• Title/Summary/Keyword: Treatment Adherence

Search Result 175, Processing Time 0.035 seconds

Comparisons of Adherence, Efficacy and Price between Sitagliptin/Metformin Fixed-dose Combination Tablets and Concomitant Administration of Sitagliptin and Metformin in Type 2 Diabetes Mellitus Patients (제2형 당뇨병 환자에서 시타글립틴과 메트포민 고정 복합제 투여와 단일제 병용간의 복약 순응도, 효과 및 약가에 대한 비교 연구)

  • Park, Ji Hye;Lee, Byung Koo;Kim, Jae Youn;Gwak, Hye Sun
    • Korean Journal of Clinical Pharmacy
    • /
    • v.24 no.3
    • /
    • pp.193-198
    • /
    • 2014
  • Objective: This study was conducted to compare the adherence, clinical and economical utility of fixed-dose combination tablets of sitagliptin/metformin with concomitant administration of sitagliptin and metformin in patients with type 2 diabetes mellitus. Methods: Adherence was measured as the medication possession ratio (MPR) of ${\geq}80%$, and MPR was calculated as the number of total prescription days divided by the total treatment period. Hemoglobin $A_{1C}$ ($HbA_{1c}$) differences between baseline and predetermined periods were analyzed. Proportions of patients who achieved $HbA_{1c}$ less than 6.5% for three or more consecutive times were compared. To evaluate cost-effectiveness, prices of sitagliptin, metformin and sitagliptin/metformin tablets were investigated. Results: More than 90% of patients showed adherence in both groups (92.0% in fixed-dose combination group vs 95.9% in concomitant administration group), and there was no statistically significant difference (P = 0.113). Proportion of patients with HbA1c less than 6.5% for three or more consecutive times tended to be somewhat higher in fixed dose combination group than in concomitant administration group without a statistically significant difference (32.6% vs. 28.0%, P = 0.344). Total price of metformin and sitagliptin was cheaper up to 222 KRW in the case of fixed-dose combination tablets compared to the case of concomitant administration. Conclusion: The sitagliptin/metformin fixed-dose combination tablet had a similar patient adherence and was not significantly different in efficacy to the concomitant administration of each component. In terms of drug prices, fixed-dose combination tablets were cheaper than concomitant administration of each tablet.

In Vitro Study Of Salivary Bacterial Adherence On e-PTFE Membrane According To Periodontal Status. (치주조직 상태에 따른 e-PTFE막 부착에 관한 연구)

  • Ju, Jae-Ig;Chung, Hyun-Ju
    • Journal of Periodontal and Implant Science
    • /
    • v.26 no.1
    • /
    • pp.117-132
    • /
    • 1996
  • The purpose of this study was to evaluate the bacterial adherence on e-PTFE membrane immersed in whole saliva from subjects with different periodontal status. Experiment involved 3 subject groups: 5 persons with healthy periodontium(probing depth below 3mm and no signs of gingival inflammation including bleeding on probing), 10 patients with gingivitis(probing depth below 3mm and apparent signs of gingival inflammation), and 10 patients with advanced periodontitis(probing depth over 7mm and apparent signs of gingival inflammation). Each disease group was included before and after scaling and root planing treatment. After obtaining whole saliva from each subject, e-PTFE membrane(Gore-Tex periodontal membrane : $GTPM^{(R)}$, W.L. Gore & Associates, Flagstaff, USA) specimens were immersed at room temperature in the saliva aliqouts for 1, 3, 7 days. The weight between pre - and post - immersion in saliva was measured with the analytical balance and the difference was recorded. The specimens were processed for SEM observation. The bacterial adherence on the membrane specimens was evaluated using the scanning electron microscope images. The obtained results were as follows : 1. There was no difference in the weight of bacteria adherent to e-PTFE membrane specimens according to the periodontal status and the immersion periods. 2. As the exposure time to saliva increased, the bacterial adherence to the membrane specimen significantly increased in all groups(P<0.005). 3. As the severity of periodontal disease increased, the bacterial adherence to the membrane specimens significantly increased(p<0.001). 4. After scaling and root planing, the bacterial adherence to the membrane specimens significantly decreased in gingivitis and periodontitis patient group(P<0.001). These results suggest that bacterial contamination on exposed barrier membrane surface be reduced through improvement of periodontal status and oral health environment before and after GTR procedure for the successful outcome.

