• Title/Summary/Keyword: Non Pharmacotherapy

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The Review for Studies of Non Pharmacotherapy on Dysmenorrhea (월경통에 대한 비약물요법관련 논문에 관한 고찰)

  • Shin, Jung-Mi;Kang, Mi-Suk;Song, Ho-Sueb;Lim, Eun-Mee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.2
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    • pp.203-213
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    • 2008
  • Purpose: This study is to evaluate the efficacy of non pharmacotherapy on dysmenorrhea. Methods: Survey was done through web site and directly searched dysmenorrhea -related articles in journals of Korean medicine Gynecology, published during 1996-2008. Results: 1. All articles reported non pharmacotherapies were significant efficacy in the decrease of dysmenorrhea. 2. The distribution of therapy was acupunture treatment 14 articles and the other treatments 6 articles. 3. The frequency of acupoint was Sanyinjiao(三陰交, SP6) 10 articles, Guanyuan(關元, CV4) 5 articles, Qihai(氣海, CV6) 4 articles and mainly used meridians were Immaek(任脈), Liver Meridian of Foot Gworeum(足厥陰肝經), Spleen Meridian of Foot Taeum(足太陰脾經). 4. The distribution of period for treatment were the most predominant as 7(35%) articles from one day before menstruation to the second day of menstruation. 5. The distribution of duration for treatment were the most predominant as 7(35%) articles in one day. 6. VAS was mainly used in the evaluation of dysmenorrhea and MDQ, MMSL, MVRS were used in premenstrual syndrome. Conclusion: In this study, non pharmacotherapies were effective on dysmenorrhea.

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The Risk of Cardiovascular Disease and Diabetes in Rheumatoid Arthritis Patients: A Propensity Score Analysis (류마티스관절염 환자의 심혈관 질환 및 당뇨병 위험분석: a propensity score analysis)

  • Rhew, Kiyon
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.2
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    • pp.109-114
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    • 2019
  • Background: Rheumatoid arthritis (RA) is a systemic inflammatory disease that manifests as joint damage or athletic disability via sustained inflammation of the synovial membrane. The risk of cardiovascular disease (CVD) is higher in RA patients. This study aimed at evaluating the association between CVD comorbidities and RA by comparing a pharmacotherapy group with a non-pharmacotherapy group. Methods: Patient sample data from the Health Insurance Review and Assessment Service (HIRA-NPS-2016) were used. Inverse probability of treatment weighting (IPTW) using the propensity score was used to minimize the differences in patient characteristics. Logistic regression analysis was used to evaluate the risk of CVD comorbidities. Results: The analyses included 1,207,213 patients, of which 33,122 (2.8%) had RA. The odds ratios (OR) of CVD comorbidities were increased in RA patients; ischemic heart disease (IHD: OR 1.75; 95% CI 1.73, 1.77), cerebral infarction (CERI: OR 1.28; 95% CI 1.26, 1.30), hypertension (HTN: OR 1.44; 95% CI 1.43, 1.45), diabetes mellitus (DM: OR 2.04; 95% CI 2.03, 2.06), and dyslipidemia (DL: OR 3.49; 95% CI 3.47, 3.51). The ORs of IHD, CERI, HTN, and DM in the traditional DMARD and biologic treatment groups were decreased, compared with those in the non-pharmacotherapy group. Conclusions: Thus, CVD risk was higher in RA patients, considering age, sex, and socioeconomic status. Appropriate pharmacotherapy could decrease the risk of CVD comorbidities in RA patients.

Factors to Predict a Remission after Short-Term Pharmacotherapy in Korean Panic Disorder Patients (한국인 공황장애 환자에서 단기간 약물치료 후 관해 예측인자 연구)

