• Title/Summary/Keyword: clinical practice recommendation

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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
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    • v.27 no.4
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    • pp.276-283
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    • 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.

A Clinical Practice Guideline for Ma-huang(Ephedra sinica) Prescription in Obesity (비만치료 및 체중감량에서의 적절한 마황 사용에 대한 임상 진료지침 개발)

  • Kim, Ho-Jun;Han, Chang-Ho;Lee, Eui-Ju;Song, Yun-Kyung;Shin, Byung-Cheul;Kim, Yun-Kyung
    • Journal of Korean Medicine for Obesity Research
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    • v.7 no.2
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    • pp.27-37
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    • 2007
  • Background Clinical practice guidelines (CPG) are systematically developed statements to assist practitioners and patients on healthcare decisions. They provide recommendations for the average patient, which should take into account individual clinical judgment and the patient's values and expectations. Ephedra has sympathomimetic effect and has been used for weight loss worldwide. However, its safety is controversial especially in autonomic and cardiovascular systems. Therefore, the need of appropriate CPG for ephedra prescription in obesity was advocated in Korean Traditional Medicine. Methods The committee comprised of specialists of obesity, oriental herbology, oriental cardiology, constitutional medicine. The committee collected all relevant references about adverse effect and safety of ephedra in the forms of meta-analysis, systematic review, randomized controlled trial, case-control study and observational study from international and domestic databases and paper journals. 11 English- and 5 Korean-language references were gathered and categorized by PICO (Patient, Intervention, Comparison, Outcome) method. We could not complete strength of recommendation which should be clarified according to the evidence grade estimation. Result The first version of CPG for ephedra prescription in obesity was issued by Korean Oriental Association for Study of Obesity. It includes topics of introduction, pharmacokinetics, side effects and adverse events, constitutional aspect and recommendations for dose, indication and contraindication. Conclusion There should be periodic upgrade of this CPG from now on. Although there are some drawbacks in this version of CPG, it has significance as the first CPG in Korean Traditional Medicine.

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A Study on the Experience of Fundamental Nursing Practice (간호 대학생의 기본 간호 실습 경험에 대한 연구)

  • 한경순;조주연
    • Journal of Korean Academy of Nursing
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    • v.29 no.2
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    • pp.293-303
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    • 1999
  • The purpose of this study was to understand and to explain how were nursing students experienced and accepted the fundemental nursing practice. In addition to, the results of this study are attempted to contribute for offer of basic data in projecting and accomplishing to promote quality practice education. The participants were 79 freshmen of S College of Nursing in kyungi-do. They presented record of feeling and thinking on their the fundemental nursing practice experience. The data were collected from 29, J une to 10, July in 1998. Collected data was analyzed by means of Van Kaam's phenomenological method. The results of this study was founded 423 descriptive expression and they were grouped under 42 common factors and they were grouped under 9 categories. By means of the frequency on the categories. the higher category is Anxiety. next Solemn. Flutter. Pride. Usefulness, Recognition of reality in nursing-system. Lack of practice environment. Self-accusation. Comprehension of nursing spirit were founded. 5 common factors. Tension. Difficulty, Dread. Apprehension, Burden were grouped under Anxiety. 7 common factors, Pledge, Memory, Importance of practice, Sincerity, Restriction of dress, Acceptance, Active attitude were grouped under solemn. 5 common factors, Interest, Strange, Beanimated, Waiting, Curiosity were grouped under Flutter. 5 common factors, Conceit, Self-confidence, Skilled, Worth, Accomplishment were grouped under Pride. 6 common factors, Acknowledge of nursing affairs, Expectation of furture, Fascination of nursing. Acquirement of disposition of nurse, Association of injection, Actual feeling of dept. of nursing were grouped under Recognition of reality in nursing-system. 4 common factors, Lack of practice time, Many persons of practice, Lack of practice instrument, Lack of reality were grouped under Lack of practice envirnment. 5 common factors, Inconvenient, Reflection, Loss of pride, Shyness, Feeling sorry were grouped under Self-accusation. 3 common factors, Utility, Connection of practice and theory, Various experience were grouped under Usefulness. 2 common factors, Comprehension on the dignity of human, Comprehension on a point of view of patient were grouped under Comprehension of nursing spirit. In conclusion, the following recommendation should be necessary a supplementary study to approach on the type of students that has a firm view and care about client prior to clinical nursing practice.

