Objectives While Temporomandibular disorders (TMD) is highly prevalent in Korea, studies examining its Korean medical treatment are currently lacking. The aim of this study was to assess current Korean medical treatment practice patterns for TMD. Methods A preliminary questionnaire was developed to investigate current practice patterns of TMD treatment and underwent further revision through external review. The final questionnaire was distributed as a web-based survey to 18,289 potential respondents by email. Results The response rate was 2.23%. Most participants replied that they received multiple Korean medicine interventions for TMD treatment consisting of such methods as acupuncture, chuna manipulation, electroacupuncture. The percentage of treatment services among uncovered services, which need to be covered by national health insurance was high in the order of pharmacopuncture, chuna manipulation, and herbal medicine. The most commonly used diagnostic examination tools for TMD was Physical examination and next was Imaging diagnosis. The frequency of TMD treatment was the highest at 2~3 times per week (76%) and the period was from 4 to 12 weeks (63%). Conclusions This survey study helps determine current practice patterns of TMD, and recognizes the need for use of diagnostic devices in TMD treatment. These results are further anticipated to provide basic data for clinical practice guide lines (CPGs).
Objectives : The purpose of this study was to describe the type of claimed adverse events related to Korean Medicine practices in South Korea. Methods : Claims with regard to the Korean Medicine practice submitted to the Korea Medical Dispute Mediation and Arbitration Agency from April 2012 to December 2016 were collected. We analyzed claims that explicitly reported the type of Korean medicine intervention and were deemed as being adverse events as defined by the Korea Good Clinical Practice. Claims that did not mention the Korean medicine practice explicitly or those related to the patient's dissatisfaction to the service rather than adverse health outcomes were excluded. Types, related interventions and the suspected severity of claimed adverse events were summarized. Results : Of 197 claims obtained, 140 claim cases were eligible and 144 claimed events were deemed as possible adverse events of the Korean medicine practice. Pain(16%), local infection/inflammation(12%) and neurological symptoms(11%) were the most frequently reported types of claimed adverse events. Thirty-nine claimed serious adverse events(SAE) were identified, including pneumothorax(28.2%) and death(17.9%). Conclusions : A wide range of claimed adverse events were identified. Routine monitoring of claims data may provide undetected safety information with regard to the Korean medicine practice. High risk of misclassification of the intervention and claimed adverse events due to insufficient information is the main caveat of this study.
Objectives : This study aimed to investigate the medical contents of Korean medical textbooks and intervention usage in clinical practice. Method : We conducted an email survey of Doctors of Korean Medicine(DKMs) registered with the Association of Korean Medicine and analyzed the 259 responses that we received. Results : 1, The study showed that most DKMs used western medical knowledge concerning "history taking and diagnosis"(96.5%), "management and prevention"(95.8%), "causes and overview"(91.9%), and "prognosis"(90.3%). DKMs did not usually use western medical knowledge with regard to "diagnosis and treatment evaluation tools"(40.9%) or "western medical treatments"(25.1%) in their clinical practice. 2. Of the DKMs surveyed, 39.0% usually used traditional and western medical terms at similar levels of frequency in explaining their patients' conditions, while 35.9% used western medical terms more often and 20.8% used Korean traditional medical terms more often. 3. Most DKMs usually used acupuncture, herbal medicine, cupping therapy, Moxibustion in their practice and used herbal prescriptions presented in Dongeuibogam(57.1%), Bangyakhappyeon(52.9%), and Sa-Sang Constitutional Medicine(36.7%), although 27.8% used their own herbal prescriptions in creating for patients. In practice, DKMs usually used meridian acupuncture(64.1%), needling myofascial trigger points(54.8%), sa-am acupuncture(42.1%), dong-shi acupuncture therapy(24.7%), and constitutional acupuncture therapy(8.5%). Conclusions : We found that most DKMs use western medical contents as well as Korean medical contents in clinical practice. New Korean medical contents should be establish based on these results.