  • PDF

Caregivers' adherence factors affecting maintenance treatment in children with well-controlled asthma : A qualitative analysis through in-depth interview (천식 조절 상태 환아의 유지 치료에 대한 보호자 순응 요인: 심층 면담을 통한 질적 분석)

  • Choi, Ic Sun;Cho, Saeng Koo;La, Kyong Suk;Byeon, Jung Hye;Song, Dae Jin;Yoo, Young;Choung, Ji Tae
    • Clinical and Experimental Pediatrics
    • /
    • v.53 no.3
    • /
    • pp.364-372
    • /
    • 2010
  • Purpose : Good adherence of caregivers is essential for successful health outcomes in the treatment of childhood asthma. The purpose of this study was to identify the factors contributing to good adherence of maintenance treatment in children with well-controlled asthma. Methods : Children with well-controlled asthma being treated with a daily controller for at least 3 months in Korea University Anam Hospital were selected. Their caregivers who had good adherence to maintenance treatment were recruited. Qualitative study through in-depth interviews was conducted with 18 caregivers who agreed to the study. Results : The 18 caregivers (mean age, 40.0 years) consisted of 15 mothers, 2 grandmothers, and 1 father. The resulting consensus were identified and grouped into 2 domains: the caregiver/patient aspect with 8 theme factors and the treatment aspect with 4 theme factors. The main theme factors in the caregiver/patient aspect were enabling participation in physical activities and exercise (77.8%), perceptions regarding asthma and the need for long-term treatment (50.0%), and perceived value of the medications outweighing the risk of side effects (38.9%). The main theme factors in the treatment aspect were trust in the physician (77.8%), general satisfaction with the manner and attitude of the physician (77.8%) and verification of the necessity of further treatment by performing tests (38.9%). Conclusion : Efforts to improve caregivers' adherence to the treatment of childhood asthma must include a range of factors related to both caregiver/patient aspects and treatment aspects. Among all of these factors, it may be most important to establish a physician-caregiver partnership.

Butyrate modulates bacterial adherence on LS174T human colorectal cells by stimulating mucin secretion and MAPK signaling pathway

  • Jung, Tae-Hwan;Park, Jeong Hyeon;Jeon, Woo-Min;Han, Kyoung-Sik
    • Nutrition Research and Practice
    • /
    • v.9 no.4
    • /
    • pp.343-349
    • /
    • 2015
  • BACKGROUND/OBJECTIVES: Fermentation of dietary fiber results in production of various short chain fatty acids in the colon. In particular, butyrate is reported to regulate the physical and functional integrity of the normal colonic mucosa by altering mucin gene expression or the number of goblet cells. The objective of this study was to investigate whether butyrate modulates mucin secretion in LS174T human colorectal cells, thereby influencing the adhesion of probiotics such as Lactobacillus and Bifidobacterium strains and subsequently inhibiting pathogenic bacteria such as E. coli. In addition, possible signaling pathways involved in mucin gene regulation induced by butyrate treatment were also investigated. MATERIALS/METHODS: Mucin protein content assay and periodic acid-Schiff (PAS) staining were performed in LS174T cells treated with butyrate at various concentrations. Effects of butyrate on the ability of probiotics to adhere to LS174T cells and their competition with E. coli strains were examined. Real time polymerase chain reaction for mucin gene expression and Taqman array 96-well fast plate-based pathway analysis were performed on butyrate-treated LS174T cells. RESULTS: Treatment with butyrate resulted in a dose-dependent increase in mucin protein contents in LS174T cells with peak effects at 6 or 9 mM, which was further confirmed by PAS staining. Increase in mucin protein contents resulted in elevated adherence of probiotics, which subsequently reduced the adherent ability of E. coli. Treatment with butyrate also increased transcriptional levels of MUC3, MUC4, and MUC12, which was accompanied by higher gene expressions of signaling kinases and transcription factors involved in mitogen-activated protein kinase (MAPK) signaling pathways. CONCLUSIONS: Based on our results, butyrate is an effective regulator of modulation of mucin protein production at the transcriptional and translational levels, resulting in changes in the adherence of gut microflora. Butyrate potentially stimulates the MAPK signaling pathway in intestinal cells, which is positively correlated with gut defense.

Development and Effects of an Acceptance Commitment-based Cognitive Behavioral Program for Patients with Schizophrenia (조현병 환자를 위한 수용전념기반 인지행동 프로그램 개발 및 효과)

  • Lee, Jae Woon;Park, Hyun Sook
    • Journal of Korean Academy of Psychiatric and Mental Health Nursing
    • /
    • v.27 no.4
    • /
    • pp.342-354
    • /
    • 2018
  • Purpose: The purposes of this study were to develop an acceptance commitment-based cognitive behavioral program for patients with schizophrenia and to use it as an intervention tool for psychiatric mental health nursing and thereby confirm the program's effects on patients' psychological flexibility, psychological well-being, and treatment adherence including insight and attitude toward treatment. Methods: This study consisted of a pretest, posttest 1, and posttest 2 for a nonequivalent control group design. The participants were 42 patients with schizophrenia (experimental group: 21, control group: 21). The acceptance commitment-based cognitive behavioral program was conducted in 10 sessions for 5 weeks. Data collected from February to April 2018 were analyzed using the SPSS/WIN 25.0 for $x^2$ test, Fisher's exact test, independent t-test, and repeated measurement ANOVA. Results: The differences between experimental and control groups were statistically significant regarding psychological flexibility, psychological well-being, and insight. Conclusion: This study findings suggest that the acceptance commitment-based cognitive behavioral program can be used as an effective mental health nursing intervention for psychological flexibility, psychological well-being, and insight of patients with schizophrenia.

