• The Journal of the Korea institute of electronic communication sciences
• /
• v.7 no.5
• /
• pp.1213-1219
• /
• 2012

As Korea is expected to enter an aging society in near future, the number of patients who need a long-term prescribtion is expected to increase as well. In particular, Korea shows the highest in both the incident rate and the death rate among OECD member nations. The current situation requires more strict monitoring and management for patients' taking medicine, there are a few practical problems such as personnel expenses. Recently the concept of directly observed treatment (DOT) that is based on the IT technologies has been introduced. This paper, therefore, proposes a digital DOT system with a smart pillbox and drives key requirements for the smart pillbox that plays an important and essential role in the proposed digital DOT system.

• 보건세계
• /
• v.59 no.3
• /
• pp.8-12
• /
• 2012

- DOT하 결핵환자 치료 성공율을 90% 이상 달성 ${\rightarrow}$ 치료 완료후 2년이내 균양성 재발율을 3% 미만으로 달성 - 질병관리본부와 결핵연구원, 보건소 및 민간 병의원에서 치료받고 있는 결핵환자에 대한 WHO의 결핵조기퇴치 기본 전략인 직접복약확인체계(DOTS, Directly observed treatment short course)시범사업 본격 실시

• Tuberculosis and Respiratory Diseases
• /
• v.56 no.5
• /
• pp.485-494
• /
• 2004

Background : To assess the effects of mDOT implementation on sputum smear conversion for AFB (Acid fast bacilli) positive pulmonary tuberculosis patients, modified Directly Observed Treatment (mDOT) was started on October $8^{th}$ 2001 at a health center in Seoul. mDOT was defined through weekly interviewing and supervising of a patient by a supervisor (doctor, nurse, or lay health worker). The sputum smear conversion of a mDOT group was compared with that of a self-medication (self) group. Methods : This study included 52 AFB positive pulmonary tuberculosis patients registered at a health center in Seoul between October $8^{th}$ 2001 and April $23^{rd}$ 2002. 24 and 28 patients were enrolled in the mDOT and self medication groups, respectively. Paired (1:1) individual matching, by gender, extent of disease, relapse and age-matching variables, was performed between the two groups, resulting in 20 paired matches. This prospective study was planned as an unblinded, non-randomized quasiexperimental pilot project. Outcomes were identified from results of sputum smear examinations for AFB in both groups at 2 weeks, and 1 and 2 months. The paired matching data were analyzed using the SAS program version 8.1 by McNemar test. Results : At the end of 2 weeks of treatment, the sputum smear conversion of the mDOT group was somewhat higher than that of the self medication group (78.57 vs. 50%, p-value=0.289), and after 1 month of treatment no statistically significant difference was shown between the two groups (83.33 vs. 50, p-value=0.125). At the end of 2 months of treatment (initial intensive phase), the sputum smear conversions of the mDOT and self groups were 95 and 75%, respectively (p-value=0.219). Conclusions : The implementation of mDOT did not result in clinically significant increases in the sputum smear conversion at 2 weeks, and 1 and 2 months compared with that of the self medication group. However, the increases experienced might contribute to diminishing the infectious period of AFB positive patients, and this approach may act as a guide for a specific group of patients. In this study, mDOT was performed for one hundred percent of the intensive treatment phase. It can also be an effective treatment for pulmonary tuberculosis patients, and may be useful for some high risk tuberculosis patients.

• 대한예방의학회:학술대회논문집
• /
• 2002.10a
• /
• pp.533-533
• /
• 2002

• The Journal of the Korea institute of electronic communication sciences
• /
• v.10 no.5
• /
• pp.571-578
• /
• 2015

Even though DOT (Directly Observed Treatment) is the most definite method for the patients who need a long-term medication, its implementation is almost impossible considering the manpower and economic cost for it. The smart medication management and monitoring system that has appeared as an alternative requires a device for its implementation. In this paper, we propose so-called a smart pillbox for the smart medication management and monitoring system and the multi-user authentication scheme for sharing the smart pillbox among the patients. Through the smart pillbox and the multi-user authentication scheme, it is expected that the recovery rate would be raised by enabling the patients to take medicine in both timely and correct manner.

