• Title/Summary/Keyword: Medication Adherence

Search Result 126, Processing Time 0.022 seconds

Effectiveness of Telemonitoring Intervention in Children and Adolescents with Asthma: A Systematic Review and Meta-Analysis (천식 아동 및 청소년에서 원격모니터링 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Jung, Youjin;Kim, Jimin;Park, Dong Ah
    • Journal of Korean Academy of Nursing
    • /
    • v.48 no.4
    • /
    • pp.389-406
    • /
    • 2018
  • Purpose: This review aimed to evaluate the effectiveness of telemonitoring (TM) in the management of children and adolescents with asthma. Methods: We searched Ovid-MEDLINE, Ovid-EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL (Cumulative Index to Nursing and Allied Health Literature), and 5 domestic databases to identify randomized controlled trials (RCTs) published through December 2017. Two reviewers independently selected relevant studies, assessed methodological quality and extracted data. We performed a meta-analysis of TM versus usual care and summarized the intervention characteristics of included studies. Results: Of the 3,095 articles identified, 8 RCTs (9 articles) were included in this review. The type of TM intervention of included studies was varying across studies (transmitted data, transmission frequency, data review, etc.). The pooled asthma control score was not significantly different between TM and usual care (standardized mean difference 0.04, 95% confidence interval (CI) -0.20~0.28). Another pooled analysis demonstrated no statistically significant difference in asthma exacerbation between TM and usual care (odds ratio 0.95, 95% CI 0.43~2.09). Overall, the pooled results from these studies revealed that TM did not lead to clinically significant improvements in health outcomes, but some studies in our analysis suggested that TM increased patient medication adherence and intervention adherence. Conclusion: The current evidence base does not demonstrate any differences between TM intervention and usual care, but TM intervention might be considered a promising strategy for the delivery of self-management support for children and adolescents with asthma. Further well-designed studies are needed to assess the effects on clinical outcomes.

Adherence to Varenicline and Abstinence Rates for Quitting Smoking in a Private Health Promotion Center-Based Smoking Cessation Clinic

  • Lee, Jin-Young;Kim, Min-Ji;Jun, Hee-Jung;Kang, Mi-Ra;Park, Ah-Rham;Oh, Dae-Eun;Choi, Yoon-Ho;Hwang, Jung-Hye
    • Tuberculosis and Respiratory Diseases
    • /
    • v.72 no.5
    • /
    • pp.426-432
    • /
    • 2012
  • Background: Varenicline is an effective smoking cessation aid. However, smokers prescribed with varenicline do not always receive varenicline for 12 weeks, as recommended. This study analyzed the subjects who received varenicline and investigated the effect of varenicline treatment duration on the success rate of 6-month smoking cessation. Methods: This study retrospectively analyzed 78 subjects, who received varenicline, out of the 105 smokers that had visited the smoking cessation clinic after medical examination from September 2007 to December 2009. Results: The subjects were all males. Twenty-two subjects (28.2%) had varenicline treatment for 12 weeks or longer; 18 subjects (23.1%) for 8~12 weeks; 22 subjects (28.2%) for 4~8 weeks; and 16 subjects (20.5%) for less than 4 weeks. The total success rate of the 6-month smoking cessation was 47.4%. The success rate of the 6-month smoking cessation was 63.6% in the group that received varenicline for 12 weeks or longer, which was higher than 41.1% of the group that early terminated the varenicline treatment (p=0.074). The period of varenicline treatment was extended for one more week, the odds ratio of the 6-month smoking cessation success increased to 1.172-folds (p=0.004; 95% confidence interval, 1.052~1.305). Adverse events occurred in 30.8% of the subjects who received varenicline, but no serious adverse events were found. Conclusion: If varenicline treatment period is extended, the odds ratio of the success rate for the 6-month smoking cessation increases. Therefore, an effort to improve drug compliance for varenicline in clinical practices could be helpful for the long-term success of smoking cessation.

Substrate reduction therapy in three patients with Gaucher disease

  • Kim, Soo Hyun;Kang, Eungu;Kim, Yoon-Myung;Kim, Gu-Hwan;Choi, In-Hee;Choi, Jin-Ho;Yoo, Han-Wook;Lee, Beom Hee
    • Journal of Genetic Medicine
    • /
    • v.13 no.2
    • /
    • pp.72-77
    • /
    • 2016
  • Purpose: Gaucher disease (GD) is the most common lysosomal storage disease caused by beta-glucocerebrosidase (GBA) deficiency. Oral substrate reduction therapy with miglustat ($Zavesca^{(R)}$) was approved for the treatment of adults with GD type 1, for whom enzyme replacement therapy (ERT) is unsuitable or not a therapeutic option. In this study, we report the effect of miglustat ($Zavesca^{(R)}$) in three Korean GD patients. Materials and Methods: Clinical findings comprising age at diagnosis, presenting signs, laboratory findings at diagnosis, GBA activity and mutations, and clinical courses of the three patients were reviewed. Results: Miglustat was administered to three patients who reported allergic reactions during intravenous imiglucerase infusions. One patient withdrew after 15 months of miglustat administration owing to continuous elevation of disease biomarker levels (chitotriosidase, acid phosphatase, and angiotensin-converting enzyme). Poor adherence to medication was suspected but was denied by the patient. In the other two patients, platelet count and levels of hemoglobin and other biomarkers remained stable during miglustat administration. However, they suffered from severe diarrhea and weight loss, which led to miglustat discontinuation after 1 and 12 months of administration. Conclusion: Our study shows that although miglustat is suggested to GD patients as an alternative treatment to ERT, significant adverse reactions may lead to discontinuation of miglustat. In addition, it is difficult to monitor the drug adherence.