Effect of Enterococcus faecalis strain PL9003 on Adherence and Growth of Helicobacter pylori

  • Nam, Hye-Ran;Ha, Mi-Sun;Lee, En-Jung;Lee, Yeon-Hee
    • Journal of Microbiology and Biotechnology
    • /
    • v.12 no.5
    • /
    • pp.746-752
    • /
    • 2002
  • The purpose of the present study was to examine the antagonistic activities of Enterococcus faecalis strain PL9003 (PL9003) on Helicobacter pylori. This strain was isolated from infant feces and found to inhibit both the growth of H. pylori and its in vitro adherence to the human gastric cell line MKN-45. The binding of PL9003 to MKN-45 was observed under a light microscope after Cram staining and under a scanning electron microscope. When detected with an FITC-conjugate antibody, both viable and nonviable PL9003 were found to decrease the number of H. pylori bound to MKN-45. When detected by an enzyme-linked immunoabsorbent assay, about 70% of the H. pylori bound on MKN-45 disappeared with the four-1314 addition of viable or nonviable PL9003. The spent culture supernatant (SCS) of PL9003 also decreased the viability of H pylori even after neutralization and pepsin treatment. The above results suggest that PL9003 has a potential as a new probiotic for the stomach.

A Study of Effectiveness of Outpatient Treatment Orders and Compliance with Outpatient Treatment (외래치료 명령제의 실효성과 외래 치료 순응도에 관한 연구)

  • Jang, Seung-Ho;Park, In-Hwan;Lee, Sang-Yeol;Roh, Suhee;Seo, Jeong-Seok
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.25 no.1
    • /
    • pp.46-55
    • /
    • 2017
  • Objectives : Outpatient treatment orders refer to a mandatory social program in which mentally ill persons are ordered by the court to participate in specified outpatient treatment programs. This study aimed to investigate the factors that affect outpatient treatment orders and adherence to outpatient treatment in mental health patients. Methods : A survey on outpatient treatment orders and adherence to outpatient treatment was conducted on 60 psychiatrists between October and November 2016. The questionnaire items were drafted based on a literature review, and they were then evaluated by 3 psychiatrists and 1 law school professor before being finalized. Answers from the respondents were analyzed using descriptive statistics, and the median, maximum, and minimum values of the effectiveness scores of outpatient treatment orders were calculated. Results : Among the 60 psychiatrists, 45(75.0%) were aware of outpatient treatment orders; however, only 2 out of the 45(4.0%) had actually used the program in the last 12 months. The subjective effectiveness was very low, with only 40 points out of 100. Furthermore, of the readmitted patients, 37.7% had received continued outpatient treatment, whereas 53.1% chose to quit the outpatient treatment programs, meaning that the number of dropouts was higher. Among the discharged patients, approximately two-thirds were receiving continued treatment. With regard to follow-up for dropouts, majority of the responses were either "Not taking any action"(n=27) or "Not following up"(n=15). Only two respondents answered "Contact the community mental health promotion center," meaning that this response was very rare. Meanwhile, when asked about efficient measures to be implemented for dropouts, a vast majority of the respondents(n=30) selected the answer "Work with the community mental health promotion center." Conclusions : The outpatient treatment orders currently being administered were found to be ineffective, and the associated adherence to outpatient treatment was also found to be extremely poor. Hence, the effectiveness of the therapeutic interventions could benefit from institutional as well as administrative improvements. Community mental health promotion centers are expected to have an important role in the future.

Risk Factors of Dyslipidemia and Related Factors of Medication Adherence in Korea Adults: KNHANES 2013-2015 (한국인의 이상지질혈증 발생 위험 요인 및 약물복용이행 영향 요인 평가: 2013-2015 국민건강영양조사 자료 이용)

