• Title/Summary/Keyword: medication review

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Understanding the Current Trend of Home Care Assessment in the Post-COVID-19 Era by Comparing Outcome and Assessment Information Set (OASIS)-D and E (미국 환자사정도구(OASIS) 개정 사례를 통한 포스트코로나 시대의 가정간호 환자사정 동향 파악)

  • Hwang, Jinkyoung;Lee, Hana;Kim, Aeri;Woo, Kyungmi
    • Journal of Home Health Care Nursing
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    • v.30 no.1
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    • pp.105-114
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    • 2023
  • Purpose: This study aimed to comprehensively analyze the recent revision of the Outcome and Assessment Information Set (OASIS)-D to version E in the United States to identify the most recent trends in home health care and provide suggestions for implementing home health care in Korea. Methods: This study is a comprehensive literature review. We compared all items in OASIS-D and OASIS-E and identified the most significant changes. Additionally, we have discussed the context in depth. Results: The addition of items related to health literacy and medication reconciliation, strengthening assessment in the cognitive and mood domains, and improving items related to pain assessment were identified. These major revisions resulted from a greater emphasis in the healthcare field on social determinants of health. Additionally, the COVID-19 outbreak highlighted the importance of monitoring and managing the symptoms of home care patients in the community. Conclusion: The key items of the OASIS amendment and their background analysis proposed in this study could serve as a cornerstone for the revision of home health care assessment tools or the development of systematic common assessment tools in Korea.

Qualitative Study on the Narcotics Information Management System (NIMS) Experience of Doctors and Pharmacists Using Narcotic Analgesics (의료용 마약류 진통제 처방자와 조제자의 마약류통합관리시스템 사용경험에 관한 질적 연구)

  • Jinyi Kim;Young-jeon Shin
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.1
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    • pp.22-34
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    • 2023
  • Background: With the increasing use of narcotic analgesics, the Ministry of Food and Drug Safety has been operating the National Narcotics Information Management System (NIMS) since 2018 in Korea. Some studies are related to the narcotic analgesics use, but the evaluation studies of system, including NIMS users are insufficient. Objective: This study evaluated the NIMS enforcement process through in-depth interviews on the experience of using NIMS of doctors and pharmacists who prescribe or dispense opioid analgesics. Methods: Participants in this study were selected through purposeful sampling as three doctors and two pharmacists in the metropolitan area. The interviews were conducted from August 27 to October 19, 2022. Each interview was analyzed using a phenomenological method. Results: Six components of this study included "Doctors and pharmacists come across drug abusers", "They respond individually to drug abusers", "They use NIMS tailored to the needs of system managers", "They are concerned about the role of NIMS in practice settings", "They face challenges against drug abusers" and "They find a way to utilize the system to deal with drug abusers." The interviews confirmed that doctors and pharmacists used NIMS little in their work, and they only reported data. Therefore, it might be difficult for doctors and pharmacists to take measures for the safe use of narcotic analgesics. Conclusion: It is likely that adding data-feedback and medication-check function can reduce the abuse of narcotic analgesics. In the future, further studies on the evaluation of the empirical results of NIMS and review of systems in other countries will be required.

Analysis of the propensity of medical expenses for auto insurance patients by type of medical institution (의료기관 종류별 자동차보험 환자의 진료비 성향 분석)

  • Ha, Au-Hyun
    • Journal of Convergence for Information Technology
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    • v.12 no.2
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    • pp.184-191
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    • 2022
  • This study aims to provide basic information necessary to find an efficient management plan for patients using auto insurance. The analysis was conducted on the five-year auto insurance medical expenses review data registered in the health care bigdata Hub from 2016 to 2020. As a result of the analysis, the number one composition ratio of auto insurance inpatient treatment expenses was treatment and surgery fees for Certified tertiary hospitals, hospitalization fees for general hospitals, hospitals and clinics, and treatment and surgery fees for oriental medical institutions and dental hospitals. outpatient treatment expenses was doctor's fee for medical institution, treatment and surgery fees for oriental medical institutions and dental hospitals. The ratio of medication, anesthesia, and special equipment significantly affected the cost of inpatient. And the ratio of physical therapy significantly affected the cost of outpatient.