  • Sim, Hyun-Bo;Kang, Eun-Ho;Yu, Bum-Hee
    • Anxiety and mood
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    • v.3 no.2
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    • pp.110-115
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    • 2007
  • Objective : The authors examined the treatment response and remission rates in patients with panic disorder after short-term pharmacotherapy in an effort to determine the factors that can be used to predict remission in Korean patients with panic disorder. Methods : Sixty-one patients with panic disorder were recruited for participation in this study. The psychological symptoms of the patients were measured using the HAMA, HAMD, STAIS, STAIT, ASI and API at baseline and after 3 months of pharmacotherapy. Results : Patients with panic disorder showed significantly lower scores on all psychological measures after 3 months of pharmacotherapy with paroxetine. The remission rate was 44.3%, and the response rate was 54.1%. The remitters showed significantly lower HAMD, HAMA, STAIS, STAIT, and ASI scores than the non-remitters. Linear regression analysis revealed that the baseline HAMA, HAMD, and ASI scores could be used to predict the remission rate after controlling for age, sex and agoraphobia. Conclusion : Compared with previous reports, our study showed a similar remission rate in Korean patients with panic disorder. Lower baseline levels of anxiety, depression, and anxiety sensitivity were found to be predictors of treatment remission in panic disorder.

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Pharmacotherapy for dementia (치매의 약물요법)

  • Youn, HyunChul;Jeong, Hyun-Ghang
    • Journal of the Korean Medical Association
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    • v.61 no.12
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    • pp.758-764
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    • 2018
  • Dementia is a clinical syndrome characterized by a cluster of symptoms and signs that manifest as difficulties in cognitive functions such as memory, psychological and psychiatric changes, and impairments in activities of daily living. As a result of worldwide trends of population aging, dementia has had a huge impact on public health in almost all countries. Disease modification therapies for dementia have not yet been developed. However, pharmacotherapy is essential in patients with dementia to combat delays in their cognitive and functional decline. In this article, we review the current pharmacotherapy for dementia. Three acetylcholinesterase inhibitors-donepezil, rivastigmine, galantamine-and memantine are the only medications that have been approved for the treatment of dementia. We present the indications, dose recommendations, side effects, and criteria for National Health Insurance coverage in Korea of these medications for dementia treatment. Although the Ministry of Food and Drug Safety in Korea has not approved any medications for managing the behavioral and psychological symptoms of dementia, some antipsychotics and antidepressants have been studied and used clinically for those purposes. Clinicians may consider vitamin E, Ginkgo biloba extract, choline alfoscerate, or omega-3 fatty acids as additional treatment options. Non-steroid anti-inflammatory drugs, estrogen hormone therapy, and statins are not generally recommended for dementia treatment. We believe that our findings will aid clinicians in the treatment of patients with cognitive decline.

Insomnia in the Elderly (노인에서의 불면증)

  • Sohn, Chang-Ho
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.5-10
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    • 2001
  • The prevalence of insomnia and the degree of impairment due to insomnia is greater than in the of young. The cause for insomnia in the elderly are various factors among the elderly is known to be high including medical, psychiatric, drug issues, circadian rhythm changes, sleep disorders, and psychosocial. So the careful evaluation to find the cause of insomnia is needed for the eldery. Treatment options for insomnia include behavior modification and pharmacotherapy. Outcome data from previous studies indicate that behavioral approaches produce reliable and durable therapeutic benefits, as evidenced by improved sleep efficiency and continuity and enhanced satisfaction with sleep patterns. Treatment methods such as stimulus control and sleep restriction, which target maladaptive sleep habits, are especially beneficial for older insomniacs, whereas relaxation-based interventions aimed at decreasing arousal, produce more limited effects. Cognitive and educational interventions are instrumental in altering age-related dysfunctional beliefs and attitudes about sleep. The choice of hypnotics is based on matching the nature of the insomnia to the hypnotic agent. The ideal agent has rapid onset, duration of action that lasts through the night but no residual daytime effects, and no adverse effects. The key for the healthcare professional is finding the appropriate treatment or treatment combination, including behavioral modification and pharmacotherapy. When hypnotics are indicated, the most appropriate short-acting agent should be considered.

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Factors Affecting Adherence to Pharmacotherapy in Children with Attention-Deficit Hyperactivity Disorder: A Retrospective Study (주의력결핍 과잉행동장애 아동의 약물치료 순응도에 영향을 미치는 요인 : 후향적 연구)