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Validation of a Translated Guideline on Pain Assessment and Management: Focused on Abdominal Surgery Patients (통증관리 근거중심 가이드라인의 국내 타당성 검증 - 복부수술 환자를 대상으로 -)

  • Hong, Sung Jung;Lee, Eunjoo
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.159-170
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    • 2012
  • Purpose: This study was designed to examine the validity of the evidence-based guideline on pain developed by Registered Nurses Association of Ontario(RNAO) translated into Korean based on the experts' opinions. Methods: The panel consisted of experts of 60 registered nurses in surgical units, medical doctors and nursing managers who were experts in pain assessment and management. The validity of translated RNAO guideline was evaluated in terms of appropriateness, applicability, and utilization in current practice. Appropriateness and applicability of each recommendation were measured with 9 point scale, whereas utilization was measured by yes/no question. Data were analyzed by mean, standard deviation, and percent. The experts' opinions were analyzed by content analysis method. Results: In general, most of the recommendations in the guideline received above 7 point in appropriateness and applicability. However, above 20% of recommendations showed less than 50% of utilization rates in current practice. Conclusion: The reasons for low utilization of recommendations in current practice are in need for investigation. This study can be used for the development of guideline more acceptable in Korean health care settings and improve the quality of care for the abdominal surgery patients suffering from pain in Korea.

Interests on Oriental Nursing by Perception, Practice, and Attitude of Oriental Medicine of Nurses Working in One Region (Survey) (일개지역 근무 간호사의 한방의학에 대한 인식, 경험 및 태도별 한방간호 관심도에 관한 조사 연구)

  • Cha, Nam-Hyun;Wang, Myoung-Ja
    • Journal of East-West Nursing Research
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    • v.15 no.1
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    • pp.34-42
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    • 2009
  • Purpose: This study investigated the perception, practice and attitude of nurses towards oriental nursing. Methods: Nurses (N=162) from a localized region were surveyed during June, 2008. Collected data was statistically analyzed using t-test, one-way ANDVA, and Sheffe test. Results: The perception of surveyed nurses to the following aspects of oriental nursing varied significantly: "chances to hear of oriental nursing", "treatment function of oriental medicine", "necessity of clinical application", "treatment method", and "educational demand on oriental nursing". Nurses' interest in the following aspects of oriental nursing was significantly different: "experiences undertaken in the treatment of oriental medicine", "treatment result", and "clinical result from the patients who were under the oriental medicine treatments". Nurses' attitude toward oriental nursing varied significantly in response to the following: "recommendation by other nurses or neighbors" and "experiences being questioned by patients on oriental nursing question". Conclusions: Support for oriental nursing and systematic education for nurses would be beneficial in light of a changing medical environment.

Evaluation of the Pharmacy Student Practice Programs in the Mono Community Pharmacy and Multiple Community Pharmacies (단일약국과 다약국 프로그램에서 수행한 지역약국 필수실무실습에 대한 평가)

  • Lee, Min Cheol;Cho, Min Hwi;Jung, Young Joon;Lee, Ji Young;Yoon, Hyonok
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.4
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    • pp.296-303
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    • 2014
  • Background: The first pharmacy student practice undergoing 6 year pharmacy school curriculum have begun in the hospital pharmacy, community pharmacy, pharmaceutical company and administrative office since 2013. Although most of practice sites have prepared the program of pharmacy student practice education for several years under guideline of Korean Association of Pharmacy Education, generally community pharmacies which start the pharmacy student practice education have difficulty in performing the desirable student practice program due to absent experience for it. So we reported the comparison of student practice programs between mono pharmacy and multiple pharmacies conducted by Gyeongsang National University College of Pharmacy to provide the future design information of the ideal pharmacy student practice in community pharmacy. Method: Students who practiced both multiple (multi) and mono pharmacy (mono) programs for each 5 weeks were participated the survey to evaluate the student practice programs. Results: The results of the survey on the student practice program reported that students were much more satisfied with the multiple pharmacies program than mono pharmacy program in both practical contents ($4.12{\pm}0.72$ : $3.27{\pm}1.28$; multi : mono) and satisfaction ($4.54{\pm}0.54$ : $3.54{\pm}1.3$; multi : mono) and they all gave the highest points ($5.00{\pm}0.00$) to multiple pharmacies program for recommendation because the multiple pharmacies program was significantly helpful for their experience to plan the future career. Conclusion: Mono and multiple pharmacy practice programs would be a great helpful for student's future career. However, the disadvantages of each program should be amended gradually for the unified and specialized program to be established the ideal community pharmacy student practice in Korea. The results will be affected the pharmacy practice program for students in community pharmacy and the other colleges of pharmacy to design the ideal community pharmacy practice program.