  • Jeon, Mi Yang;Choi, Won Hee;Seo, Yeong Mi
    • Journal of Korean Biological Nursing Science
    • /
    • v.19 no.3
    • /
    • pp.131-140
    • /
    • 2017
  • Purpose: Dyslipidemia was a known risk factor for cardiovascular disease and was a leading cause of mortality in worldwide. This study aimed to determine the factors associated with prevalence and medication treatment of dyslipidemia in Korean adult population. Methods: In this study, based on the criteria set by the Korean Society of Lipidology and Atherosclerosis, the factors associated with prevalence and medication treatment of dyslipidemia was evaluated in a population of 12,506 people ($age{\geq}20$), who participated in the Korean National Health and Nutrition Examination Survey (2013-2015). The findings were tested by using multivariate logistic regression. Results: Dyslipidemia prevalence rate was 36.5%. Among populations with dyslipidemia, 17.5% were treated with lipid-lowering drugs. In the multivariate logistic regression model, male, increase in age, lower education level, non-drinker, current smoking, less physical activity, increase of body mass index, hypertension, and diabetes were associated with an increased odd of dyslipidemia. Female, increase in age, higher income, excess fat intake, hypertension, diabetes, myocardial infarction, and angina were associated with an increased odd of medication treat. Conclusion: The results of this study could be used to screen patients at the high risk for dyslipidemia or to predict medication adherence.

Effect of Defibrotide on Rat Reflux Esophagitis

  • Kim, Hyoung-Ki;Choi, Soo-Ran;Choi, Sang-Jin;Chio, Myung-Sup;Shin, Yong-Kyoo
    • The Korean Journal of Physiology and Pharmacology
    • /
    • v.8 no.6
    • /
    • pp.319-327
    • /
    • 2004
  • This study was aimed at evaluating the effect of defibrotide on the development of the surgically induced reflux esophagitis, on gastric secretion, lipid peroxidation, polymorphonuclear leukocytes (PMNs) accumulation, polymorphonuclear leukocytes adherence, superoxide anion and hydrogen peroxide production in PMNs, scavenge of hydroxyl radical and hydrogen peroxide, cytokine (interleukin-1 ${\beta}$, tumor necrosis $factor-{\alpha}$) production in blood, and intracelluar calcium mobilization in PMNs. Defibrotide did not inhibit the gastric secretion and not change the gastric pH. Treatment of esophagitis rats with defibrotide inhibited lipid peroxidation, and myeloperoxidase (MPO) in the esophagus in comparison with untreated rats. Defibrotide significantly decreased the PMN adherence to superior mesenteric artery endothelium in a dose-dependent manner, Superoxide anion and hydrogen peroxide production in $1{\mu}M$ formylmethionylleucylphenylalanine (fMLP)- or $0.1{\mu}g/ml$ N-phorbol 12-myristate 13-acetate (PMA)-activated PMNs was inhibited by defibrotide in a dose-dependent fashion. Defibrotide effectively scavenged the hydrogen peroxide but did not scavenge the hydroxyl radical. Treatment of esophagitis rats with defibrotide inhibited interleukin-1 ${\beta}$ production in the blood in comparison with untreated rats, but tumor necrosis $factor-{\alpha}$ production was not affected by defibrotide. The fMLP-induced elevation of intracellular calcium in PMNs was inhibited by defibrotide. The results of this study suggest that defibrotide may have partly beneficial protective effects against reflux esophagitis by the inhibition lipid peroxidation, PMNs accumulation, PMNs adherence to endothelium, reactive oxygen species production in PMNs, inflammatory cytokine production(i.e. interleukin-1 ${\beta}$), and intracellular calcium mobilization in PMNs in rats.

The effect of pretreating resorbable blast media titanium discs with an ultrasonic scaler or toothbrush on the bacterial removal efficiency of brushing

  • Koh, Minchul;Park, Jun-Beom;Jang, Yun-Ji;Ko, Youngkyung
    • Journal of Periodontal and Implant Science
    • /
    • v.43 no.6
    • /
    • pp.301-307
    • /
    • 2013
  • Purpose: This in vitro study was performed to assess the adherence of Porphyromonas gingivalis to a resorbable blast media (RBM) titanium surface pretreated with an ultrasonic scaler or toothbrush and to evaluate the effects of the treatment of the RBM titanium discs on the bacterial removal efficiency of brushing by crystal violet assay and scanning electron microscopy. Methods: RBM titanium discs were pretreated with one of several ultrasonic scaler tips or cleaned with a toothbrush. Then the titanium discs were incubated with P. gingivalis and the quantity of adherent bacteria was compared. The disc surfaces incubated with bacteria were brushed with a toothbrush with dentifrice. Bacteria remaining on the disc surfaces were quantified. Results: A change in morphology of the surface of the RBM titanium discs after different treatments was noted. There were no significant differences in the adherence of bacteria on the pretreated discs according to the treatment modality. Pretreatment with various instruments did not produce significant differences in the bacterial removal efficiency of brushing with dentifrice. Conclusions: Within the limits of this study, various types of mechanical instrumentation were shown to cause mechanical changes on the RBM titanium surface but did not show a significant influence on the adherence of bacteria and removal efficiency of brushing.