• 한국임상약학회지
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• 제24권3호
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• pp.193-198
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• 2014

Objective: This study was conducted to compare the adherence, clinical and economical utility of fixed-dose combination tablets of sitagliptin/metformin with concomitant administration of sitagliptin and metformin in patients with type 2 diabetes mellitus. Methods: Adherence was measured as the medication possession ratio (MPR) of ${\geq}80%$, and MPR was calculated as the number of total prescription days divided by the total treatment period. Hemoglobin $A_{1C}$ ($HbA_{1c}$) differences between baseline and predetermined periods were analyzed. Proportions of patients who achieved $HbA_{1c}$ less than 6.5% for three or more consecutive times were compared. To evaluate cost-effectiveness, prices of sitagliptin, metformin and sitagliptin/metformin tablets were investigated. Results: More than 90% of patients showed adherence in both groups (92.0% in fixed-dose combination group vs 95.9% in concomitant administration group), and there was no statistically significant difference (P = 0.113). Proportion of patients with HbA1c less than 6.5% for three or more consecutive times tended to be somewhat higher in fixed dose combination group than in concomitant administration group without a statistically significant difference (32.6% vs. 28.0%, P = 0.344). Total price of metformin and sitagliptin was cheaper up to 222 KRW in the case of fixed-dose combination tablets compared to the case of concomitant administration. Conclusion: The sitagliptin/metformin fixed-dose combination tablet had a similar patient adherence and was not significantly different in efficacy to the concomitant administration of each component. In terms of drug prices, fixed-dose combination tablets were cheaper than concomitant administration of each tablet.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.117-132
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• 1996

The purpose of this study was to evaluate the bacterial adherence on e-PTFE membrane immersed in whole saliva from subjects with different periodontal status. Experiment involved 3 subject groups: 5 persons with healthy periodontium(probing depth below 3mm and no signs of gingival inflammation including bleeding on probing), 10 patients with gingivitis(probing depth below 3mm and apparent signs of gingival inflammation), and 10 patients with advanced periodontitis(probing depth over 7mm and apparent signs of gingival inflammation). Each disease group was included before and after scaling and root planing treatment. After obtaining whole saliva from each subject, e-PTFE membrane(Gore-Tex periodontal membrane : $GTPM^{(R)}$, W.L. Gore & Associates, Flagstaff, USA) specimens were immersed at room temperature in the saliva aliqouts for 1, 3, 7 days. The weight between pre - and post - immersion in saliva was measured with the analytical balance and the difference was recorded. The specimens were processed for SEM observation. The bacterial adherence on the membrane specimens was evaluated using the scanning electron microscope images. The obtained results were as follows : 1. There was no difference in the weight of bacteria adherent to e-PTFE membrane specimens according to the periodontal status and the immersion periods. 2. As the exposure time to saliva increased, the bacterial adherence to the membrane specimen significantly increased in all groups(P<0.005). 3. As the severity of periodontal disease increased, the bacterial adherence to the membrane specimens significantly increased(p<0.001). 4. After scaling and root planing, the bacterial adherence to the membrane specimens significantly decreased in gingivitis and periodontitis patient group(P<0.001). These results suggest that bacterial contamination on exposed barrier membrane surface be reduced through improvement of periodontal status and oral health environment before and after GTR procedure for the successful outcome.

• 보건행정학회지
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• 제25권2호
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• pp.90-96
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• 2015

Background: This study aimed to research on how adherence and blood control could make a difference when it comes to develop complications. Methods: The study's subjects were 255,916 patients who were newly diagnosed with hypertension in 2009 using data collected by National Health Insurance Cooperation. Patients are considered as a group under adherence if visit days and prescription days are more than 300 days. Patients are considered to have successfully controled their hypertension based on actual value measured by National Health Insurance Cooperation and the study takes a look at whether they were diagnosed with complications of cerebrocardiovascular disease in 2012. Chi-square test and logistic regression was used to analyze. Results: Patients who were able to control their hypertension show 0.80 times chance of developing cerebrovascular disease, and 0.89 times chance of developing cardiocerebrovascular disease. The group of adherence shows lower chance of developing complication in general than the group of non-adherence. Conclusion: The study revealed that hypertension's constant treatment could control the blood pressure and prevent complications. It is important that encourages patients to effort for persistent treatment for reducing complication.

