• Title/Summary/Keyword: Therapeutic guideline

Search Result 89, Processing Time 0.028 seconds

The Effect of Biological Equivalence Examination on Prescribing Practice of Doctors (글리메피라이드 제제의 생물학적동등성 시험이 의사의 처방전발행에 미치는 영향)

  • Jang, Mal-Sook;Choi, Byung-Chul;Yong, Chul-Soon;Choi, Han-Gon;Rhee, Jong-Dal;Yoo, Bong-Kyu
    • Korean Journal of Clinical Pharmacy
    • /
    • v.16 no.2
    • /
    • pp.96-100
    • /
    • 2006
  • Korea Food and Drug Administration (KFDA) has been expediting the Biological Equivalence Examination (BEE) project to encourage generic substitution without expense of inappropriate therapeutic outcome. However, little is known about which considerations are most important in making the decision to prescribe a drug among many generic drugs. The purpose of this survey was to identify how strongly the KFDA certification of BEE influenced doctors when they make a choice between brand and generics of glimepiride preparations. Telephone survey was performed towards doctors working at local clinics by using a questionnaire. Most influential factor to doctors' decision was drug cost followed by pharmaceutical representatives, therapeutic efficacy, and review guideline for reimbursement. Advertisement of the drug was the least influential followed by KFDA certification of BEE. The meaning of BEE was best understood by relatively young doctors with specialty in surgical parts. This survey result further indicated that the doctors considered the therapeutic equivalence examination a preferred measure to expedite generic substitution.

  • PDF

A Study on the Composition between Nature and Architectural Space in Healthcare Facilities (의료시설에서 자연과 건축공간의 관계 구성에 대한 연구)

  • Yoon, Eunji;Lim, Yeonghwan
    • Journal of the Architectural Institute of Korea Planning & Design
    • /
    • v.34 no.12
    • /
    • pp.113-122
    • /
    • 2018
  • The purpose of healthcare facility should be user healing and health promotion. However, healthcare facilities have a bigger impact on the natural environment than the general buildings, eventually effecting the health of people globally. 'Environmentally friendliness' is a more important concept in hospitals, not just in technical or mechanical performance but in therapeutic effects on users. Therapeutic environment is closely related to the natural environment. Depending on how the natural environment is drawn into the space, the healing effect of the patients is also increased. Most of the previous studies are statistical and comparative researches that cannot provide theoretical basis of architectural planning. Therefore, architectural research on the composition of architectural space and nature is needed. In this study, we categorize 16 types of relation between architectural space and nature, and based on this, analyze the present situation of 7 regional public hospitals' 33 spaces, and provide theoretical background and guideline for therapeutic space.

Clinical Practice Guideline of Gastric Cancer in Korea (위암 표준진료권고안)

  • Jae Gyu Kim
    • Journal of Digestive Cancer Research
    • /
    • v.4 no.1
    • /
    • pp.10-16
    • /
    • 2016
  • There were no Korean evidence-based multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework and the recommendation grades were classified as either strong or weak. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. Major limitation of the present guideline is that there is no enough evidences in Korea. Therefore, clinical studies about gastric cancer for evidence generation should be conducted.

  • PDF

Current Guidelines on the Management of Dyslipidemia (이상지질혈증의 국내 및 국외 치료 가이드라인 비교)

  • Choi, Yunjeong;Lee, Song;Kim, Ju Young;Lee, Kyung Eun
    • Korean Journal of Clinical Pharmacy
    • /
    • v.27 no.4
    • /
    • pp.276-283
    • /
    • 2017
  • Objective: Dyslipidemia is recognized as a prominent risk factor for cardiovascular and cerebrovascular diseases but it is manageable through therapeutic and lifestyle intervention. Interpreting the latest guidelines is essential for an application of recommendation from guidelines into clinical practice. Therefore, this study aimed to compare the most recent guidelines on dyslipidemia treatment recommendations in Korea and USA. Methods: This study analyzed and compared 2015 Korean guidelines for the management of dyslipidemia, 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline and 2016 supportive guidelines from ACC. Results: A comparison was made focused on the following: target patients based on cardiovascular risk assessment, target goal, and treatment strategies including statin and non-statin therapies. Four target patient groups by risk were suggested in 2015 Korean guideline and cardiovascular risk factors were also considered for initiation of lipid lowering therapy. Titrated statin regimen was recommended by Korean guideline to reach LDL cholesterol and non-HDL cholesterol target level. In 2013 ACC/AHA guideline, four statin benefit group was introduced considering ASCVD risk and high intensity statin or intermediate intensity statin use were recommended without dose titration. 2016 update was to support non-statin therapy based on updated evidence and new consideration of ezetimibe, PCSK9-inhibitor and bile acid sequestrant was brought up. Conclusion: Guidelines are continuously updating as new and important clinical data are constantly released along with the advent of newly approved drugs for lipid disorder. This article provides resources that facilitates uptake of these recommendations into clinical practice.

