• Title/Summary/Keyword: Treatment Adherence

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Study on Clinical Patient-oriented Education System for Medical Organizations (의료기관에서의 환자 중심 교육 시스템 연구)

  • Park, Hwagyoo
    • Journal of The Korean Association of Information Education
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    • v.17 no.4
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    • pp.475-486
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    • 2013
  • Recent healthcare studies evaluate the effective impacts of a patient educational information intervention in hospitals on adherence to communicating knowledge, life quality, and therapeutic response in patients treated with highly active therapy in medical organizations. Therefore, the aim of this study is to design and implement the effective and systematic frameworks by providing clinical patient-oriented education system(CPES), which enhances health promotion and medical cures. CPES initiatives accelerate positive financial returns with network-driven educational system. To validate the CPES, the author analyzes the efficiency and effectiveness using statistical survey works. With this outcome, it is compared with previous system. One of the findings is that the system can improve compliance with treatment right dietetics and give patients self-manage their conditions in S hospital. Patients' acknowledge of their condition and its treatment process can be improved through the educational systems.

Study of the Drugs Prescribed on Alzheimer's Disease: from the Insurance Claims Data of Korea National Health Insurance Service (우리나라 건강보험 청구자료를 이용한 알츠하이머성 치매 치료제의 사용현황 분석)

  • Kim, Jungeun;Lee, Jonghyuk;Jeong, Ji Hoon;Kang, Minku;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.4
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    • pp.255-264
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    • 2014
  • Objective: The aims of this study are to investigate the total volume of prescribed medicines against Alzheimer's disease (AD) and the trends of usage by analyzing the claims-data from the Korea National Health Insurance Service. Method: The demographic and claims-data were included the major AD treating medicines such as donepezil, galantamine, rivastigmine and memantine, and analyzed during the period of 2010~2012. The assessing criteria were gender, age, habitation, types of medical institution, code of ingredients, outcomes of treatment, volume and amount of claims, and the numbers of patients with dementias. After trimming the data, it were analyzed by the market size, demographic traits, characteristics of medical service, characteristics of each anti-AD medicine, etc. Results: Among the chosen 4 medicines, donepezil had the top prescription volumes. Most prevalent prescribing preparations of donepezil were conventional types. However, among the non-conventional types, oro-dispersible formulation is the fast increasing one in both volume and growth rate. This specialized preparations to improve both toleration and adherence, tend to being prescribed generally at the tertiary medical institutions. While the younger patients with mild-to-moderate AD mostly treated by expensive medicines in resident at the tertiary hospitals, the rest older patients with severe AD have been treated non-expensive one at long-term care facilities. Conclusion: AD is a chronic illness therefore, long-term use of therapeutic medications are highly important. If an anti-AD treatment was applied steadily in the earlier stages, it would be achieved not only improving the quality of life of patient but also reducing the expenses in the medical and nursing cares. As the socioeconomical impacts of AD is expanding, healthcare professionals need to aware the importance of pharmacotherapy and to improve sociopolitical fundamentals.

Protective Effect of Defibrotide on Splanchnic Injury following Ischemia and Reperfusion in Rats

  • Choi, Soo-Ran;Jeong, Ji-Hoon;Song, Jin-Ho;Shin, Yong-Kyoo
    • The Korean Journal of Physiology and Pharmacology
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    • v.10 no.2
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    • pp.85-94
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    • 2006
  • A splanchic artery occlusion for 90 min followed by reperfusion of the mesenteric circulation resulted in a severe form of circulatory shock, characterized by endothelial dysfunction, severe hypotension, marked intestinal tissue injury, and a high mortality rate. The effect of defibrotide, a complex of single-stranded polydeoxyribonucleotides having antithrombotic effect, was investigated in a model of splanchnic artery occlusion (SAO) shock in urethane anesthetized rats. Occlusion of the superior mesenteric artery for 90 min produced a severe shock state, resulting in a fatal outcome within 120 min of reperfusion in many rats. Defibrotide (10 mg/kg body weight) 10 min prior to reperfusion significantly improved mean arterial blood pressure in comparison to vehicle treated rats (p<0.05). Defibrotide treatment also significantly attenuated in the increase of plasma amino nitrogen concentration, intestinal myeloperoxidase activity, intestinal lipid peroxidation, infiltration of neutrophils in intestine and thrombin induced adherence of neutrophils to superior mesentric artery segments. Superoxide anion and hydrogen peroxide production in $1{\mu}M$ formylmethionylleucylphenylalanine (fMLP)-activated PMNs was inhibited by defibrotide in a dose-dependent fashion. Defibrotide effectively scavenged hydrogen peroxide, but not hydroxyl radical. Treatment of SAO rats with defibrotide inhibited tumor necrosis factor-${\alpha}$, and interleukin-1${\beta}$ productions in blood in comparison with untreated rats. These results suggest that defibrotide partly provides beneficial effects by preserving endothelial function, attenuating neutrophil accumulation, and antioxidant in the ischemic reperfused splanchnic circulation