The Experience of People with HIV/AIDS : A Phenomenological Study (HIV 감염자의 생활 경험에 관한 현상학적 연구)

  • Kim, Eun Young;Lee, Myoung Sun
    • Korean Journal of Adult Nursing
    • /
    • v.12 no.4
    • /
    • pp.497-506
    • /
    • 2000
  • The purpose of this phenomenological study was to explore and describe the experience of people with HIV/AIDS. Three men and three women with HIV/AIDS participated in the study. They were asked open-ended and descriptive questions in order for them to talk about their experience in their own terms. Interviews were audiotaped and transcribed to maintain data integrity and to reduce perceptual bias. The transcripts were analyzed by the Colaizzi method. Member checks from the participants were used to validate the emergent themes. Seven themes emerged from the analysis. 1. People with HIV/AIDS have a strong impact and emotional reaction when receiving positive HIV test results. 2. All people with HIV/AIDS attempt to conceal HIV infection because of fear of stigma or rejection. 3. After the initial brief traumatic reaction to HIV/AIDS diagnosis, all participants feel lonely because they had no one to express or share their own experiences. 4. People with HIV/AIDS reflect on their life, think about the death and dying process and they become depressed. 5. Most participants feel that the family members who know his/her diagnosis are a big source of support. 6. According to the normativeness of infection route of HIV, the degree of guilty feeling differs among participants. 7. Although all participants think medication is a lifeline, the adherence to medication is not maintained because of side effects, denial and concealment of HIV/AIDS. The results of this study may help nurses and other health care workers to implement more efficient nursing strategies for people with HIV/AIDS by more deeply understanding their experience.

  • PDF

Semantic network analysis of schizophrenia through newspaper articles. (신문기사를 통해 본 조현병의 의미연결망 분석)

  • Song, Hye-Jin;Kim, Suk-Sun
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.22 no.6
    • /
    • pp.375-384
    • /
    • 2021
  • This study explored the change in keywords and topics in newspaper articles related to schizophrenia after the Gangnam murder case. The study examined newspaper articles related to schizophrenia for five years before and after the Gangnam murder case. A semantic network analysis was conducted using the NetMiner 4.4.1 program. 610 articles between 2013 and 2018 were retrieved from 8 national newsletters. The most frequent core keyword was 'treatment' before the murder case, but 'incidents' after the case. Four topics were identified: 'becoming chronic if missing the time of treatment due to prejudice', 'being curable with early treatment', 'living an ordinary life with medication', 'being indicted as a murderer while impaired by a mental disorder' before the murder case. After the case, four topics were identified: 'committing murder for delusions, not misogyny', 'medication non-adherence leads to more impulsive behavior', 'claiming leniency for criminals due to the mental impairment', 'killing the police who were mobilized to stop stabbing rampage'. These findings suggest that newspaper articles should provide accurate information about schizophrenia to reduce prejudice and stigma toward patients with schizophrenia and other forms of mental illness.

Korean Medication Algorithm for Bipolar Disorder 2018 : Safety and Tolerability (한국형 양극성 장애 약물치료 알고리듬 2018 : 안정성과 내약성)

  • Sohn, InKi;Bahk, Won-Myong;Yoon, Bo-Hyun;Jon, Duk-In;Seo, Jeong Seok;Kim, Won;Lee, Jung Goo;Woo, Young Sup;Jeong, Jong-Hyun;Kim, Moon-Doo;Jung, Young-Eun;Shim, Se-Hoon;Song, Hoo-Rim;Min, Kyung Joon
    • Mood & Emotion
    • /
    • v.16 no.3
    • /
    • pp.134-139
    • /
    • 2018
  • Objectives : Treatment for bipolar disorder is often complicated by various clinical situations. We undertook a survey of expert opinions to facilitate clinical decisions in special situations such as weight gain, metabolic syndrome, hyperprolactinemia, genetic counseling, and treatment adherence. Methods : A written survey that asked treatment strategies related to safety and tolerability, was prepared focused on weight gain, antipsychotic related hyperprolactinemia, lamotrigine related skin rash, treatment non-adherence and genetic counseling. Sixty-one experts of the review committee completed the survey. Results : In the case of weight gain related to medications, experts preferred exercise and education for diet-control. First chosen medications were lamotrigine, aripiprazole and ziprasidone. Recommendations based on expert survey results for treatment of bipolar patients in other special situations are outlined. Conclusion : With limitation of expert opinions, authors hope that results of this study provide valuable information to make clinical decisions about treatment of bipolar disorder in complicated situations.

