• Title/Summary/Keyword: Clinical Effectiveness

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An Economic Evaluation of Thread Embedding Acupuncture for the Treatment of Lumbar Herniated Intervertebral Disc in a Randomized Controlled Clinical Trial

  • Kim, Ha-Na;Kim, Jun-Yeon;Park, Kyeong-Ju;Hwang, Ji-Min;Jang, Jun-Yeong;Jo, Min-Gi;Ko, Min-Jung;Chae, Sang-Yeup;Kim, Jung-Hyun;Goo, Bonhyuk;Park, Yeon-Cheol;Seo, Byung-Kwan;Baek, Yong-Hyeon;Nam, Sang-Soo
    • Journal of Acupuncture Research
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    • v.38 no.4
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    • pp.312-319
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    • 2021
  • Background: Lumbar herniated intervertebral disc (LHIVD) is a frequently presented condition/disease in Korean medical institutions. In this study, the economics of thread embedding acupuncture (TEA) was evaluated in a randomized controlled trial comparing TEA with sham TEA (STEA). Methods: This economic evaluation was analyzed from a limited social perspective, and the per-protocol set was from a basic analysis perspective. The cost-effectiveness analysis was based on the change in visual analog scale score, and the cost-utility analysis was based on the quality-adjusted life years. The final results were expressed as the average cost-effectiveness ratio and incremental cost-effectiveness ratio, and furthermore sensitivity analysis was performed to confirm the robustness of the results observed. Results: The cost-effectiveness analysis showed that TEA was 9,908 won lower than STEA, while the decrease in 100 mm visual analog scale score was 8.5 mm greater in the TEA group compared with the STEA group (p > 0.05). The cost-utility analysis showed that TEA was 9,908 won lower than STEA, while the quality-adjusted life years of TEA was 0.0026 years higher than STEA (p > 0.05). These results were robust in the sensitivity analysis, but were not statistically significant. Conclusion: In treating LHIVD, TEA appeared to have cost-effectiveness and cost-utility compared with STEA. However, there were no significant differences between the groups in terms of cost, effectiveness, and utility indicators. Therefore, results must be interpreted prudently; this study was the 1st to conduct an economic evaluation of TEA for LHIVD.

A Comparison of Effectiveness and Compliance among Alendronate Pharmaceutical Products in Koreans (한국인에 있어서 알렌드로네이트 제제의 제형간 유효성 및 순응도 비교)

  • Yoon, Ji-Won;Lee, Byung-Koo;Song, Young-Chun;Kim, Jae-Youn;Shin, Hye-Young;Lee, Yeon-Hong;Gwak, Hye-Sun
    • Korean Journal of Clinical Pharmacy
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    • v.18 no.2
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    • pp.114-119
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    • 2008
  • Alendronate is a bisphosphonate that selectively inhibits osteoclast-mediated bone resorption. Dosing convenience is an important element for the enhancement of patient compliance and the effective management of osteoporosis. The purpose of this study was to compare the effectiveness and compliance among alendronate pharmaceutical products (oral once-weekly alendronate 70 mg, daily alendronate 10 mg, and once-weekly alendronate 70 mg with Vitamin $D_3$ 2800 IU) in terms of the change in bone mineral density (BMD), biochemical markers, and compliance estimates. A retrospective chart review was conducted in patients with osteoporosis who received alendronate 70 mg (Group 1), alendronate 10 mg (Group 2), or alendronate 70 mg with Vitamin D3 2800 IU (Group 3) at the endocrinology department of a hospital in Korea from Jan. 1, 1998 to Mar. 31, 2008. The primary endpoints were the increases in spine antero-posterior BMD T-score and femur trochanter BMD T-score, and the compliance of alendronate products. Secondary endpoints included changes in bone turnover-related biochemical markers including bone-specific alkaline phosphatase, urinary N-terminal telopeptides (NTX) and osteocalcin, and in serum vitamin $D_3$ concentration. There was no statistical difference in the BMD increase among the three alendronate products; spine BMD T-score increased by $0.49{\pm}0.52$, $0.39{\pm}0.48$ and $0.50{\pm}0.41$, and femur trochanter BMD T-score by $0.29{\pm}0.42$, $0.21{\pm}0.53$ and $0.24{\pm}0.22$ in Group 1, 2 and 3, respectively. With respect to the increases in femur trochanter BMD T-score and the decreases in NTX and osteocalcin, 70 mg once-weekly group was remarkably superior to 10 mg daily group (p < 0.05) The compliance of 70 mg once-weekly group was significantly higher than that of 10 mg daily treatment group (p < 0.001). In conclusion, all three alendronate treatment groups were equivalent in effectiveness, and the compliance of 70 mg once-weekly group was better than that of 10 mg daily treatment group.