Concept Analysis of Self-stigma in Patients with Tuberculosis (결핵 환자의 자기 낙인(self-stigma)에 대한 개념 분석)

  • Yeom, Seonmi;Kang, Jeong Hee;Yang, Youngran
    • Research in Community and Public Health Nursing
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    • v.32 no.3
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    • pp.312-324
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    • 2021
  • Purpose: Tuberculosis is an infectious condition with a high disease burden, and the stigma in patients with tuberculosis causes negative health outcomes. The purpose of this study was to define and clarify the concept of self-stigma among patients with tuberculosis. Methods: The analysis was conducted using Walker and Avant's conceptual approach. Twenty-seven studies met the selection criteria. Results: Self-stigma in patients with tuberculosis can be defined by the following attributes: 1) self-esteem decrement; 2) fear; 3) negative emotions to oneself; 4) social withdrawal; and 5) discrimination. The antecedents identified were 1) inappropriate knowledge of tuberculosis, 2) spread of improper health information through media and social communications, 3) stereotypes and prejudices, 4) visibility due to symptoms appearing, 5) recognizing the risk of infection, and 6) low financial status. The consequences were 1) concealing the disease, 2) treatment delay, 3) poor treatment adherence, 4) poor quality of life, and 5) deterioration in or lack of social activities. Conclusion: The definition and attributes of self-stigma identified by this study can be applied to enhance the understanding of stigma in tuberculosis patients and to improve communications between healthcare providers and researchers. It can also be used to develop theories and measurements related to stigma in patients with tuberculosis.

Effects of different surface finishing protocols for zirconia on surface roughness and bacterial biofilm formation

  • Lee, Du-Hyeong;Mai, Hang-Nga;Thant, Phyu Pwint;Hong, Su-Hyung;Kim, Jaewon;Jeong, Seung-Mi;Lee, Keun-Woo
    • The Journal of Advanced Prosthodontics
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    • v.11 no.1
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    • pp.41-47
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    • 2019
  • PURPOSE. Surface finishing of a zirconia restoration is essential after clinical adjustment. Herein, we investigated the effects of a surface finishing protocol for monolithic zirconia on final roughness and bacterial adherence. MATERIALS AND METHODS. Forty-eight disk-shaped monolithic zirconia specimens were fabricated and divided into four groups (n = 12) based on initial surface treatment, finishing, and polishing protocols: diamond bur+polishing bur (DP group), diamond bur+stone grinding bur+polishing bur (DSP group), no diamond bur+polishing bur (NP group), and no diamond bur+stone grinding bur+polishing bur (NSP group). Initial and final surface roughness was measured with a profilometer, and shown using scanning electron microscope. Bacterial adhesion was evaluated by quantifying Streptococcus mutans in the biofilm. Kruskal-Wallis and Mann-Whitney U tests were used to compare results among groups, and two-way analysis of variance was used to evaluate the effects of grinding burs on final roughness (${\alpha}=.05$). RESULTS. The DP group had the highest final Ra value, followed by the DSP, NP, and NSP groups. Use of the stone grinding bur as a coarse-finishing step significantly decreased final Ra values when a diamond bur was used (P<.001). Omission of the stone grinding bur increased biofilm formation on specimen surfaces. Combining a stone grinding bur with silicone polishing burs produced the smallest final biofilm values, regardless of the use of a diamond bur in initial surface treatment. CONCLUSION. Coarse finishing of monolithic zirconia with a stone grinding bur significantly decreased final Ra values and bacterial biofilm formation when surfaces had been roughened by a diamond bur.

