• Title/Summary/Keyword: Treatment adherence

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Enhancement of Microbial Immobilization on the Surface of a Reticulated PU-g-PAAc Foam prepared through Graft Copolymerization induced by Atmosoheric Pressure Plasma Treatment (대기압 플라즈마 유도 그라프트 공중합으로 합성된 망상형 PU-g-PAAc 폼의 미생물 고정화능 향상)

  • Myung Sung Woon;Jang Yung Mi;Nam Ki Chun;Choi Ho Suk;Cho Dae Chul
    • KSBB Journal
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    • v.19 no.5
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    • pp.399-405
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    • 2004
  • A reticulated PU-g-PAAc foam was modified through the surface treatment of PU foam by one atmospheric pressure plasma. The synthesized PU-g-PAAc foam was prepared for the purpose of immobilizing microbial organisms. We also attempted different plasma treatment methods including simple plasma treatment, plasma induced grafting and plasma induced grafting followed by plasma re-treatment. The effect of grafting on equilibrium water content (EWC) of PU forms was examined by swelling measurements. Adhesion test was performed to investigate the effect of different plasma treatment methods on the improvement of microbial immobilization. Two foams modified by plasma induced grafting and plasma re-treatment after grafting showed 2.7 and 3.0 fold higher microbial immobilization than unmodified one, respectively. Meanwhile, simple plasma treatment showed a little enhancement. FT-IR analysis of each sample verified the contribution of surface functional groups on the enhancement of microbial immobilization. SEM observation confirmed microbial adherence.

Quality indicators for cervical cancer care in Japan

  • Watanabe, Tomone;Mikami, Mikio;Katabuchi, Hidetaka;Kato, Shingo;Kaneuchi, Masanori;Takahashi, Masahiro;Nakai, Hidekatsu;Nagase, Satoru;Niikura, Hitoshi;Mandai, Masaki;Hirashima, Yasuyuki;Yanai, Hiroyuki;Yamagami, Wataru;Kamitani, Satoru;Higashi, Takahiro
    • Journal of Gynecologic Oncology
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    • v.29 no.6
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    • pp.83.1-83.10
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    • 2018
  • Objective: We aimed to propose a set of quality indicators (QIs) based on the clinical guidelines for cervical cancer treatment published by The Japan Society of Gynecologic Oncology, and to assess adherence to standard-of-care as an index of the quality of care for cervical cancer in Japan. Methods: A panel of clinical experts devised the QIs using a modified Delphi method. Adherence to each QI was evaluated using data from a hospital-based cancer registry of patients diagnosed in 2013, and linked with insurance claims data, between October 1, 2012, and December 31, 2014. All patients who received first-line treatment at the participating facility were included. The QI scores were communicated to participating hospitals, and additional data about the reasons for non-adherence were collected. Results: In total, 297 hospitals participated, and the care provided to 15,163 cervical cancer patients was examined using 10 measurable QIs. The adherence rate ranged from 50.0% for 'cystoscope or proctoscope for stage IVA' to 98.8% for 'chemotherapy using platinum for stage IVB'. Despite the variation in care, hospitals reported clinically valid reasons for more than half of the non-adherent cases. Clinically valid reasons accounted for 75%, 90.9%, 73.4%, 44.5%, and 88.1% of presented non-adherent cases respectively. Conclusion: Our study revealed variations in pattern of care as well as an adherence to standards-of-care across Japan. Further assessment of the causes of variation and non-adherence can help identify areas where improvements are needed in patient care.

The Association between the Adherence to Dietary Guidelines for Breast Cancer Survivors and Health-related Quality of Life among Korean Breast Cancer Survivors (한국 유방암 경험자들의 유방암 식사지침 수행 정도와 건강관련 삶의 질의 연관성)