An Improvement Plan with Assessment of Therapeutic Drug Monitoring Service for Vancomycin (Vancomycin Therapeutic Drug Monitoring 운영 실태 조사와 업무 개선 방안)

  • Kim, Hae-Sook;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
    • /
    • v.19 no.2
    • /
    • pp.120-130
    • /
    • 2009
  • The objective of this study was to analyze and to improve therapeutic drug monitoring(TDM) service of vancomycin in a local hospital. Patients with TDM service between September 2005 and December 2008 were included and the data were collected for vancomycin use and components of TDM. During that period, 421 cases of TDM service of vancomycin in 236 patients were retrospectively reviewed. The first dosages of vancomycin were appropriate in 135(57.2%) patients and administration of vancomycin was discontinued in 126(53.4%) patients due to therapeutic failure or adverse drug reaction. MRSA was identified in 191(80.9%) patients and 135(70.7%) samples for the identification were sputum. According to the TDM reports, 232(55.1%) serum samples were obtained at the steady-state conditions and 55.5% of the samples that were drawn before the steady-state was due to the physician's inappropriate knowledge about the steady-state. Based on the time of vancomycin administration, 35.8% of the samples were not obtained at the recommended sampling time. For the patients in general wards, the most common reason for the incorrect samples was routine serum sampling by the laboratory medicine phlebotomists between 6 and 8 a.m. except sunday. In contrast, samples drawn by nurses or physicians at inappropriate time were the most common reason for the incorrect samples with patients in the intensive care units. Physicians accepted 68.5% of the recommendations for vancomycin dosage and administration. In conclusion, TDM service of vancomycin needs to be improved in inappropriate sampling time and vancomycin dosage. For solving these problems, current team made of TDM pharmacists and physicians of laboratory medicine can be expanded to include a physician of infectious diseases, nurses and laboratory medicine phlebotomists as new members. Through the TDM service of vancomycin by the new team, we can settle the problems and make the guideline for the scientific controversies associated with therapeutic monitoring of vancomycin.

  • PDF

LITERATURE REVIEW OF ANTIBIOTICS PRESCRIPTION IN GENERAL DENTAL AND ORAL-MAXILLOFACIAL SURGICAL PRACTICE (치과분야 항생제 처방에 대한 국내외 문헌 분석)

  • Jo, Sae-Hyung;Alrashdan, Mohammad;Choung, Han-Ul;Pang, Kang-Mi;Park, Jong-Chul;Kim, Soung-Min;Kim, Myung-Jin;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.35 no.3
    • /
    • pp.164-169
    • /
    • 2009
  • Objectives : Administration methods of antibiotics implements a variety for indications and diseases. Therefore, it is impossible to produce a single guideline. Many antibiotics have been prescribed without specific index, by practicians for a long period of time. In general dental practice and oral and maxillofacial surgical practice, there is not a guidelines for antibiotics. Therefore, there is a dependency on pre-existent methods rather than following an exact guideline. Consequently, a controversy was issued that prescription of antibiotics tend to be misused or abused. And it is also direct relation to the tolerance of antibiotics as well. Moving forward, in this review we will be analyzing the exact usage and indication of antibiotics in dental treatment. Materials and Methods : 29 published articles of both domestic and international were researched through Pubmed and Kormed, and the review from these articles were performed accordingly. We examined the administration of antibiotics through the objective usage, that classified prophylactic and therapeutic. Results : For therapeutic usage, empirical prescription is mandatory for the first step. Next is to moderate the empirical prescription depending upon the result of its culture. Administration of antibiotics must be kept for 2days after the symptoms disappear. For a prophylactic use, we can generally pr escribe antibiotics to prevent local infection or systemic infection. Although the method of prescription and neccessity of antibiotics to prevent local in fection are controversial, exact guidelines of antibiotics to prevent systemic infection are established by AHA. Conclusion : Most crucial concept for prescript antibiotics is to determine if it is adequately suitable for all circumstances. In this decision making, a guideline for prescription of antibiotics in various dental surgical practice is necessary. This guideline can reduce the misusage and disusage of a ntibiotics in general dental practices and oral and maxillofacial surgical practices.