• Tuberculosis and Respiratory Diseases
• /
• v.86 no.2
• /
• pp.82-93
• /
• 2023

Tuberculosis (TB) is a significant public health concern. Globally, TB is among the top 10 and the leading cause of death due to a single infectious agent. Providing standard anti-TB therapy for at least 6 months is recommended as one of the crucial strategies to control the TB epidemic. However, the long duration of TB treatment raised the issue of non-adherence. Non-adherence to TB therapy could negatively affect clinical and public health outcomes. Thus, directly observed therapy (DOT) has been introduced as a standard strategy to improve anti-TB medication adherence. Nonetheless, the DOT approach has been criticized due to inconvenience, stigma, reduced economic productivity, and reduced quality of life, which ultimately could complicate adherence issues. Apart from that, its effectiveness in improving anti-TB adherence is debatable. Therefore, digital technology could be an essential tool to enhance the implementation of DOT. Incorporating the health belief model (HBM) into digital technology can further increase its effectiveness in changing behavior and improving medication adherence. This article aimed to review the latest evidence regarding TB medication non-adherence, its associated factors, DOT's efficacy and its alternatives, and the use of digital technology and HBM in improving medication adherence. This paper used the narrative review methodology to analyze related articles to address the study objectives. Conventional DOT has several disadvantages in TB management. Integrating HBM in digital technology development is potentially effective in improving medication adherence. Digital technology provides an opportunity to improve medication adherence to overcome various issues related to DOT implementation.

• The Journal of the Korea institute of electronic communication sciences
• /
• v.8 no.4
• /
• pp.611-617
• /
• 2013

Although tuberculosis can be recovered if patients take medicine consistently, Korea shows significantly high rate in terms of incident rate and death rate of the tuberculosis patients. Considering such a situation, this paper has developed a smart pillbox that facilitates for patients requiring a long-term administration to take medicine in a regular and consistent manner. The developed smart pillbox is equipped with a load cell that can measure the weight in unit of 0.1g so that it can determine whether or not the medicine is dispensed out of itself. In addition, a software has been developed to determine the status of patient's taking medicine based on the measurement result.

• The Journal of the Korea institute of electronic communication sciences
• /
• v.8 no.9
• /
• pp.1391-1397
• /
• 2013

As Korea is expected to enter an aging society in near future, the number of patients who need a long-term prescription is expected to increase as well. In particular, Korea shows the highest in both the incident rate and the death rate among OECD member nations. The current situation requires more strict monitoring and management for patients' taking medicine, there are a few practical problems such as personnel expenses. In order to realize the efficient management of medicine administration, this paper proposes a smart pillbox that is developed based on IT technologies. Through the experiments in which actual patients participate, it is proved that the smart pillbox is beneficial to the patients taking medicine.

• The Korean Society of Law and Medicine
• /
• v.16 no.2
• /
• pp.55-84
• /
• 2015

The tuberculosis is the infectious disease. Generally, the active tuberculosis patient can infect the 10 persons for one year within the daily activities like casual conversation and singing together. The infectivity of tuberculosis can continue for a life time, and infected persons can remain at risk for developing active tuberculosis. To control this contagious disease, along with the active tuberculosis patients, non-infectious but non-compliant patients who can be infectious if their immune systems become impaired have to be managed. To control the non-complaint patients, medical treatment order should be combined with the public order. Because tuberculosis is the risk of community health, the human rights like liberty and freedom of movement can be restricted for public welfare under the article 37(2) of constitution. Even when such restriction is imposed, no essential aspect of the freedom or right shall be violated. The degree of restriction on the rights of citizens is different what methods are chosen to non-complaint patients. For example, under the directly observed therapy program, the patients and medical staffs make an appointment and meet to confirm the drug intakes according to the schedule, which is the medical treatment combined with the mildest public order. If the patients break the appointments or have the history of disobedient, the involuntary detention can obtain the legitimate cause. The Tuberculosis Prevention Act has the two step programs on this involuntary detention, The admission order (Article 15) is issued when the patients are infectious. The quarantine order (Artle 15-2) is issued when the patients are infectious and non-complaint. The legal criteria for involuntary detention are discussed and published through the international conventions and covenants. For example, World Health Organization had made guidance on human rights and involuntary detention for tuberculosis control. The restrictions should be carried out in accordance with the our law and in the legitimate objective of public interest. And the restriction should be based on scientific evidence and not imposed in an unreasonable or discriminatory manner. We define and adopt these international criteria under our constitution and legal system. Least restrictive alternative principle, proportionality principle and the individual evaluation methods are explained through the reviews of United States court decisions. Habeas Corpus Act is reviewed and adopted as the procedural due process to protect the patient rights as a citizen. Along with that, what conditions and facilities which are needed to performed quarantine order are discussed.