Ovarian cancer is the tenth most common cancer in Korean female, and the third most common cancer of female reproductive organ after breast cancer and uterine cervical cancer. In spite of develop of conventional treatment, high modality of ovarian cancer comes from difficulty of an early diagnosis. Recent studies revealed that combining conventional and integrative medical treatment can reduce the adverse effect of surgical operation, chemotherapy and radiotherapy. Also it can improve survival rate, quality of life. However there isn't still a systemic clinical protocol for ovarian cancer in Korean medicine. This study will be helpful to establish clinical practice guidelines of Korean Medicine for ovarian cancer. And further studies on integrative ovarian cancer treatment are needed to build the clinical practice guidelines of ovarian cancer.
Objectives : The purpose of this study was to investigate the current status of clinical practice for gout in Korean Medicine (KM). Methods : On-line survey was adopted for this study, targeted at KM Doctors who were registered in the Association of Korean Medicine. The questionnaire included the general status of treatment, pattern identification and treatment method according to three stages given: acute, chronic and asymptomatic hyperuricemia stage. Results : Data from a total of 384 respondents was analyzed. Participants who responded most were in their 40s, working in KM clinics located in Seoul. Acupuncture and herbal medicines were the top priority treatments in preparing recommendations in clinical practice guidelines for gout, and where clinical trials were considered essential. As of the past year, the average number of first visits per month was 86.7%, and the average treatment duration was less than 1 month, accounting for 72.9%. As for the diagnostic method used for gout patients, the "diagnosed by clinical pattern" response was the highest, and the "blood and urine test" response was the highest as the diagnostic equipment used. As for the evaluation scale being used, the "VAS/NRS" response was the highest. Regardless of the gout stage, acupuncture was the most commonly used treatment method for gout patients, and bee venom pharmacopuncture was the highest for the pharmacopuncture used. In the case of herbal medicine, it was found that a wider variety of herbal medication uninsured in health insurance and herbal prescription were used for the staged treatment of gout than herbal medication in national health insurance coverage. In clinical practice, "acupuncture treatment three times a week" was the most common, and the "acupoints in the limb" were the most frequently used; LR3 and SP3 were the most frequently used acupoints. Conclusions : It is suggested that this survey should be helpful to develop clinical practice guideline for gout that reflects actual clinical practice.
Chang-woo Seon;Ye-jin Hong;Kyung-bok Park;Jeong-rock Kim;Dong-woo Nam;Ye-eun Kim;Min-jeong Kim
대한한의학회지
/
제43권4호
/
pp.33-51
/
2022
Objectives: This study aimed to understand the current status of clinical practice patterns of Korean medicine in the treatment of degenerative arthritis of the hip and finger joints using web-based survey. Methods: An e-mail questionnaire survey was conducted with the Korean Medicine Doctor(K.M.D) registered in the Korean Medicine Association. The survey data were analyzed using Microsoft Excel. Results: Although the response rate of the survey was low, the characteristics of the respondents generally reflected the characteristics of the study population. A total of 35.2% of the respondents had heard of the guidelines; however, they did not use them for medical treatment. The reason as answered by 32.8% of the respondents was "not enough treatment time to check the manual and apply it." More than half (78.80%) answered that they were treating patients with both degenerative hip and finger arthritis; however, the average monthly number of first-time patients was ≤5. A total of 379 (60.9%) respondents answered that "acupuncture is very important," which was the only one that exceeded the majority compared to other treatments. As a result of the safety investigation, "Acupuncture, herbal medicine, cupping" were considered high in safety, while "Pharmacopuncture and Bee venom acupuncture" were considered low in safety. Conclusions: This survey helped to determine the current clinical practice patterns of Korean medicine treatments, further providing basic data for CPGs for degenerative arthritis of the hip and finger joints.