• 한국융합학회논문지
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• 제12권12호
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• pp.125-137
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• 2021

본 연구는 지역사회 노인복지관 이용 노인의 주관적 건강상태, 의료인과 의사소통, 약물오남용이 약물복용이행에 대한 융합 영향요인을 파악하기 위한 서술적 조사연구이다. 본 연구 대상자는 지역사회 노인복지관 이용 노인 179명이었다. 자료는 2020년 1월13일부터 2020년 1월17일까지 수집하였다. 자료분석은 빈도, 백분율, 평균, 표준편차, t-test, ANOVA, 사후검정은 Scheffe test, Pearson's correlation coefficients, 다중회귀분석을 실시하였다. 본 연구 회귀식은 약물복용이행을 24%를 설명하였다. 대상자의 약물복용이행에 가장 큰 영향을 미치는 요인은 약물오남용(𝛽=-4.32, p=<.001)이었고 다음은 만성질환 유,무(𝛽=-3.04, p=.003), 결혼상태(𝛽=2.64, p=.009), 의료인과 의사소통(𝛽=2.26, p=.025 ) 순으로 나타났다. 따라서 지역사회 노인복지관 이용 노인의 약물복용이행을 위한 융합적 시스템 구축이 요구된다.

• Journal of Preventive Medicine and Public Health
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• 제54권3호
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• pp.190-198
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• 2021

Objectives: Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes. Methods: This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study. Results: Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members' advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55). Conclusions: Knowledge of the adverse effects of diabetes, physicians' and healthcare providers' advice about the benefits of early disease detection, and family members' advice were independent predictors of screening adherence.

• 임상간호연구
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• 제25권2호
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• pp.170-178
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• 2019

Purpose: The purpose of this study was to determine the mediating effects of self-efficacy and the belief about medication on the association between depression and medication adherence in patients with systemic lupus erythematosus. Methods: 128 patients aged ${\geq}19years$, who were regular outpatients or admitted patients diagnosed with systemic lupus erythematosus at a tertiary hospital in B city, participated in this study. Data were collected by using a self-administered questionnaire. Testing of mediating effects was analyzed by a parallel redundant mediated model using the PROCESS macro for SPSS version 3.3. Results: They scored an average of $16.71{\pm}11.13$ for depression, $694.14{\pm}170.68$ for self-efficacy, $3.05{\pm}4.60$ for the belief about medication, and $90.14{\pm}15.37$ for medication adherence. The direct effect of depression on medication adherence was not statistically significant, but the indirect effects of depression mediated with self-efficacy and belief about medication were statistically significant. Conclusion: It is necessary to develop and apply a nursing intervention program that can not only relieve depression but also promote self-efficacy and the belief about medication with the objective of improving medication adherence among patients with systemic lupus erythematosus.

• 한국의료질향상학회지
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• 제25권1호
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• pp.52-65
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• 2019

Purpose: Outbreaks resulting from medication injections have recently been on the rise in Korea despite various established guidelines. The objective of this study was to assess the degree to which healthcare professionals are aware of safe injection practice guidelines and to account for the adherence to and the deviation from safe injection guidelines formulated by healthcare providers. Methods: In November 2016, a cross-sectional anonymous questionnaire covering general characteristics of injections, patient safety culture, awareness of safe injection practices, and adherence to and barriers to safe injection guidelines was issued to healthcare providers who administer medication injections or manage and supervise these injections (N=550). Multivariate logistic regression analysis via enter method was performed to define the influencing factors of adherence of safe injection practices. Results: On average, respondents adhere to 17 of the 24 guidelines. Multivariate logistic regression found that those who were more likely to adhere to safe injection guidelines either underwent a patient safety training experience within the last year, provided care in a setting characterized by a highly developed patient safety culture, or were employed as physicians or nurses, as opposed to some other type of care provider. Barriers to safe injection guidelines were attributable to; thoughts of waste to discard leftover medicine, provisions that made adherence cumbersome, a weak culture of compliance, and insufficient amounts of injectable medicine, products, and education. Conclusions: The results of this study indicate that controllable factors like training experience of healthcare providers and patient safety culture were positively associated with adherence to safe injection practices. It was suggested that the training of healthcare providers on safe injection practices be a continuous process to promote patient safety. Additionally, there should be an increased focus on developing and implementing policies to improve patient safety culture from a prevention rather than post-management perspective.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제25권2호
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• pp.65-72
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• 2014