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Effect of Wrist Extensor Strength and Pain on Extracorporeal Shock Wave Therapy of the Lateral Epicondylitis (체외충격파치료가 주관절 외측상과염 환자의 손목 신전근의 근력과 통증에 미치는 영향)

  • Cho, Nam-Jung;Park, Jang-Sung;Cho, Woon-Su
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.6 no.1
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    • pp.57-68
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    • 2008
  • Purpose : The purpose of this study was to assess the effectiveness of Extracorporea Shock-wave therapy(ESWT) on the pain and improvement of wrist extensor strength which is one of the available medical treatment in patients with lateral epicondylitis. Object and Methods : The subjects of this study were consisted of 15 patients with lateral epicondylitis, These medical treatments was conducted total 6 time for 3 weeks. In the ESWT application group. To investigate the effectiveness of the treatment after ESWT treatment, Pain was measured by visual analogue scale(VAS) which is divided into 10 ranks and wrist extensor strength was measured by Aneroid phygmomanometer Results : 1. It was showed that VAS and wrist extensor strength before treatment and after two treatment(1 week) were no significant differences(p<0.05). 2. It was showed that VAS and wrist extensor strength before treatment and after four treatment(2 week) were significant differences(p<0.05). 3. It was showed that VAS and wrist extensor strength before treatment and after six treatment(3 week) were significant differences(p<0.05). Conclusion : We think that ESWT for the patients with lateral epicondylitis. is effective to wrist extensor strength and decrease of pain.

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Success Factors for the Smoking Cessation Service of the Safe Pharmacy (세이프약국 금연서비스의 성공요인)

  • Kang, Eunjeong;Park, Hyekyung
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.1
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    • pp.38-43
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    • 2017
  • Objective: Seoul City has implemented the Safe Pharmacy in 2013. This study aimed to ascertain the success factors of the smoking cessation service of the Safe Pharmacy. Methods: The data for the smoking cessation registration cards were obtained from the pharmacies which participated in 2014 Safe Pharmacy. The sample included 289 smokers in 6 districts who participated at least one sessions of smoking cessation service. the service included both behavioral intervention and nicotine replacement therapy. In order to identify the effectiveness of the smoking cessation service, logistic regression analysis was used. The dependent variable was the success of quitting smoking at the 4th week. The independent variables included age, sex, employment, chronic disease, district, smoking amount, registration path, supporters for quitting smoking and number of service sessions. Results: Fifty eight point eight percent of the sample successfully quit smoking at the 4th week. Unemployment, higher smoking amount, and less service sessions were negatively related to the success of quitting smoking. There were differences in the success rate across districts. Age, sex, chronic disease, registration path, and anti-smoking supporters were not related to the success rate. Conclusion: Pharmacy can be an effective community resource for smoking cessation. Factors that could increase the effectiveness of smoking cessation service of the Safe Pharmacy and possible ways to enhance the participation of pharmacies in smoking cessation services were also discussed.