Electroacupuncture for Carpal Tunnel Syndrome: A Review of Randomized Controlled Trials

  • Park, Cheol Woo;Lim, Min Ji;Lee, Se Won;Yi, Yeon Hoo;Song, Da Woon;Yu, Sang Gu;Kim, Min Ju;Oh, Da Yoon;Choi, Hyo Jung;Ju, Ah Ra
    • Journal of Acupuncture Research
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    • v.39 no.2
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    • pp.96-104
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    • 2022
  • This study aimed to examine the clinical efficacy of electroacupuncture treatment for carpal tunnel syndrome by reviewing published randomized controlled trials. Among the 186 studies retrieved from 7 online databases (PubMed, Cochrane library, CNKI, NDSL, RISS, OASIS, KMbase) on October 29, 2021, 4 studies were selected according to the inclusion, exclusion criteria, and were evaluated using risk of bias. Control groups for electroacupuncture were wearing a splint at night, traditional acupuncture, and medication. Methods such as total effective, functional status scale, symptom severity scale, electromyography, tip pinch strength, visual analogue scale, numeric rating scale, and ultrasound were used to evaluate the therapeutic effect. Electroacupuncture was reported to have significant treatment results compared with the control group in methods such as total effectiveness, electromyography, and tip pinch strength. However, the quality of the studies (using risk of bias) does not allow reliable conclusions to be made. Many high quality (low risk of bias) randomized controlled trials are needed to examine the efficacy of electroacupuncture treatment for carpal tunnel syndrome.

Summary of Korean Asthma Guideline

  • Chin Kook Rhee;Ji-Yong Moon;Hyonsoo Joo;Ji Ye Jung;Jung-Kyu Lee;Kyung Hoon Min;Hyeon-Kyoung Koo;Seong Yong Lim;Hyoung Kyu Yoon;Sang Yeub Lee;The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD)
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.3
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    • pp.158-165
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    • 2023
  • Asthma is a chronic inflammatory airway disease that is characterized by variable airflow obstruction. The Korean Asthma Study Group of the Korean Academy of Tuberculosis and Respiratory Diseases has recently updated the Korean Asthma Guideline. This review summarizes the updated Korean Asthma Guideline. Asthma prevalence is increasing worldwide, and in Korea. Variable airflow obstruction can be confirmed by bronchodilator response or other tests, and should be established prior to the controller medication. A low-dose inhaled corticosteroid-formoterol is used to alleviate symptoms in all treatment step, and it can be used as a controller as well as reliever in steps 3-5. This approach is preferred, because it reduces the risk of severe exacerbations, compared to the use of short-acting β2-agonist as reliever. In severe asthma, phenotype/endotype based on the underlying inflammation should be evaluated. For type 2 severe asthma, the biologics should be considered.

Isolated unilateral temporalis muscle hypertrophy of unknown etiology: a case report and literature review

  • Jun Ho Choi;Seung Yeon Choi;Jae Ha Hwang;Kwang Seog Kim;Sam Yong Lee
    • Archives of Craniofacial Surgery
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    • v.24 no.6
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    • pp.278-283
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    • 2023
  • The initial instance of isolated unilateral temporalis muscle hypertrophy (IUTMH) was reported in 1990. Since then, only few cases have been documented. The cause of this condition remains ambiguous; however, it is presumed to be linked to compensatory and stress-induced hypertrophy. We introduce a rare case of the diagnosis and treatment of IUTMH. A 39-year-old woman presented with a steadily enlarging pain-free swelling on the left side of her face, first noticed a month ago. Apart from a hyperthyroidism medication regimen her medical history was unremarkable. She had no history of temporomandibular joint disease, bruxism, surgery, or trauma. However, she complained of having been under substantial stress lately. Contrast-enhanced magnetic resonance imaging revealed asymmetric temporalis muscle hypertrophy. The treatment plan consisted of administering type A botulinum toxin injections into left temporalis muscle, supplemented by lifestyle changes and relaxation techniques. At a follow-up visit 9 months after the injections, the muscle contour was normalized both in physical and in radiologic examinations. While further supportive evidence is needed, it can be anticipated that cosmetic treatment with botulinum toxin, rather than surgical interventions, will become the standard treatment of IUTMH.

