• Title/Summary/Keyword: Patient adherence

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Self-management levels of diet and metabolic risk factors according to disease duration in patients with type 2 diabetes

  • Cho, Sukyung;Kim, Minkyeong;Park, Kyong
    • Nutrition Research and Practice
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    • v.12 no.1
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    • pp.69-77
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    • 2018
  • BACKGROUND/OBJECTIVES: Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. SUBJECTS/METHODS: Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998-2014). In our analysis, 4,148 patients with T2DM, aged ${\geq}30years$, were categorized according to the duration of their illness (< 5 years, 5-9 years, and ${\geq}10years$). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. RESULTS: In the multivariable adjusted models, patients with a longer duration (${\geq}10years$) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61-3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ${\geq}10years$ (P for trend = 0.004). CONCLUSION: Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.

Childhood Trauma and Pharmacotherapy Retention among Outpatients with Panic Disorder (공황장애 외래 환자의 아동기 외상과 약물치료 유지)

  • Kim, Dong Joo;Kim, Daeho;Lee, Jinbok;Kim, Yaeseul;Sohn, Sujin
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.53-62
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    • 2020
  • Objectives : This study investigated lifetime experiences of trauma, treatment retention, and psychiatric symptoms among outpatients with panic disorder after initiation of pharmacotherapy. Our research hypothesis was that panic patients with childhood trauma would display more severe symptoms and less treatment retention compared to those without such history. Methods : A total of 135 first-visit outpatients with DSM-IV panic disorder were approached during the period from March 2012 to August 2016. Fifty-three patients (39%) either refused or returned incomplete questionnaires, leading to a final sample size of 82. Participants completed the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : The number of lifetime trauma was significantly correlated with treatment retention (rho=-0.269, p=0.015). Among subtypes of trauma, only childhood physical abuse was significantly correlated with treatment retention (rho=-0.298, p=0.007). Conclusions : Our results indicated that psychological trauma, particularly of an interpersonal nature from childhood, can affect pharmacotherapy treatment retention in panic disorder. This may be mediated by poor patient-doctor relationships originating from trust issues among childhood trauma survivors or lack of perceived improvement due to the more severe symptoms and unfavorable course experienced by those with childhood trauma. Further studies are needed to explore the reasons for poor treatment adherence in this population.

Assessment of the Quality of Reporting on Case Reports in Journal of Sasang Constitutional Medicine from June 2018 to December 2021: Using CARE Guideline (2018~2021년 사상체질의학회지 증례 보고의 질 평가 : CARE지침을 바탕으로)

  • Kim, Ji Hwan;Jeong, Aram;Lee, Hye Lim
    • Journal of Sasang Constitutional Medicine
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    • v.34 no.1
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    • pp.13-27
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    • 2022
  • Objectives The purpose of this study is to reevaluate the quality of reporting on case reports published in Journal of Sasang Constitutional Medicine (SCM) from June 2018 to December 2021, compared with January 2015 to May 2018. Methods Case reports were identified by searching from archive on the website of society of Journal of SCM. We assessed the quality of reporting on them based on CAse REport (CARE) guideline. Results A total of 32 case reports was finally included for the assessment. Overall quality of reporting was improved compared to one of previous study. The median reported rate of 'sufficiently' reporting increased by 7.8% from 66.7% to 74.5%, while the one as evaluated 'not sufficiently' and 'not reported' decreased by 4.1% from 14.8% to 10.7%, and 3.5% from 21.4% to 17.9%, respectively. However, more than 50% of 32 case reports did not still report 5 items about intervention adherence and tolerability(96.9%), diagnostic challenges(93.8%), adverse events(87.5%), timeline(68.8%), and patient's perspective on interventions(65.6%). Compared to the results of previous study, continuous attention is required for adverse events and changes in intervention in which the unreported rate increased by 18.3% and 6.3%, respectively. In addition, prognostic characteristics, patient's informed consent, patient's occupation, and keyword of 'Case report' and 'Sasang (Constitutional) medicine' should be sufficiently reported in the future. Conclusions Despite the overall improvement in the quality of reporting, efforts to improve the quality of reporting should be continued by referring to well-reported cases reports previously published in Journal of SCM.