Current State and Challenges of Pharmacoeconomic Evaluation in Korea (우리나라 의약품 경제성평가의 현황과 과제)

  • Choi, Sang-Eun
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.2
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    • pp.74-79
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    • 2008
  • Since the positive listing system for prescription drug reimbursement has been introduced in Korea, the number of pharmacoeconomic evaluation studies has increased. However it is not clear if the quality of pharmacoeconomic evaluation study has improved. Due to the lack of randomized clinical studies in Korean health care setting, Korean economic evaluation studies have typically integrated the local cost data and foreign clinical data. Therefore methodological issues can be raised in regard to data coherence and consistency. But the quality of data was not questiened and the potential bias has not been investigated yet. Even though changes in policy have encouraged the undertaking of pharmacoeconomic evaluations, there is few public-side funding for validation study of cost-effectiveness models and data. Several companies perform economic evaluation studies to be submitted on behalf of their own products, but do not want the study results to be disclosed to the academic community or public. To improve the present conduct of pharmacoeconomic evaluations in Korea, various funding sources need to be developed, and, like other multidisciplinary areas, the experts in different fields of study should collaborate to ensure the validity and credibility of pharmacoeconomic evaluations.

Clinical Effectiveness of Bone Grafting Material Using Autogenous Tooth: Preliminary Report (자가치아를 이용한 골이식재의 임상적 유용성: 일차 보고)

  • Lee, Jeong-Hoon;Kim, Su-Gwan;Moon, Sung-Young;Oh, Ji-Su;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.2
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    • pp.144-148
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    • 2011
  • Purpose: The purpose of this study was to evaluate the effectiveness of a novel bone grafting material using an autogeneous tooth (AutoBT) and provide the basis for its clinical application. The AutoBT contains organic and inorganic mineral components and is prepared from autogenous grafting material, thus eliminating the risk of immune reactions that may lead to its rejection. AutoBT can be used as bone material as is has both osteoinduction and osteoconduction activities at guided bone regeneration for implant placement and maxillary sinus graft. Methods: In a total of 63 patients, guided bone regeneration surgery was performed at the time of implant placement, and tissue samples were harvested at the time of the second surgery with the patient's consent. Results: There were no complications in guided bone regeneration using autogeneous tooth. Conclusion: We concluded that AutoBT underwent gradual resorption and was replaced by new bone of excellent quality via osteoinduction and osteoconduction.

Recent Clinical Research on Effect of Acupuncture for Rhinitis - Within RCT, Review - (비염의 침 치료에 대한 최근 임상 연구 동향 - RCT, Review 중심으로 -)

  • Shin, Ji-Hye;Lee, Jang-Cheon;Kim, Ki-Bong
    • The Journal of Pediatrics of Korean Medicine
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    • v.26 no.1
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    • pp.46-59
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    • 2012
  • Objectives The purpose of this study is to investigate recent clinical studies on effect of acupuncture for rhinitis in other countries. We have analyzed the studies on effect of acupuncture for rhinitis within randomized controlled trial(RCT), reviewed for 11 years (from 2001 to 2011). Methods The search database includes PubMed. To narrow the search, the following key search terms were used: 'rhinitis, acupuncture'. The search was limited to the publication date from 2001 to 2011. Results Total 20 studies were selected: RCT(13), review(5), case report(1), and cost effectiveness study(1). In RCT, 9 studies used acupuncture only, and 8 studies of them have revealed that acupuncture is effective on rhinitis. In review, 3 studies are systematic review, 2 studies are no systematic review. Among systematic review, 2 studies have revealed partial effectiveness of acupuncture for rhinitis, but they suggested the necessity of further studies. Conclusions Domestic studies on effect of acupuncture for rhinitis are necessary. For more accurate results, controlled, large scale and well designed studies are recommended.

