• 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.

• Journal of Korean society of Dental Hygiene
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• v.20 no.5
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• pp.707-716
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• 2020

Objectives: This study aims to provide basic data for high-quality dental services. In addition, we will promote the operation of preventive dentistry that implements preventive measures. It was conducted to study the change of patient's treatment behavior and treatment cost due to the discontinuation of preventive dentistry in university dental hospitals. Methods: This study collected data using the integrated medical information system of the C University Dental Hospital. From September 1, 2017 to August 31, 2019, data were analyzed using frequency, percentage, mean, standard deviation, chi-square test using SPSS version 24.0 statistical program, and T-test. Results: There was a significant difference in the number of preventive dental treatment cases from 58.3% of preventive dental operation periods to 41.7% of preventive dental operation periods. As a result of comparing the medical expenses, the total medical expenses during the preventive dental operation period decreased from 521,308,872 won to 379,724,995 won during the discontinuation period, 141,583,877 won. The number of medical treatments by treatment behavior decreased 3,835 (28.4%) from a total of 13,520 preventive dental operation periods to 9,685. Conclusions: This study is meaningful as the first study to confirm the change in the treatment behavior and the change in the cost of treatment due to the discontinuation of the operation of preventive dentistry at university dental hospitals. In conclusion, it is thought that there is a possibility of the lack of accessibility and the limitation of professional preventive care due to the discontinuation of preventive dentistry.

• The Journal of Korean Medicine
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• v.24 no.3
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• pp.184-191
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• 2003

Background : Nowadays asthma is considered to be an inflammatory disease characterized by airway hyperresponsiveness and pulmonary eosinophilia. Production of cytokines by bronchial epithelial cells may contribution to the local accumulation of inflammatory cells in patients with bronchial asthma. Chungsangboha-tang is the herbal treatment of choice in persistent asthma patients. It has been recognized that cessation of treatment with Chungsangboha-tang evokes a recurrence of symptoms in patients with controlled asthma. This study was designed to evaluate the long-term effect of Chungsangboha-tang. Materials and Methods : The subjects consisted of 24 patients with asthma who had been treated with Chungsangboha-tang for four weeks. Chungsangboha-tang is an herbal decoction which has been used as the traditional therapeutic agent for asthma. PFT, QLQAKA, blood eosinophils, serum IgE, Serum IL-4, IL-5, $IFN-{\gamma}$ were checked before treatment, before withdrawal and 3 months after cessation of treatment with Chungsangboha-tang. Results : Treatment with Chungsangboha-tang for four weeks resulted in significant increase in FEV1.0%, PEFR%, and QLQAKA. The patients were treated with Chungsangboha-tang for four weeks with no significant difference in the blood eosinophils, serum IgE, IL-4 and IL-5. The serum $IFN-{\gamma}$ in asthmatic patients decreased significantly after 4 weeks of treatment. Discontinuation of treatment with Chungsangboha-tang resulted in significant drops in QLQAKA. Others measures in asthmatic patients 3 months after discontinuation of treatment with Chungsangboha-tang showed no significant difference. Conclusion : This study demonstrates that asthma can be exacerbated by discontinuation of treatment with Chungsangboha-tang in patients with asthma. Obviously further research concerning this is still necessary.

• Annals of dermatology
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• v.30 no.6
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• pp.668-675
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• 2018

Background: Drug survival, defined as the time until discontinuation, is a parameter reflecting real-world therapeutic effectiveness. Few studies have examined the influence of economic factors on the drug survival of biologic agents for psoriasis, particularly in Asian countries. Objective: To determine the drug survival for ustekinumab in real-life settings and investigate the factors affecting drug survival for psoriasis patients in Korea. Methods: We evaluated 98 psoriasis patients who were treated with ustekinumab at a single center. We analyzed the efficacy and drug survival of ustekinumab. Cox proportional hazard analysis and competing risk regression analysis were performed to reveal the factors affecting the drug survival of ustekinumab. Results: The overall mean drug survival was 1,596 days (95% confidence interval [CI], 904~2,288). Among the 39 cessations of ustekinumab treatment, 9 (23.1%) patients discontinued treatment after experiencing satisfactory results. Multivariate Cox proportional hazard analysis revealed that paying on patients' own expense was the major predictor for the discontinuation of ustekinumab (hazard ratio [HR], 9.696; 95% CI, 4.088~22.998). Competing risk regression analysis modeling of discontinuation because of factors other than satisfaction of an event also revealed that ustekinumab treatment at the patient's expense (HR, 4.138; 95% CI, 1.684~10.168) was a predictor of discontinuation rather than satisfaction. Conclusion: The results of our study revealed that the cost of biologics treatment affects the drug survival of ustekinumab and suggested that economic factors affect the drug survival of ustekinumab treatment in Korea.