  • Song, Sihan;Youn, Jiyoung;Park, Myungsook;Hwang, Eunkyung;Moon, Hyeong-Gon;Noh, Dong-Young;Lee, Jung Eun
    • Korean Journal of Community Nutrition
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    • v.20 no.2
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    • pp.129-140
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    • 2015
  • Objectives: We examined the association between the adherence to dietary guidelines for breast cancer survivors and health-related quality of life in a cross-sectional study of Korean breast cancer survivors. Methods: A total of 157 women aged 21 to 79 years who had been diagnosed with stage I to III breast cancers according to the American Joint Committee on Cancer (AJCC) and had breast cancer surgery at least 6 months before the baseline were included. We used a Korean version of the Core 30 (C30) and Breast cancer 23 (BR23) module of the European Organization for Research and Treatment Cancer Quality of Life Questionnaire (EORTC-QLQ), both of which have been validated for Koreans. Participants were asked about their adherence to dietary guidelines for breast cancer survivors, suggested by the Korean breast cancer society, using a 5-point Likert scale. We summed dietary guideline adherence scores for each participant and calculated the least squares means of health-related quality of life according to dietary guideline adherence scores using the generalized linear model. Results: Breast cancer survivors who had higher adherence to dietary guidelines for breast cancer survivors had lower constipation scores than those with lower adherence (p for trend=0.01). When we stratified by the stage at diagnosis, this association was limited to those who had been diagnosed with stage II or III breast cancers. Also, sexual functioning scores increased significantly with increasing adherence scores of dietary guidelines among those with stage II or III breast cancers (p for trend < 0.001). However, among those who had been diagnosed with stage I, higher scores of dietary guidelines were associated with higher scores of pain (p for trend=0.03) and breast symptoms (p for trend=0.05). Conclusions: Our study suggested that the health-related quality of life levels of breast cancer survivors are associated with the adherence to dietary guidelines and may differ by the stage of the breast cancer.

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
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    • v.24 no.3
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    • pp.193-198
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    • 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
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    • v.26 no.1
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    • pp.117-132
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    • 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.

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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
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    • v.53 no.3
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    • pp.364-372
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    • 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.

The Role of Pharmacists' Interventions in Increasing Medication Adherence of Patients With Epilepsy: A Scoping Review

  • Iin Ernawati;Nanang Munif Yasin;Ismail Setyopranoto;Zullies Ikawati
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.3
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    • pp.212-222
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    • 2024
  • Objectives: Epilepsy is a chronic disease that requires long-term treatment and intervention from health workers. Medication adherence is a factor that influences the success of therapy for patients with epilepsy. Therefore, this study aimed to analyze the role of pharmacists in improving the clinical outcomes of epilepsy patients, focusing on medication adherence. Methods: A scoping literature search was conducted through the ScienceDirect, PubMed, and Google Scholar databases. The literature search included all original articles published in English until August 2023 for which the full text was available. This scoping review was carried out by a team consisting of pharmacists and neurologists following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and the Joanna Briggs Institute guidelines, including 5 steps: identifying research questions, finding relevant articles, selecting articles, presenting data, and compiling the results. Results: The literature search yielded 10 studies that discussed pharmacist interventions for patients with epilepsy. Five articles described educational interventions involving drug-related counseling with pharmacists. Two articles focused on similar pharmacist interventions through patient education, both verbal and written. Three articles discussed an epilepsy review service, a multidisciplinary intervention program involving pharmacists and other health workers, and a mixed intervention combining education and training with therapy-based behavioral interventions. Conclusions: Pharmacist interventions have been shown to be effective in improving medication adherence in patients with epilepsy. Furthermore, these interventions play a crucial role in improving other therapeutic outcomes, including patients' knowledge of self-management, perceptions of illness, the efficacy of antiepileptic drugs in controlling seizures, and overall quality of life.

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
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    • v.9 no.4
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    • pp.343-349
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    • 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.

Self-Monitoring of Blood Pressure and Feed-back Using APP in TReatment of UnconTrolled Hypertension (SMART-BP): A Randomized Clinical Trial

  • Dong-Ju Choi;Jin Joo Park;Minjae Yoon;Sung-Ji Park;Sang-Ho Jo;Eung Ju Kim;Soo-Joong Kim;Sungyoung Lee
    • Korean Circulation Journal
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    • v.52 no.10
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    • pp.785-794
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    • 2022
  • Background and Objectives: Self-monitoring of blood pressure (SMBP) is a reliable method used to assess BP accurately. However, patients do not often know how to respond to the measured BP value. We developed a mobile application-based feed-back algorithm (SMBP-App) for tailored recommendations. In this study, we aim to evaluate whether SMBP-App is superior to SMBP alone in terms of BP reduction and drug adherence improvement in patients with hypertension. Methods: Self-Monitoring of blood pressure and Feed-back using APP in Treatment of UnconTrolled Hypertension (SMART-BP) is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App compared with SMBP alone. Patients with uncomplicated essential hypertension will be randomly assigned to the SMBP-App (90 patients) and SMBP alone (90 patients) groups. In the SMBP group, the patients will perform home BP measurement and receive the standard care, whereas in the SMBP-App group, the patients will receive additional recommendations from the application in response to the obtained BP value. Follow-up visits will be scheduled at 12 and 24 weeks after randomization. The primary endpoint of the study is the mean home systolic BP. The secondary endpoints include the drug adherence, the home diastolic BP, home and office BP. Conclusions: SMART-BP is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App. If we can confirm its efficacy, SMBP-App may be scaled-up to improve the treatment of hypertension.

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
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    • v.27 no.4
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    • pp.342-354
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    • 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.