The Effect of Voice Therapy Applying Self-Regulation Concepts on Dysphonia Patients (자기 조절 개념을 적용한 음성치료 기법이 발성장애 환자에게 미치는 효과)

  • Lee, Chang-Yoon;An, Soo-Youn;Son, Hee Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.1
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    • pp.15-20
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    • 2019
  • Background and Objectives : The goal of this study is to present a strategy for improving the self-regulation (SR) ability and facilitating the change of vocal behavior by applying voice therapy using the SR concept to the patients with vocal cord nodule and muscle tension dysphonia. Materials and Method : The subjects were 80 patients and 80 patients who were diagnosed with muscle tension dysphonia and vocal nodules. As a control group, the results were compared among patients with the same dysphonia without using SR strategies. The concept of SR before voice therapy was explained to the patients, and the treatment was divided into three stages according to the goal of voice therapy. The treatment stages consist of 1) skill acquisition, 2) habit formation, and 3) habit changes. voice therapy was performed by applying SR strategies such as goal implementation intentions and a less routine behavior. Patient's dropout rates were measured to compare the adherence of voice therapy. Results : Significant improvement was seen in all groups receiving voice therapy. However, in the group using the SR strategy, the voice analysis results showed a relatively low dropout rate of voice therapy. In the generalization confirmation stage, patients who applied SR concept showed better results. SR strategy did no longer be necessary to maintain newly adopted vocal behavior. Conclusion : The results of this study show that SR is one of the cognitive factors that can have a significant impact on the outcome of voice therapy, and also has a positive impact on the acquisition and generalization of new skills. A better understanding of SR and the development of therapeutic strategies using it will play an important role in solving voice problems in clinical settings.

Mental Health Issues in Solid-Organ Transplant Recipients; Pre-, Peri-, and Post-Transplant Phases (고형장기이식 환자의 정신건강: 이식의 시기별 이슈)

  • Yeonjin Jung;Jee In Kang
    • Anxiety and mood
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    • v.19 no.2
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    • pp.37-47
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    • 2023
  • This review article explores the psychological characteristics, comorbid mental disorders, and psychosocial assessments throughout the solid organ transplant journey, spanning the pre-transplant, peri-transplant, and post-transplant phases for transplant recipients. The psychological burden and anxiety in the pre-transplant phase are high for organ failure patients with complex physical difficulties who are deciding to undergo transplantation and are on the waiting list. The pre-transplant psychosocial evaluation covers various aspects, including the patient's readiness, awareness of, and commitment to transplant treatment, medical compliance, psychopathological conditions such as cognitive function and personality disorders, lifestyle factors, including substance abuse, as well as various psychosocial factors like social support. During the peri-transplant phase, mental health problems such as postoperative delirium should be carefully recognized and addressed. After transplantation, it is essential to assist patients in coping with the various stressful experiences they encounter, manage psychiatric symptoms such as depression, anxiety, and insomnia, and improve treatment adherence and quality of life during long-term care for the transplanted organ. Managing psychiatric problems in post-transplant patients requires a deep understanding of immunosuppressant medications and a keen awareness of associated risks, including adverse effects and potential drug interactions. This comprehensive review emphasizes the significance of proactive mental health care and psychosocial evaluation, highlighting the necessity of a multidisciplinary approach to enhance the quality of life and overall success of transplant patients throughout all phases of transplantation.

Treatment Characteristics of Soil Clothing Contact Oxidation Process using Bio-media (생물담체를 충진한 토양피복 산화접촉공정의 하수처리특성)