• The Journal of Internal Korean Medicine
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• v.42 no.6
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• pp.1356-1365
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• 2021

This study examined the effectiveness of Korean medical treatment in a patient with persistent drug-induced parkinsonism after drug discontinuation. The changes in symptoms were assessed using the unified parkinson's disease rating scale (UPDRS), postural instability-gait disturbance (PIGD) score, and the 20 m gait time and steps. After 22 days of hospitalization, the UPDRS, PIGD score, and 20 m gait time and steps showed clinically significant improvement. The improvement persisted after discharge. This study indicated that Korean medical treatment could be an effective alternative therapy for treating persistent drug-induced parkinsonism after drug discontinuation.

• Korean Journal of Adult Nursing
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• v.27 no.2
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• pp.156-169
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• 2015

Purpose: This study identified the reasons why tuberculosis (TB) patients withhold treatment in a bid to develop a assessment scale to select patients who needs nursing intervention in the early stage and decrease the risk of discontinuation of treatment. Sample: There were two samples. A sample of 191 patients with TB and having primary treatment and a second sample of N who were under re-treatment Methods: The study design included qualitative and quantitative methods. Qualitative data were collected from in-depth interviews of TB patients under re-treatment. The quantitative data were collected from 191 patients with TB under primary treatment. Results: Exploratory factor analysis revealed 11 factors explaining 69.6% of total variance. These factors were categorized into four subgroups. A depression scale was used to establish concurrent validity. The depression scale had a positive relationship (r=54) with the discontinuing of primary treatment. The internal consistency reliability for the four subgroups was over .84. The confidence coefficient was Cronbach's ${\alpha}$ .95. The final scale was a self-reported four Likert scale including 50 items. Conclusion: Reliability and validity was established for the scale and the scale can be used to examine the risk of treatment discontinuation for TB. The scale is an important resource for nursing interventions in identifying and treating high risk clients.

• Child Health Nursing Research
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• v.26 no.1
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• pp.35-46
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• 2020

Purpose: The purpose of this study was to test a model for intention to discontinuation drinking high caffeinated beverages among undergraduate students. This model was based on the Ajzen's theory of planned behavior and Becker's health belief model. Methods: Participants consisted of 201 undergraduate students. Data were collected by questionnaires from March 11 to May 24, 2019. Collected data were analyzed using SPSS/WIN 22.0, AMOS 22.0 program. Results: The assessment of the model indicated an acceptable fit (normed x²=1.65, goodness-of-fit index [GFI]=.83, adjusted GFI=.79, comparative fit index [CFI]=.92, standardized root mean square residual [SRMR]=.05, Tucker-Lewis index [TLI]=.91, normed fit index [NFI]=.87, root mean square error of approximation [RMSEA]=.07). Perceived behavior control, subjective norm, the subjective attitude was found to have a significant direct effect on the intention to discontinuation of drinking a high caffeinated beverage. The variances of this model explained 45.3% of the variance in intention to discontinuation of drinking a high caffeinated beverage. Conclusion: These results suggest that a need to increase awareness of adverse effects and potential risks of high caffeinated beverage consumption in undergraduate students. Besides, the university and government should provide education and campaigns to prevent excessive high-caffeinated beverage consumption.

• Journal of Yeungnam Medical Science
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• v.37 no.4
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• pp.321-328
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• 2020

Background: This study aimed to investigate the incidences of and risk factors for perioperative events following anticoagulant discontinuation in patients with non-valvular atrial fibrillation (NVAF) undergoing non-cardiac surgery. Methods: A total of 216 consecutive patients who underwent cardiac consultation for suspending perioperative anticoagulants were enrolled. A perioperative event was defined as a composite of thromboembolism and major bleeding. Results: The mean anticoagulant discontinuation duration was 5.7 (±4.2) days and was significantly longer in the warfarin group (p<0.001). Four perioperative thromboembolic (1.9%; three strokes and one systemic embolization) and three major bleeding events (1.4%) were observed. The high CHA₂DS₂-VASc and HAS-BLED scores and a prolonged preoperative anticoagulant discontinuation duration (4.4±2.1 vs. 2.9±1.8 days; p=0.028) were associated with perioperative events, whereas the anticoagulant type (non-vitamin K antagonist oral anticoagulants or warfarin) was not. The best cut-off levels of the HAS-BLED and CHA₂DS₂-VASc scores were 3.5 and 2.5, respectively, and the preoperative anticoagulant discontinuation duration for predicting perioperative events was 2.5 days. Significant differences in the perioperative event rates were observed among the four risk groups categorized according to the sum of these values: risk 0, 0%; risk 1, 0%; risk 2, 5.9%; and risk 3, 50.0% (p<0.001). Multivariate logistic regression analysis showed that the HAS-BLED score was an independent predictor for perioperative events. Conclusion: Thromboembolic events and major bleeding are not uncommon during perioperative anticoagulant discontinuation in patients with NVAF, and interrupted anticoagulation strategies are needed to minimize these.