Current Pharmacogenetics in Psychiatry (정신의학에서의 약물유전학 현황)

  • Kim, Il Bin;Lee, Yu Sang
    • Korean Journal of Biological Psychiatry
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    • v.28 no.1
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    • pp.1-6
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    • 2021
  • Pharmacogenetics is opening a new era of precision medicine in psychiatry. Drug-metabolizing enzymes are characterized by genetic polymorphisms, which render a large portion of variability in individual drug metabolism. Dose adjustment based on pharmacogenetics knowledge is a first step to translate pharmacogenetics into clinical practice. However, diverse factors including cost-effectiveness should be addressed to provide clinical recommendation. To address current challenges in pharmacogenetics testing in psychiatry, this review provides an update regarding genotyping (SNP analysis, array, and next-generation sequencing), genotype-phenotype correlations, and cost-effectiveness. The current updates on pharmacogenetics in psychiatry will provide guidance for both clinician and researchers to have a consensus in harmonizing efforts to advance the pharmacogenetics field in a part of precision medicine in psychiatry.

Convergence effectiveness verification for developing practice guidelines for dementia patients cognitive programs (치매환자 인지프로그램 실무지침 개발을 위한 융합적 효과검증)

  • Ham, Min-Joo
    • Journal of the Korea Convergence Society
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    • v.12 no.5
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    • pp.85-91
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    • 2021
  • This study is a methodological study that explains the procedure for verifying effectiveness in developing practical guidelines for cognitive programs suitable for dementia patients. Based on the development of evidence-based new clinical practice guidelines, a preliminary recommendation for the domestic dementia patient care guidelines was developed. The practical guidelines consisted of the final four types, and the content validity score of the configuration items was 0.87 to 1 point. In the sub-categories of field applicability, appropriateness score was 3.95 to 4.34 points, applicability score was 3.57 to 4.27 points, and predicted effect score was 3.84 to 4.22 points. Through the examination of the content validity and field applicability of experts, it was confirmed that the practical guidelines developed in this study can be used as the basis for establishing an intervention plan for dementia cognitive program managers engaged in clinical practice. In future studies should further facilitate the development of evidence-based treatment guidelines to select appropriate treatment activities for dementia patients.

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
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    • v.10 no.3
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    • pp.57-69
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    • 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.

Standardized Imaging and Reporting for Thyroid Ultrasound: Korean Society of Thyroid Radiology Consensus Statement and Recommendation

  • Min Kyoung Lee;Dong Gyu Na;Leehi Joo;Ji Ye Lee;Eun Ju Ha;Ji-Hoon Kim;So Lyung Jung;Jung Hwan Baek
    • Korean Journal of Radiology
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    • v.24 no.1
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    • pp.22-30
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    • 2023
  • Ultrasonography (US) is a primary imaging modality for diagnosing nodular thyroid disease and has an essential role in identifying the most appropriate management strategy for patients with nodular thyroid disease. Standardized imaging techniques and reporting formats for thyroid US are necessary. For this purpose, the Korean Society of Thyroid Radiology (KSThR) organized a task force in June 2021 and developed recommendations for standardized imaging technique and reporting format, based on the 2021 KSThR consensus statement and recommendations for US-based diagnosis and management of thyroid nodules. The goal was to achieve an expert consensus applicable to clinical practice.