Retrospective Analyses of Long-Term Use of SSRI in Children and Adolescents with Autism Spectrum Disorder (소아청소년 자폐성 스펙트럼 장애에서 SSRI 장기 사용에 대한 후향적 분석)

  • Goo, Ae-Jin;Park, Jin-Park;Lee, Jong-Il;Jhin, Hye-Kyung;Kim, Yeni
    • Korean Journal of Biological Psychiatry
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    • v.19 no.4
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    • pp.205-210
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    • 2012
  • Objectives The purpose of this study was to investigate clinical profile, efficacy, and safety of long-term treatment with selective serotonin reuptake inhibitors (SSRIs) in Korean autism spectrum disorders (ASDs) patients. Methods Effectiveness was assessed through a retrospective review of self-reported target symptom improvement at the last follow-up visit. Changes in illness severity and improvement were measured using the Clinical Global Impression-Severity (CGI-S) of illness and Clinical Global Impression-Improvement (CGI-I) Scales. Tolerability was assessed through a review of the reason for discontinuation of SSRI and documented adverse events. Results A total of 21 ASDs patients (aged 9 to 19 years) treated with SSRI during July 2010 to July 2011 in department of child and adolescent psychiatry of Seoul National Hospital were identified. The mean duration of SSRI treatment was 47.9 (standard deviation = 36.9) months (range 0.7-114.5), and the mean fluoxetine equivalent dosage of SSRIs was $27.1{\pm}10.8$ mg. Nineteen (90.5%) patients were using concomitant medication. We found that SSRIs were prescribed for symptoms of agitation, stereotyped behavior, aggression, depression, impulsivity and self-injury in ASDs. Ten patients (47.6%) reported improvement in their target symptom after SSRI treatment based on CGI-I scores (CGI-I ${\leq}$ 2). The side effects were reported in 5 patients (23.8%) ; vomiting (n = 2, 9.5%), excessive mood elevation (n = 1, 4.8%), insomnia (n = 1, 4.8%), somnolence (n = 1, 4.8%) and decreased appetite (n = 1, 4.8%). Self-injurious behavior was reported in one patient (4.8%). Conclusions The results of this study suggest that SSRIs may be used effectively in children and adolescents diagnosed with ASDs. However, safety issues need to be considered carefully when choosing SSRIs for treatment. Future controlled trials are needed to confirm these findings.

Development of Tuberculosis Education Model for Junior Health Care Professionals (예비보건의료인을 위한 결핵 교육 모형 구축)

  • Baek, Seolhyang;Lee, Ji-Soo;Lee, Hyun-Jung
    • The Journal of the Korea Contents Association
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    • v.18 no.5
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    • pp.432-445
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    • 2018
  • For health care professionals(HCPs) who have relatively higher possibility of exposing tuberculosis(Tb), it is important for them to equip with proper levels of knowledge and prevention activities. In terms of establishment of Tb education model for junior HCPs, therefore, literature review was done alongside 129 junior HCPs and 14 HCPs were asked to answer questionnaires and telephone survey. The results are follows.; Firstly, six educational themes such as epidermiology of Tb, Tb transmission and patho-physiology, test and diagnosis, latent Tb, Tb treatment, and Tb prevention were identified, based on the literature review. Secondly, the junior HCPs showed lower levels of knowledge regarding epidermiology, transmission and patho-physiology and latent Tb, compared to the other themes. When education courses are planned, longer period of time should be given to the lower level of knowledge areas. Thirdly, the HCPs emphasized that definition and type of Tb should be well integrated into the education in particular epidermiology education. They also responded that hospital infection and infection cycle of Tb need to be addressed during educational session about transmission and patho-physiology. in addition, they said that specific and detailed contents about diagnosis and group examination should be carefully delivered during the education, along with diagnosis, test and application of personal protective devices during education of latent Tb. They also answered that patient education and adverse effect of Tb medication should be taught during Tb treatment session, as well as self activities of health promotion for junior HCPs and systematic TB education as key way of Tb prevention. As the findings were from limited numbers of respondents and contained the sampling bias, the result has to be carefully interpretated prior to generalization. Therefore, further survey with larger study population is required in terms of development of Tb education model.

