Ambulatory Medical Care Survey dataset was used to quantify topical mupirocin prescription in United States for comparison. Results: In South Korea, the prescriptions rate for use over 10 days was 3%, the repeat prescription rate within 30 days was 8.87% and the prescription proportion within labeled indications was 33.84%. The most frequent diagnostic code was nonbacterial infection. The prescription rate per 1000 population of topical mupirocin in South Korea was calculated to be 46.07, whereas in United States was calculated to be 13.10. Conclusion: Topical mupirocin has been used frequently and inappropriately, so further studies are required to investigate the rationale behind such prescribing mupirocin patterns.

• Journal of Veterinary Clinics
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• v.31 no.3
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• pp.233-236
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• 2014

An 11-year-old, intact male Shih Tzu presented with obesity, thin hair coat, and abdominal distention. The patient had previously received corticosteroid therapy for dermatitis. Thoracic radiographs showed incidental findings of a generally diffuse bronchointerstitial pattern and markedly radiolucent pleural lines between the middle and caudal lung lobes, but clinical signs related to the thoracic radiographic findings were absent. Echogenicity of the hepatic parenchyma was increased and bilateral adrenal glands were not enlarged on ultrasonography. On computed tomography, the central regions of the lung lobes showed ground-glass attenuation, the peripheral regions of the lung lobes were relatively hypoattenuated compared with the central regions, and hyperattenuated nodules were distributed throughout the pulmonary parenchyma. Iatrogenic hyperadrenocorticism and secondary pulmonary mineralization was diagnosed on the basis of diagnostic imaging and adrenocorticotropic hormone stimulation test.

• YAKHAK HOEJI
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• v.59 no.3
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• pp.85-91
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• 2015

Highly active antiretroviral therapy (HAART) has reduced AIDS-related morbidity and mortality; however, it has been associated with metabolic abnormalities including dyslipidemia and dysglycemia depending on the regimens used. The aims of this study were to analyze the prescription patterns of antiretroviral agents and to examine the prevalence of lipid abnormalities among the prescriptions of HAART. The electronic medical records (EMR) of HIV patients were retrospectively reviewed from January 2007 to September 2012 based on our inclusion criteria. The patients who had taken HAART for at least 3 months were included in this study. The lipid profiles of patients on antiretrovirals (ARTs) were collected from his or her laboratory data, and dyslipidemia was defined as total cholesterol (TC) ${\geq}240mg/dL$ and triglycerides (TG) >200 mg/dL. Eighty-four prescriptions were discovered during the study period. Twenty-three prescriptions were the combination of two nucleoside reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor (NNRTI). Fifty-three prescriptions were the combination of two NRTIs and one protease inhibitor (PI) and thirty-nine prescriptions of them included a PI booster. Eight prescriptions were the combination of two NRTIs and one integrase inhibitor. The Incidence of hypertriglyceridemia among the patients receiving HAART was totally about 41.7% (2NRTIs+PI regimen vs. 2NRTIs+NNRTI regimen vs. 2 NRTIs+integrase inhibitor regimen, 52% vs. 12.5% vs. 25%), but there was no incidence of hypercholesterolemia. This study investigated that the prescription medication patterns and dyslipidemia associated with lipid abnormalities among HIV patients receiving HAART. The types of HAART prescription regimens had an effect on the occurrence of hypertriglycemia. Further studies related to metabolic abnormalities and adverse effects of HIV patients on ARTs are needed in the near future.

• The Journal of the Korea Contents Association
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• v.11 no.8
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• pp.23-32
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• 2011

U-health services have been progressed as treatment and management for specific diseases and prevention services for providing the behavior management to customers according to the increase in chronic patients. The conventional U-health services provide required services and bio-information monitoring only through remote diagnoses and counsels and that represent limitations in preventing and managing metabolic syndrome patients like chronic patients. Thus, in this study a multi platform based U-health service model for managing the health of chronic patients is proposed. The multi-platform based U-health service model can provide continuous health information, diet, and exercise services regardless of the location of customers through PCs and smart phones. In addition, it is able to provide prescription services to doctors and nurses using a CDS (Clinical Decision Support) module based on clinical information. Doctors can identify the life pattern of patients through a behavior modification program and provide customized services to patients. The U-health service model provides effective services in multi-platform environments to customers and that will improve the health of chronic patients.