Quality Evaluation of the Occupational Therapy Guidelines for Stroke (뇌졸중 작업치료 지침의 질 평가)

  • Lee, Eun-Young;Han, Dae-Sung;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
    • /
    • v.10 no.3
    • /
    • pp.57-69
    • /
    • 2021
  • Objective : The purpose of this study was to identify occupational therapy guidelines for patients with stroke according to the clinical guidelines, and to investigate the quality and characteristics of the identified guidelines. Methods : This involved a review of domestic and foreign rehabilitation treatment guidelines from 2008 to 2019. These guidelines were searched using, the search terms: 'stroke', 'guideline', 'practice guideline', 'recommendation', 'protocol compliance', 'practice guideline', and 'stroke guidelines'. Results : A total of 708 papers were identified from the search. Eight guidelines met the selection criteria and were included in this review. The selected guidelines were developed in Canada, Australia, the United States, the United Kingdom, and Korea. One of the eight guidelines was occupational therapy guidelines, and the other seven were rehabilitation guidelines. The guidelines were categorized into a total of 36 topics, including 28 guidelines for stroke rehabilitation in Australia, 24 guidelines for the British and American Heart Association, and 23 guidelines for stroke rehabilitation developed in Korea. Conclusion : In this study, the guidelines for occupational therapy for existing stroke patients were identified, and the quality and characteristics of the guidelines were compared. The results of this study will provide important basic data for the development of occupational therapy guidelines for stroke in the future.

Guideline for Bioequivalence Studies of Generic Products for Topical Use (국소용 후발의약품의 생물학적동등성시험을 위한 가이드라인)

  • Choi, Sun-Ok;Jung, Sung-Hee;Um, So-Young;Jung, Seo-Jeong;Kim, Joo-Il;Chung, Soo-Youn
    • Journal of Pharmaceutical Investigation
    • /
    • v.34 no.4
    • /
    • pp.333-340
    • /
    • 2004
  • A new medical system of separation of dispensary from medical practice was started in 2000 in Korea. To expand bioequivalence-proven drug products and to ensure the credibility of the therapeutic equivalence of generic drug are hot issues in Korea. The KFDA also has a plan to revise the pharmaceutical affairs law that bioequivalence reports of all the generic prescription drugs should be submitted to the KFDA in the application for drug approval. Therefore, it becomes more necessary to develop bioequivalence-demonstrating methods for specific preparations such as topical drug products. There are some differences between US and Japanese guidances of bioequivalence studies of generic drug products for topical use. In this paper, we examined the recently published Japanese guideline, Guideline for Bioequivalence Studies of Generic Products For Topical Uses, and Q&A of the guideline, which will be references to make a guidance on bioequivalence studies of topical drug products in Korea.

Multidisciplinary Approaches in Developing Guideline for Mediating Behavioral Problems in Children and Adolescents with Neurodevelopmental Disorders (발달장애 문제행동 치료 가이드라인 제작을 위한 다학제적 접근)

  • Hong, Kyungki;Song, Hokwang;Oh, Maehwa;Oh, Yunhye;Park, Subin;Kim, Yeni;Choi, SungKu
    • Journal of Korean Neuropsychiatric Association
    • /
    • v.57 no.2
    • /
    • pp.190-208
    • /
    • 2018
  • Objectives To initiate and develop a treatment guideline in multidisciplinary approaches for related professions who are either working and/or living with children and adolescents with neurodevelopmental disorders who show behavioral problems. Methods To collect and reflect opinions from multiple professions who assumedly have different interventions or mediations on behavioral problems, a self-report survey and Focus Group Interview (FGI) were conducted for a group of child and adolescent psychiatrists, behavioral therapists, special education teachers, social welfare workers, and caregivers. Results According to a self-report survey and FGI results from multiple professional groups, aggressive behavior is the mostly common behavioral problem necessitating urgent interventions. However, both mainly used intervention strategies and effective treatment methods were different depending on professional backgrounds, such as pharmacological treatment, parent training, and behavior therapy, even though they shared an importance of improving communication skills. In addition, there was a common understanding of necessity to include parent training in a guideline. Lastly the data suggested lack of proper treatment facilities, qualified behavior therapists, and lack of standardized treatment guideline in the field needed to be improved for a quality of current therapeutic services. Conclusion It is supported that several subjects should be included in the guidelines, such as how to deal with aggressive behavior, parent training, and biological aspects of neurodevelopmental disorders. Also, it is expected that publishing the guideline would be helpful to above multiple professions as it is investigated that there are lack of treatment facility and qualified behavioral therapists compared to need at the moment.

Treatment Guidelines of Sepsis and Septic Shock (패혈증과 패혈쇼크의 치료 지침)

  • Lee, Heung Bum;Moon, Hee
    • Tuberculosis and Respiratory Diseases
    • /
    • v.67 no.6
    • /
    • pp.491-498
    • /
    • 2009
  • Severe sepsis and septic shock are major healthcare problems with high mortality, ranging from 20% to 60%, affecting millions of individuals around the world each year. The speed and appropriateness of therapy administered in the initial hours after severe sepsis develops have an important impact on the outcome. In 2004, an international guideline that the bedside clinician could use to improve the outcomes in severe cases of sepsis and septic shock was published. Several landmark studies recently demonstrated that therapeutic strategies may reduce mortality substantially. The "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock: 2008", using a new evidence-based methodology system for assessing the quality of evidence and the strength of the recommendations, was updated. The revised version is based on an updated search into 2007. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improving the outcomes of critically ill patients. We review the treatment guidelines of sepsis and septic shock.