Potentially Inappropriate Prescriptions of Antibiotics in Patients with Acute Rhinosinusitis in Ambulatory Settings in South Korea (외래 급성 비부비동염 환자의 잠재적으로 부적절한 항생제 사용)

  • Daei Jung;Nam Kyung Je
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.4
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    • pp.261-269
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    • 2023
  • Background: Acute rhinosinusitis (ARS) is a common condition encountered in ambulatory practice and is one of the most common reasons for antibiotic prescriptions. This study aimed to evaluate the potentially inappropriate antibiotic prescribing for ARS in South Korea and identify influencing factors. Methods: We analyzed Health Insurance Review and Assessment Service-National Patient Samples data. We selected outpatients aged 20 to 64 with ARS, prescribed antibiotics between February and November 2020. Potentially inappropriate antibiotic prescribing was categorized as: 1) inappropriate antibiotic selection and 2) inappropriate antibiotic dosage or duration. Multiple logistic regression was conducted to estimate the impact of various factors on inappropriate antibiotic prescribing. Results: Of 1,210 patients, 80.83% received potentially inappropriate ARS antibiotic prescriptions. Inappropriate antibiotic selection accounted for 43.55%, and inappropriate antibiotic dosage and duration contributed to 37.28%. Otolaryngologists had higher odds ratio (OR) of potentially inappropriate antibiotic prescribing compared to internal medicine practitioners, while dentists had lower OR. Patients aged 20 to 29 years had a higher OR than other age groups, and those who visited primary care clinics had a higher OR than those who visited hospitals. Conclusion: Potentially inappropriate antibiotic prescribing for ARS is prevalent in South Korea. This study identified physician specialty, patient age group, and the level of healthcare facility as factors influencing potentially inappropriate antibiotic prescriptions. Addressing this issue through targeted interventions, such as improved guidelines adherence and patient education, is imperative to mitigate the risks associated with antibiotic misuse and antibiotic resistance.

Efficacy of 10-Injection Induced Modified Rush Immunotherapy in Dogs with Atopic Dermatitis

  • Kim, Hyun-Tae;Lee, Wang-Hui;Park, Seong-Jun
    • Journal of Veterinary Clinics
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    • v.37 no.3
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    • pp.141-144
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    • 2020
  • Modified rush immunotherapy (IT), by combination of rush IT and conventional IT, provides a faster method to reach maintenance dose, leading to higher patient adherence when compared with conventional IT, decreasing systemic adverse reactions when compared with a standard rush IT. Ten atopic dogs of this study include fulfillment of Favrot's criteria. Offending allergens were identified by the use of IDST. During the induction period, the dogs were received a total of 10 injections. Five injections were administrated every 30 minutes in a day with gradually increasing amounts and concentrations of allergens, and the last 5 injections were administered every 3 days. The efficacy of 10-injection induced mRIT was assessed using the canine atopic dermatitis extent and severity index (CADESI). During maintenance period, reduction rate from baseline scores varied between 3.2% and 60.9% and the after 6 months of therapy for CADESI-03 score in 6 of the 10 dogs. Adverse reactions were not observed in these dogs during induction period by mRIT with 10 injections. Based on these results, our modified rush IT protocol is considered to be a useful protocol to treat canine atopic dermatitis.

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
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    • v.8 no.4
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    • pp.611-617
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    • 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.

Assessment of the Quality of Case Reports in the Journal of Acupuncture Research Using the CARE and STRICTA Guidelines