Development of the Critical Pathway for Cesarean Section Patient (제왕절개술 환자를 위한 Critical Pathway 개발)

  • Chung Kyung-Hee;Jang Keum-Seung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.4 no.1
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    • pp.66-80
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    • 1998
  • With the opening of healthcare market, the health care environment in Korea is anticipating a drastic change. In this Internationally open market environment, it is necessary to introduce a systematic health care plan and DRG system which offer qualitative medical services as well as reduced cost. Purpose of this study is to develop and test the critical pathway for Cesarean section patient in the way to be possible the integrated inpatient management. It was adopted the process of six phases to develop the critical pathway as the theoretical framework implemented by Johns Hopkins Hospital, Maryland, U.S.A. In the first phase, make a selection of diagnosis/procedures to develop. In the second phase, organize a development team consisted of eight expertises working in maternity nursing area. In the third phase, analyze the overall medical service offered to patient through review medical records and decided the service content and the implementation period for the Cesarean section patient. In the forth phase, make out a preliminary critical pathway after verification of expert group on content validity. In the fifth phase, validity operate to ten Cesarean section patients to test implementation in practice by using the preliminary critical pathway, In the sixth phase, defined the final critical pathway. The result of this study was as follows. 1. There were classified 8 categories as monitoring/assesment, treatment, medication, activity, diet, test, consult, education/discharge plan for vertical axis and showed hospital stayed from admission to discharge for horizontal axis of critical pathway through analysis 68 Cesarean section patients medical records. 2. After critical review 68 medical records to make out a preliminary critical pathway, hospital stays for horizontal axis were showed 6 days, mean hospital stays were 7.5 days, 2.1 days were to be taken operation after admission and 4.2 days were stayed until discharge after operation. 3. After making out a questionare in 90 items of a medical service content of eight categories and verifying the content validity of expertises, the 85 items of the preliminary critical pathway were selected by expertises agreement over 88% and modified or deleted 5 items showing agreement below 75%. 4. After verifying a validity to 10 patients for 4 weeks, hospital stays were 5.9 days. There were deleted 1 item and modified or supplemented the 9 items of the 10 items.

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Application of Molecular Diagnostics Technology in the Development of a Companion Diagnostics for Malignant Solid Tumors (악성 고형암의 항암제 동반진단 기술에서 분자진단기술의 적용)

  • Kim, Jin-Hee
    • The Journal of the Korea Contents Association
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    • v.19 no.3
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    • pp.365-374
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    • 2019
  • Unlike benign tumors, malignant tumors are capable of metastasis, easy to relapse, poor survival, and low quality of life. In Korea, here is a tendency to treat the tumors collectively according to the General Principles of Cancer Chemotherapy(GPCC) of the Health Insurance Review & Assessment Service (HIRA). But recently, companion diagnostics(CDx) is recommended rather than unilateral medication because biomarker-based molecular diagnostics is possible to predict the drug response of patients before drug treatment. Not only domestic but also overseas Food and Drug Administratio (FDA) recommends the development of the CDx system at the stage of drug development to ensure the responsiveness and safety of medicines. In this study, I focused on the necessity of CDx development direction as well as CDx development status through literature review. Furthermore I also discussed CDx types according to the molecular diagnostic technology such as immunohistochemistry (IHC), polymerase chain reaction (PCR), in situ hybridization (ISH), and next-generation sequencing (NGS) not only in the approved CDx but also in the developing one by US FDA. And I suggested the technology issue of CDx development process such as a selection of molecular diagnostics at the time of release, a clear understanding of the CDx mechanism, and a convergence of drug with CDx development. The necessity of social insurance system also was proposed for CDx development.