A systematic review of the literatures was conducted to evaluate the effect of clinical practice guideline. The 77 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and Blackwell synergy from January, 1997 to October, 2007. The main search terms were "clinical practice guideline" and "effectiveness", "clinical practice guideline" and "impact", "clinical practice guideline" and "evaluation". These studies were assessed the Quality twice by one Qualified expert and converted into weighted scale. The 63 studies were eligible inclusion criteria and subdivided into type of effect. Final indicator using for policy effect of clinical practice guidelines were classified as 4 categories; "improvement of outcomes" in 81 studies, "betterment in practice patterns" in 68 studies, "rationalization in resource utilization" in 84 studies and "cost containment" in 31 studies. The vote-counting method, one of meta-analysis method, was applied to summarized the effect of clinical practice guidelines and test statistically. From results of meta analysis, all indices were statistically significant. In conclusion, this meta-analysis showed that introduction of clinical practice guidelines were resulted positive outcomes in health policy.
Objectives: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician-nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.
Purpose : This study was designed to identify the perception and practice level of infection control among korean medical doctors and to identify factors that may influence the performance and practice level. Methods : Data were collected using the online survey method. Seven hundred and eighty four Korean medical doctors(KMD) participated the survey. The study was conducted from December 2018 to January 2019. Results : The results of this study are as follows. 1. Participants who experienced infection risk by needles or sharp instruments were 596(76%). and participants who had experienced blood or body fluid contact with the mucous membrane or skin of the patient during treatment were 226(28.8%) of them. 2. The degree of perception and practice of the infectious guideline was higher in the group over 50 years, in the doctor group, in the group with more than 6 years experience in clinic and in the group who work in the hospital. (p < 0.05) 3. In the performance of the infection control management related to the Korean medical treatment, the practice level of the article 'Discard the remaining needle that used for one patient' was the lowest at 4.02, 'Identify the patient and check the validity period of sterilization of medicines or instruments' was the second lowest in 4.16. 4. Among the contents of "Prevention of Nosocomial infection and Sanitary Safety Guidelines" issued by the Korean Medical Association in 2008, the guideline "Prevention of infection by pathogens such as HIV, MRSA, SARS" were lowest article in the perception and practice level of participants. 5. Regression analysis was performed to find out the factors affecting perception and performance of the participants. The regression model showed significant difference in the regression model of the working years. (p < 0.05) 6. In order to examine the effect of the variables on the perception and practice of the infectious guideline, the mediated effect of the knowledge and education level according to the years of working, age, education degree was found to be significant only in the education degree variable. (p < 0.05) In conclusion : in order to improve the perception and practice of infectious control of Korean medicine doctors, it is necessary to include the contents of infection management as essential education during the continuing education of Korean medicine association.
Objectives In this study, we analyzed the effect of Dioscoreae Rhizoma on exercise practice ability and blood fatigue variable factor in the forced swimming test. Methods Male mice were divided into four group. Mice were administrated with saline, Discorae Rhizoma extracted by water (DRW), Discorae Rhizoma extracted by 30% ethanol (DRE), red ginseng (RG), orally once per day, for 1 week. Exercise performance was evaluated by exhaustive swimming time and weights. Glycogen contents of liver and soleus muscle were measured at the end of the experiment. In addition, the biochemical parameters such as asparate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen, creatine, lactate dehydrogenase (LDH), ammonia, triglycerides (TG), total cholesterol (TC) and free fatty acid (FFA) were analyzed. Results Both DRW and DRE showed an improvement of swimming endurance compared with control group. Levels of ALT, ammonia, TG, TC and FFA were significantly decreased in both DRW and DRE compared with control group. Levels of AST, Creatine were significantly reduced in DRE group compared with control group. Moreover LDH showed only a tendency to increase in the DRW and DRE groups. Conclusions In summary, the present study showed that Dioscoreae Rhizoma improved in physical fatigue and exercise practice ability and DRE improved the superior than those of DRW.
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