• Journal of Korean Academy of Nursing
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• v.4 no.1
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• pp.121-134
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• 1974

This study is an attempt to evaluate the use of an oral contraceptive by: 1. Deforming the acceptance rate of the oral contraceptive according to socio-demographic characteristics 5. Estimating the duration of the use of the contraceptive f. Discovering reasons why the contraceptive was discontinued 4. Computing the cumulative continuation and discontinuation rate according to socio-demographic characteristics, history of pregnancies, and attitude of husband at the time of selection of the contraceptive. One hundred sixty-eight women of child bearing age (14-49 years), residing in Yonhee Dong, Seoul, Korea and registered as oral contraceptive accepters at Yonsei Community Health Center, were interviewed during a three week period in 1973. The questionnaire was designed to determine the socio-demographic characteristics of the oral contraceptive accepters, the current status of their family planning practice, medical reactions if any, discontinuation practice, and the duration of the use of the contraceptive. The major findings of the study were as follows; 1. The acceptance rate was highest for women between 30 and 34 years of age, the mean age being 34.4 years. 2. Fifty six point five percent of all respondents said that thirty years of age was the ideal age to stop having children. 3. The average number of living children was 3.5 and fifty four point eight percent of respondents felt 2 boys and I girl was the ideal number of children. 4. The average number of pregnancies was 5.2 and the average number of induced abortion was I. 4. 5. Fifty eight point eight percent of the respondents had experience in the use of contraceptive methods in the past. 6. Forty one point seven percent of the respondents replied that they chose the oral contraceptive because, "it was not complicated to use." 7. Sixty four point eight percent of the women said their husband approved of their taking the pill. 8. The cumulative discontinuation rate was sixty point five percent of the total respondents for one year in first segment. 9. Sixty six point nine percent of the respondents had experienced side-effect while using the pill. The side effects for 68.9 percent of these women were castro-intestinal upsets. Twenty point eight percent of the women who had side effects consulted with medical personnel about them. Women who had more education had more side effects. 10. Seventy three point two percent of the women who discontinued the pill did so because of medical reasons. Women who were younger discontinued the pill for personal reasons more-often than older women. Among personal reasons listed for discontinuing the pill was the attitude of the husband. 11. The average duration of continuance of the contraceptive was 5.3 cycles under 29 years of age; 7.4 cycles between 30 and 34 years of age; and 8.4 cycles over 40 years of age. 12. The discontinuation rate was seem to increase sharply in the early cycle and increase more slowly in later cycle. Conclusions and suggestions: Since the attitude of the husband was shown to be important, the current family planning program should be expended to include approach to husband. For women who must use the oral contraceptive, education and support must be enhanced so that the discontinuation rate due to side effects will be decreased.

• Tuberculosis and Respiratory Diseases
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• v.81 no.4
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• pp.299-304
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• 2018

Background: Roflumilast is the only approved oral phosphodiesterase-4 inhibitor for the treatment of severe chronic obstructive pulmonary disease (COPD) in patients with chronic bronchitis and a history of frequent exacerbations. The purpose of this study was to examine the incidence of adverse effects associated with roflumilast treatment in a real-world setting. Further, we compared the incidence of adverse effects and the discontinuation rate among patients receiving different doses. Methods: We identified all outpatients diagnosed with COPD at Seoul St. Mary's Hospital between May 2011 and September 2016 and retrospectively reviewed their medical records. Roflumilast was prescribed to patients in doses of $500{\mu}g$ and $250{\mu}g$. Results: A total of 269 COPD patients were prescribed roflumilast in our hospital during the study period. Among them, 178 patients were treated with $500{\mu}g$ and 91 patients were treated with $250{\mu}g$. The incidence of adverse effects was 38.2% in the $500{\mu}g$ group and 25.3% in the $250{\mu}g$ group (p=0.034). The discontinuation rate of roflumilast was 41.6% (n=74) in the $500{\mu}g$ group and 23.1% (n=21) in the $250{\mu}g$ group (p=0.003). When adjusted by age, sex, smoking status, and lung function, $500{\mu}g$ dose was significantly associated with the discontinuation of roflumilast (odds ratio, 2.87; p<0.001). Conclusion: There was a lower incidence of adverse effects and discontinuation among patients treated with $250{\mu}g$ compared with $500{\mu}g$ dose. Further studies regarding the optimal dose of roflumilast are required.