Self-Management and Its Predictors for Patients with Poorly Controlled Type 2 Diabetes (혈당조절이 잘 안되는 당뇨 환자의 자기관리 정도와 관련요인 연구)

  • Lee, Jong-Kyung
    • Korean Journal of Adult Nursing
    • /
    • v.21 no.5
    • /
    • pp.447-457
    • /
    • 2009
  • Purpose: The purpose of this study was to investigate the level of self management of patients with poorly controlled type 2 diabetes, and to investigate the factors influencing self management. Methods: The subjects consisted of 117 diabetes patients who visited the outpatient department of a university hospital from March to August 2008. Data were collected by asking the subjects to answer a 54-item questionnaire and were analyzed using the SPSS/WIN 14.0 program. Results: The total mean score of the patients in self -management was 4.38 out of 7. Medication adherence obtained the highest score under self-management, and the self-monitoring of blood glucose obtained the lowest score. Family support, self-efficacy, severity, and depression were found to be significantly correlated with self-management. In stepwise multiple regression analysis a total of 44.5% of the variance in self management was accounted for by family support, self-efficacy, severity, and depression. Conclusion: Therefore, a diabetic intervention program should be designed and provided for increasing family support, self efficacy, and severity and for reducing depression of patients with poorly controlled type 2 diabetes.

  • PDF

Developing a Smart Pillbox to Improve the Medication Adherence of the Patients Requiring a Long-term administration (장기 투약대상자의 약물순응도를 높이기 위한 스마트 약상자의 구현)

  • Kim, Beom-Joon
    • 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.

Patients' Sources of Drug Information and Their Preferences in Community Pharmacy (외래 환자들의 의약품 정보원과 선호도 분석)

  • Lee, Yu-Jeung
    • YAKHAK HOEJI
    • /
    • v.54 no.4
    • /
    • pp.282-287
    • /
    • 2010
  • Appropriate drug information is essential in pharmaceutical care practice. In recent years, educating patients with their prescription and drug therapy is becoming an increasingly important aspect of health care. Appropriate drug information has been shown to improve patients' adherence to their medication and the results of pharmacotherapy. The purpose of this study was to study patients' sources of drug information and their preferences in Korea. This study was a 11-questionnaire survey conducted from February 8, 2010 to February 25, 2010. Major sources of drug information used by respondents, proportions of respondents who received drug information on administration, dosage, indication, or warnings and precautions, sources of drug information which patients prefer, and the reasons of their preferences were studied. Of the 303 respondents, the most common sources of drug information were pharmacists (29.7%), doctors (23.8%), and the Internet (17.2%). There were significant differences according to sources of drug information in proportions of respondents who received drug information on administration, dosage, indication, or warnings and precautions. Patients preferred pharmacists as a drug information source the most (38.9%), and the reasons were reliability (72.0%) and easy to use (28.0%). Based on the results of this study, further studies should be conducted to establish the best way to provide appropriate drug information for patients and improve the results of pharmacotherapy.

Using Intervention Mapping to Develop a Community-based Disease Self-management Support Program for Patients with Osteoarthritis (Intervention Mapping을 적용한 지역사회기반의 골관절염 자기관리지지 프로그램 개발)

  • Ahn, Yang Heui
    • Journal of muscle and joint health
    • /
    • v.22 no.3
    • /
    • pp.245-257
    • /
    • 2015
  • Purpose: The purpose of this study was to apply intervention mapping (IM) to develop a community-based disease self-management support program for patients with osteoarthritis. Methods: IM was applied as follows: i) a needs assessment has been carried out by a literature review, survey and interview with osteoarthritis patients; ii) on the basis of the needs assessment, identification of expected outcomes and change objectives for the target population; iii) selection of theory-based methods and practical applications to influence self-management and the determinants of behavior; iv) design of the intervention by developing activities and materials such as osteoarthritis self-management guide and smart patient pocket book. The activities were integrated into an existing healthcare activities; v) implementation and evaluation plan has been developed. Results: The program is aimed at improving health status through activating patients by a patient-centered and tailored intervention for patients with osteoarthritis; consists of 8 sessions with coaching and cognitive emotional psychological skills; includes smart patient, communication, osteoarthritis, medication adherence, pain control, depressive mood control, physical activity and healthy diet. Conclusion: The IM is a systematic and feasible method for developing the program. The next step is to evaluate the impact of the intervention on activation, and health status.