Objectives : The objective of this study was to evaluate the treatment duration and adherence of osmotic-controlled release oral delivery system (OROS) methylphenidate for treatment of attention-deficit hyperactivity disorder (ADHD). Methods : A total of 843 children with ADHD were recruited : 213 children (25.3%) who had previously taken medications for ADHD and 630 drug-na$\ddot{i}$ve children (74.7%) were recruited. The dosage was adjusted according to the clinician's judgment. The primary efficacy endpoint of this study was treatment retention rate, which was estimated at Week 12 and Week 20 using the Kaplan-Meier curve. The Swanson, Nolan and Pelham-IV (SNAP-IV), Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement, and the side effect rating scale were measured at every visit. Remission rates were presented based on SNAP-IV and CGI-S, respectively. Results : The treatment retention rate at 12 weeks and at 20 weeks was 76.2% and 66.8%, respectively. Divided according to 6-8, 9-11, 12-14 and 15-18 years of age, younger children tended to show a statistically higher treatment retention rate (p=.02). Based on SNAP-IV and CGI scores, children with better response to medication showed tendencies of statistically higher treatment retention rate. The most common adverse events included loss of appetite (7.1%) and insomnia (3.3%). There was no serious adverse event related to the treatment, such as death. Conclusion : The use of OROS methylphenidate for treatment of ADHD was safe and tolerable for children. In this study, lower age and better treatment response showed a statistically significant relationship with higher treatment adherence. Boys showed a trend of high treatment adherence. The treatment adherence at 20 weeks was satisfactory, however, the treatment adherence after 20 weeks showed a sharp decrease. Therefore, treatment persistence for six months after the beginning of ADHD treatment is important. In addition, the positive role of psycho-education for children and parents is necessary for increasing treatment adherence.

• Journal of Biosystems Engineering
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• 제29권2호
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• pp.121-130
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• 2004

This study was carried out to develop a miller to produce white embryo rice with functional nutrients by improving the conventional vertical miller. The effects of rice moisture content and the shaft revolution speed of the miller on germ(embryo) adherence rate, whiteness, broken rice rate, and cracked rice rate were investigated. Also, the effect of the mesh size of emery stones on the germ adherence rate was investigated. The vertical prototype miller was improved with the increasement of about 42% in producing white embryo rice at proper conditions(shaft revolution speed of 900 rpm, emery stones of mesh ＃50, processing capacity of 2.3t/h, zero outlet resistance, rice moisture content of 16.2%). The results were as follows: 1. The germ adherence rate of white rice was significantly influenced by the moisture content of brown rice. The germ adherence rate of white rice decreased rapidly with the increase of the moisture content of brown rice. When brown rice with moisture content of 13.2%, 14.5%, 15.2%, 15.4% was milled by the prototype with emery stones of mesh ＃35 and shaft speed of 900(1,100) rpm, rpm adherence rate of milled rice was 76.2%(70%), 69.2%(66%), 45.9(38%), 13.0(9%), respectively. 2. The whiteness of white rice milled by the prototype with emery stones of mesh ＃35 and shaft speed of 1,100(900)rpm increased from 27(23) to about 40, respectively, as the moisture content of brown rice increased from 13.2% to 17.2%. 3. The rate of broken rice of white rice milled at 900rpm decreased by 0.6∼1.0% compared with that at 1,100rpm when the moisture content of brown rice was less than 15.2%. 4. The germ adherence rate was increased by 10.3% and 11.0%, respectively when brown rice with moisture content of 16.2% and 15.5% was milled by the prototype miller with shaft speed of 900rpm and emery stones of mesh ＃50 instead of mesh ＃35. 5. Considering the germ adherence rate, broken rice rate, and whiteness of milled rice, the proper milling conditions of the prototype miller for producing embryo rice were the moisture content of about 15%, the processing capacity of 2.3t/h and minimum outlet resistance of 0Nㆍm with shaft speed of 900rpm and emery stones of mesh ＃50.

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.76-83
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• 2018

Background: Elderly patients with multiple myeloma (MM) are vulnerable to adverse events (AEs). This study evaluated adherence to chemotherapy and treatment outcomes in elderly patients treated with a frontline bortezomib (BTZ), melphalan, and prednisone (VMP) regimen and regimens without BTZ. Methods: One-hundred and forty elderly patients who were diagnosed with MM from March 2007 to March 2015 were included in this retrospective study. To evaluate regimen adherence, patients who were treated with more than 4 cycles were assigned to the good adherence group. Results: Among the 140 patients, 71 were treated with a frontline VMP and 69 with non-BTZ regimens. The median age was 71 years (range, 65-90 years). The VMP group showed a higher complete response rate than the non-BTZ group: 26.8% vs. 7.2%. More patients in the VMP group achieved ${\geq}$very good partial response (VGPR) and ${\geq}PR$. In the VMP group, 27 patients (38.0%) received less than 4 cycles. The VMP good adherence group showed a higher 3-year overall survival (OS) rate (70.9%) than the poor adherence group (60.2%, p=0.059). In the multivariate analysis, treatment with ${\geq}4$ cycles of VMP was a favorable factor for OS. Conclusion: A good adherence to a frontline VMP regimen resulted in favorable long-term survival. Adequate management of AEs will be needed to achieve favorable outcomes in elderly patients with MM.