  • Kim, Yoon-Jung;Oh, So-Young;Lee, Ji-Ah;Moon, Su-Jin;Lee, Won-Hae;Bahn, Geon-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.21 no.3
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    • pp.174-181
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    • 2010
  • Objectives: To identify the factors affecting long-term adherence to methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). Methods: A retrospective medical record review of 239 ADHD patients (mean age $9.3{\pm}2.6$ years, range 6.0-17.4 years) who had visited the child and adolescent psychiatry clinic at a university hospital, in Seoul, Korea from March 2005 to February 2008. Subjects were diagnosed as ADHD based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision version (DSM-IV-TR) and underwent neuropsychological tests including the continuous performance test (CPT). Treatment discontinuation was defined as the last prescription date when the medication possession rate (MPR) became less than 0.80. Subjects were divided into three groups and labeled as Group I, non-adherence without pharmacotherapy, Group II, non-adherence with short-term pharmacotherapy, and Group III, adherence with long-term pharmacotherapy. Results: Ninety (37.7%) patients were grouped as non-adherent (Groups I+II) and 149 (62.3%) as adherent (Group III). The adherence group exhibited lower intelligence, higher symptom severity, and a higher number of comorbid psychiatric disorders than controls. The use of stimulants was significantly associated with long-term adherence to treatment. Additionally, the duration of interval between the date of the first visit and the date of the first prescription was positively associated with long-term adherence. Conclusion: About two-thirds of patients diagnosed as ADHD adhered to the treatment six months after the first visit. With respect to patient evaluation and the development of treatment strategies, factors affecting early drop-out and longer follow-up must be considered.

Management of Temporomandibular disorder (측두하악장애의 치료)

  • Jung, Da-Woon;Chung, A-Young;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.4
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    • pp.441-452
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    • 2012
  • Most of signs and symptoms of temporomandibular disorder(TMD) is temporary and self-limiting as other musculoskeletal diseases. Conservative, reversible treatment; self care, behavior modification, physical therapy, pharmacotherapy, splint therapy should be considered as initial treatment for temporomandibular disorder rather than non conservative, irreversible treatment.

Patterns and Persistence of Pharmacotherapy for Children and Adolescents with Attention Deficit Hyperactivity Disorder in South Korea (국내 주의력결핍 과잉행동 장애 아동 및 청소년의 약물요법 패턴 및 지속성)

  • Lee, Kyeong Eun;Je, Nam Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.3
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    • pp.216-223
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    • 2018
  • Objective: This study aimed to assess treatment persistence in Korean children and adolescents with attention deficit hyperactivity disorder (ADHD) and the factors influencing their adherence to ADHD pharmacotherapy. Methods: The study included patients between 6 and 18 years of age with ADHD who were taking various formulations of methylphenidate and atomoxetine on June 1, 2014. Patients were dichotomized as "persistent" or "non-persistent", depending on whether they continued ADHD therapy for 6 months (therapy persistence). We also investigated if the patients were taking the same medication(s) as before and also classified the patients as "medication persistent" or "non-persistent". Patient' characteristics were correlated with therapy persistence and medication persistence. Multiple logistic regression analyses were performed to assess potential risk factors for treatment persistence. Results: Overall, 3,317 patients were included in the analysis. A majority of patients were taking stimulants (82.0%), 16.2% were taking non-stimulants and 1.8% were taking a combination therapy of stimulants and non-stimulants. After 6 months, 2,290 patients (69.0%) continued to take medication for ADHD with 1,953 patients taking the same medication(s) as 6 months previously. Common positive factors for therapy persistence and medication persistence were identified as younger age, retardation, and developmental delay, and long-acting formulations of methylphenidate as either monotherapy or in a combination therapy may be used. Conclusion: ADHD medications were proven to improve academic performance and social skills of children. Collaboration between patients, parents, school staffs, and prescribers is required to improve the persistent use of ADHD medications.

Pharmacotherapy for Obesity in Mood Disorders (기분장애 환자의 비만에 대한 약물치료)

  • Sohn, Inki;Lee, Kyu-Hang
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.63-70
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    • 2014
  • The prevalence of obesity and overweight is increasing in mood disorder, and it is connected to an increased cardiovascular mortality. Because of them, treatment for obesity may be an essential part of mood disorder treatment. Similar to the general population, non-pharmacological treatment such as correction of life habits should be considered first of all. If this approaches are fail, pharmacological treatment for obesity would be required as next step. Any drug for obesity is not approved officially in mood disorder. So approved drugs in general population, and drugs supported by several studies are prescribed in clinical settings. Several treatment guidelines for mood disorder and studies support that orlistat, metformin, topiramate and bupropion is effective and safe.

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