  • Kim, Hong-Jae;Kang, Jae-Hee;Lee, Ki-Seok;Motoki, Kubo;Kang, Chang-Min;Chung, Seon-Yong
    • Journal of Korean Society of Environmental Engineers
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    • v.27 no.4
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    • pp.414-419
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    • 2005
  • This study was performed to compare the treatment efficiencies of two media, newly developed Bio-rock and conventional gravel, in soil clothing contact oxidation process. The composition of synthetic wastewater were $COD_{Cr}$ $150{\sim}370\;mg/L$, $BOD_5$ $150{\sim}270\;mg/L$, T-N $20{\sim}60\;mg/L$, T-P $5{\sim}25\;mg/L$, pH 7 and 2 mL/L of trace element solution. The experiment using two reactors was comparatively conducted for the flow rate of 40 L/d for 13 months, respectively. Initially Bio-rock reactor was increased to pH 12 due to $Ca(OH)_2$ with hydration of cement, but gravel reactor was dropped to pH 4 due to the degradation of organic material and nitrification. This significant pH variation deteriorated the growth and activity of microorganism. But the high pH of Bio-rock seems favorite to ammonia stripping and precipitation of phosphate. Such pH variation of Bio-rock and gravel reactors were finally stabilized to pH 8 and pH 6, respectively. The removal efficiencies of organic compounds from Bio-rock reactor were 96% of $COD_{Cr}$, 98% of $BOD_5$, 80% of T-N and 85% of T-P which stably coping against variation of influent concentration. But those of gravel reactor were 96% of $COD_{Cr}$, 96% of $BOD_5$, 42% of T-N and 40% of T-P, respectively. The Bio-rock was 2 times higher than T-N and T-P in treatment efficiency. And electron-microscopic examination showed that Bio-rock was more favorable to microbial adherence than gravel. The microbial populations were $5.2{\times}10^6\;CFU/mL$ of Bio-rock reactor compared to $2.6{\times}10^6\;CFU/mL$ in gravel reactor. In result Bio-rock was favor to microbial adherence and high treatment efficiency in spite of variation of influent concentration which had the advantages in saving running time and reducing site requirement.

Management of Weight Gain and Obesity Associated With Antipsychotics (항정신병약물 사용과 연관된 체중 증가와 비만의 관리)

  • Lee, Na-Hyun;Lee, Jae-Chang
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.86-94
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    • 2021
  • Objectives : The risk of weight gain is high when using antipsychotic drugs, and the prevalence of obesity in people with mental illness is high. Obesity management in psychiatric patients is important because obesity causes various complications and lowers treatment adherence and quality of life. Methods : In this review, we summarized the management strategies for obesity that can occur when using antipsychotic drugs through a web search. Results : Evaluate obesity-related risk factors and related indicators from the beginning of treatment, and conduct regular monitoring. If an antipsychotic drug is used and obesity is induced, a change to a drug with a low metabolic risk may be attempted. Sufficient interventions are also needed on the need to manage obesity, a healthy diet, and exercises in patients and their families. If weight loss is not achieved and obesity-related complications are associated, the use of anti-obesity drugs may be considered. Pharmacological treatment approaches should be carefully considered. Conclusions : Non-pharmacological and pharmacological therapies can be applied to manage weight gain and obesity caused by the use of antipsychotic drugs. When using anti-obesity drugs, the characteristics of mental disorders, drug safety, and drug interactions should be considered.

Evaluation of Clinical Outcomes by Therapeutic Dosing Interval of Denosumab (Prolia®) and Calcium-Vitamin D Prescriptions (Denosumab (Prolia®)의 투여 간격 및 칼슘·비타민 D 복합제제 처방 여부에 따른 임상적 결과 평가)

  • Kim, Youkyeong;Kim, Junghyun;Doh, Hyunjeong;Jeong, Young Mi;Lee, Jeonghwa;Lee, Ju-Yeun;Lee, Euni
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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    • pp.185-190
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    • 2022
  • Background: Denosumab (Prolia®) is administered every 6 months for osteoporosis treatment. Co-administration of calcium and vitamin D is required to minimize hypocalcemia risk. We evaluated clinical outcomes based on the administration interval of denosumab and co-prescription with calcium-vitamin D combination products. Methods: A retrospective study was conducted using electronic medical records from 668 patients who started denosumab therapy between January 1 and December 31, 2018, at Seoul National University Bundang Hospital. Clinical outcomes, as measured by changes in T-score, were evaluated by the intervals and concurrent prescriptions with calcium-vitamin D combination products. Results: Of the 668 patients, 333 patients met the eligibility criteria. These patients were divided into two groups based on appropriateness of the administration interval: "Appropriate" (304 patients, 91.3%) and "Inappropriate" (29 patients, 8.3%). T-score changes were significantly higher in the "Appropriate" than in the "Inappropriate" group (0.30±0.44 vs. 0.13±0.37, p=0.048). At the beginning of the treatment, 221 patients (66.4%) were prescribed calcium-vitamin D combination products, but the changes in T-scores were not significantly different by the prescription status of the product (0.29±0.46 vs. 0.28±0.38, p=0.919). Conclusion: T-scores were significantly improved in patients with appropriate administration intervals. No significant changes in T-scores were observed by the prescription status with calcium-vitamin D combination products. For optimal treatment outcomes, prescribers should encourage adherence to the approved prescription information on dosage and administration, and pharmacists should provide medication counseling for patients.