A Comparative Study of Nurses and Physicians' Attitudes about Complementary and Alternative Therapy (보완대체요법에 대한 간호사와 의사의 태도 비교 연구)

  • Jang, Eun-Hee;Park, Kyung-Sook
    • Korean Journal of Adult Nursing
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    • v.15 no.3
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    • pp.402-410
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    • 2003
  • Purpose: The purpose of this study was to develop a fundamental reference for the clinical implementation of Complementary and Alternative Therapy(CAT) by surveying and analyzing different perception and attitude between nurses and physicians. Method: A total of 167 nurses and 103 physicians from two C university health science centers participated in this survey, and SPSS program with version 10.0 was used to analyze the result of survey. Result: As results, 72.7% nurses and 57.1% physicians showed positive attitude for the concept of CAT, 60.6% nurses and 36.7% physicians responded positively while 2.6% nurses and 25.9% physicians responded negatively for the application of CAT to the clinical practice. There was a meaningful difference between two groups in the belief of therapeutic effectiveness of CAT. 67.7% nurses believed the therapeutic effectiveness of CAT while 38.8% physicians did. For attitudes of nurses and physicians toward CAT showed meaningful difference according to general characteristics: age, gender, marital status, a level of education, position in the organization, religion, and duration of health care service other than inpatient units. Conclusion: In this study, the attitudes of nurses and physicians about CAT showed meaningful difference that nurses were more positive than physicians in application.

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Educational Intervention on Breast Cancer Early Detection: Effectiveness among Target Group Women in the District of Gampaha, Sri Lanka

  • Vithana, PVS Chiranthika;Ariyaratne, MAY;Jayawardana, PL
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2547-2553
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    • 2015
  • Purpose: The present study concerns the effectiveness of an educational intervention for improving knowledge, attitudes and practices (KAP) of breast cancer early detection among target group women (TGW) in the district of Gampaha, Sri Lanka. Materials and Methods: The study was a community-based intervention. Two medical officer of health areas in Gampaha district were selected using random sampling as intervention (IA) and control (CA). Public health midwives (PHMs) in the IA were exposed to the educational intervention first, conducted the same among the TGW through PHMs. KAP was assessed using an interviewer- administrated questionnaire among 260 TGW from each area selected using cluster sampling before and six months after the intervention. Results: The overall median scores for KAP among TGW in IG increased significantly from pre intervention level of 54% (IQR: 46-59%), 50% (IQR: 41-59%), and 0% (IQR: 0-20%) to post intervention level of 77% (IQR: 72-82%), 68% (IQR: 59- 76 %) and 40% (IQR: 20-60%) respectively. In CG, overall median scores for KAP remained almost the same at pre intervention 54% (IQR:44-59%), 50% (IQR:36-59%) and 0% (IQR: 0-20%) and post intervention 54% (IQR:46-59%), 50% (IQR:36-64%) and 0% (IQR: 0-20%) respectively. Conclusions: The educational intervention was found to be effective.

Effective Teaching Skills in Pharmacy Practice Education (약학 실무실습교육에서의 효과적인 교수법)

  • Yoon, Jeong-Hyun
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.4
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    • pp.283-290
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    • 2016
  • Experiential education is a core curriculum of 6-year pharmacy education. Practicing pharmacists lie at the heart of experiential education serving as preceptors for undergraduate pharmacy students during experiential education. Preceptors are, however, confronted with a challenge of caring for patients and teaching students at the same time in a time-constrained environment. To improve the effectiveness and outcomes of experiential education, practicing pharmacists are required to demonstrate educational competence. Even small teaching moments can provide students with valuable learning opportunities that they could not have from on their own. Thus, it is vital to provide education and training for preceptors to advance their teaching skills. This article will describe practical and effective teaching skills that preceptors could adopt in the experiential education for pharmacy students. It is important that preceptors should use different teaching skills for different learners, according to their level of experience and knowledge, learning styles and needs, as well as the type of the practice. Therefore, possessing diverse teaching skills provides flexibility to adapt teaching to each student's learning levels and needs, and to the charateristics of the practice environment. Preceptors' level of confidence and comfort in using teaching skills can be enhanced through continuous practice and training, which consequently leads to the improved effectiveness of experiential education and student's satisfaction with the education.