  • Nam, Eun-Young;Hwang, Ji Hye
    • Journal of Acupuncture Research
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    • v.37 no.4
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    • pp.224-232
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    • 2020
  • The purpose of this study was to assess the quality of the case reports in the Journal of Acupuncture Research (JAR). All case reports were retrieved from November 2017 to June 2020. There were 19 case reports included in this assessment based on the case report (CARE) guidelines and case report and standards for reporting interventions in clinical trials of acupuncture (STRICTA) guidelines. The overall quality of reporting was relatively high (83.08% on Case Report guidelines and 77.78% on Standards for Reporting Interventions in Clinical Trials of Acupuncture guidelines), but several crucial items remained substantially underreported, such as identifying as a case report (keywords), patient information and perspective, clinical findings, diagnostic assessment, and intervention information. In 18 out of 19 included case reports of acupuncture-related interventions, several items remained considerably underreported such as acupuncture regimen variation, depth of needle insertion, response sought, and experience of acupuncturists. In the classification by disease, condition, or syndrome, 13 out of 19 included case reports were for musculoskeletal disorders (68.4%), which is the main clinical medical field of Korean medicine services. The results of this study may help develop more appropriate reporting guidelines for case reports published in JAR.

Stability of implant screw joint (임플란트 나사의 안정성)

  • Chung, Chae-Heon;Kwak, Jong-Ha;Jang, Doo-IK
    • Journal of Dental Rehabilitation and Applied Science
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    • v.19 no.2
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    • pp.125-137
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    • 2003
  • The use of screw-retaind prosthesis on an osseointegrated implant is a popular treatment modality offering relative ease in the removal of the restoration. One of the complications associated with this modality is the loosening of the abutment and coping screws. Loosening of the screws results in patient dissatisfaction, frustration to the dentist and, if left untreated, component fracture. There are several factors which contribute to the loosening of implant components which can be controlled by the restorative dentist and lab technician. This article offers pratical solutions to minimize this clinical problem and describes the factors involved in maintaining a stable screw joint assembly. To avoid joint failure, adherence to specific clinical, as well as mechanical, parameters is critical. With respect to hardware, optimal tolerance and fit, minimal rotational play, best physical properties, a predictable interface, and optimal torque application are mandatory. In the clinical arena, optimal implant distribution; load in line with implant axis; optimal number, diameter, and length of implants; elimination of cantilevers; optimal prosthesis fit; and occlusal load control are equally important.

Prevention of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients

  • Shankar, Abhishek;Roy, Shubham;Malik, Abhidha;Julka, PK;Rath, GK
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6207-6213
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    • 2015
  • The supportive care of patients receiving antineoplastic treatment has dramatically improved over the past few years and development of effective measures to prevent nausea and vomiting after chemotherapy serves as one of the most important examples of this progress. A patient who starts cancer treatment with chemotherapy lists chemotherapy-induced nausea and vomiting as among their greatest fears. Inadequately controlled emesis impairs functional activity and quality of life, increases the use of health care resources, and may occasionally compromise adherence to treatment. New insights into the pathophysiology of chemotherapy-induced nausea and vomiting, a better understanding of the risk factors for these effects, and the availability of new antiemetic agents have all contributed to substantial improvements in emetic control. This review focuses on current understanding of chemotherapy-induced nausea and vomiting and the status of pharmacological interventions for their prevention and treatment.

Factors associated with Disease Specific Self-efficacy of Mothers of Children with Atopic Dermatitis (아토피피부염 자녀를 둔 어머니의 질환관리 효능감 관련 요인)

  • Lee, Hyejung;Son, Hae Kyoung;Kim, Ji Su;Han, Man Yong;Noh, Geunwoong
    • Korean Parent-Child Health Journal
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    • v.19 no.1
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    • pp.9-16
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    • 2016
  • Purpose: The disease specific self-efficacy of mothers caring children with atopic dermatitis is a crucial factor for adherence to recommended treatments. This study investigated factors associated with disease specific self-efficacy of mothers of atopic dermatitis children. Methods: A cross-sectional study was used. One hundred twenty five mothers recruited from the out-patient clinic of three hospitals completed self-administrative questionnaires, including the disease specific self-efficacy, general parenting efficacy, and severity of atopic dermatitis. Descriptive statistics, ANOVA, and multiple regression analysis were performed. Results: The degree of disease specific self-efficacy of mothers was significantly different according to the disease severity, and parenting efficacy. 26.0% of the variance of disease specific self-efficacy was explained by the severity of disease and parenting efficacy. Conclusions: Future studies need to focus on the development of educational programs that will help to improve mothers' disease specific self-efficacy as well as parenting efficacy.

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