• YAKHAK HOEJI
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• v.53 no.4
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• pp.217-221
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• 2009

Diabetes mellitus is a group of metabolic disorders characterized by hyperglycemia and abnormalities in carbohydrate, fat, and protein metabolism which is resulting chronic microvascular, macrovascular, and neuropathic complications. Therefore, correct and consistent educations for pharmacotherapy is important and especially drug consultation by the specialty pharmacist of diabetic pharmacotherapy is necessary for all diabetic patients. The purpose of this study is to evaluate the necessity of the specialty pharmacist of diabetic pharmacotherapy and this study was performed from June 31th, 2008 to October 9th, 2008 in Kangnam St. Mary's Hospital, Seoul, S. Korea throughout the questionnaire and evaluated the total 68 patients who were participating the multidisciplinary diabetes team programs. We evaluated the patient characteristics (n=68), learning status (difficulty 70.4%), wanted further education (68.3%) and preference of educator (pharmacist 46%) after finishing team teaching by multidisciplinary diabetes team program. In conclusion, many diabetic patients(80.3%) wanted individual and further drug consultation by the pharmacists who are specialized in the diabetes individually and they are needed.

• Korean Journal of Social Welfare Studies
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• v.44 no.2
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• pp.201-230
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• 2013

The study attempted to analyze the experiences concerning professional identities of social workers working in hospice palliative care(HPC) multidisciplinary team by adopting ground theory method. The data were drawn from in-depth interviews with 11 social workers working in HPC teams for more than a year. As a result of the study, 166 concepts, 21 themes and 10 categories were presented. The core theme was identified as "growing up as a professional recognized by clients and other team members". The characteristics of social work and those of hospital setting systematic barriers and problems of the governmental support program worked as external conditions. The conflicts and confusions in social workers' professional identities were brought about as results of the conditions while successful team and the characteristics of individual setting promoted to get over the problems. The social workers experienced professional rewards and personal growth from hospice practices by utilizing diverse strategies. It was proposed that social workers should make efforts to be recognized as an essential profession in HPC multidisciplinary teams together with resolving the institutional problems such as regulations on qualifications of HPC social worker, professional education and governmental supports to improve work conditions.

• Korean Journal of Cleft Lip And Palate
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• v.8 no.2
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• pp.95-105
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• 2005

Cleft lip and palate is a congenital deformity which needs a professional and consistent management from the birth and along with the physical growth of patients. The patients with cleft lip and palate can have general speech problems with resonance disorders, voice disorders and articulation disorders after the successful primary surgical management and the physical growth. Speech problems of Cleft lip and palate are characterized hypernasality, nasal air emission, increased nasal air flow, and aberrant speech marks which decrease intelligibility. These speech problems of cleft lip and palate can be treated with the secondary surgical procedure, the application of temporary prosthesis and the effective and well-timed speech therapy. The speech and language problems of cleft lip and palate, the general procedures and schedules of the speech assessment and therapy based on the multidisciplinary approach are introduced for the patients with cleft lip and palate, their family and the other members of the cleft palate treatment team.

• Korean Journal of Clinical Pharmacy
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• v.30 no.2
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• pp.113-119
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• 2020

Background: Reducing the total anticholinergic burden (AB) in older adults is recommended owing to the several peripheral and central adverse effects. This study aimed to identify the AB status of patients admitted to geriatric centers for assessing the influence of the pharmacist-involved multidisciplinary geriatric team care on reducing the AB. Methods: We retrospectively reviewed the medical records of 328 older patients hospitalized in geriatric centers from July 1, 2018 to June 30, 2019, who received comprehensive geriatric assessment and pharmaceutical interventions from a multidisciplinary geriatric team. We measured the total AB scores for the medications at the time of admission and upon hospital discharge using the Korean Anticholinergic Burden Scale (KABS). The pre-admission factors associated with high AB (KABS score ≥3) at the time of admission were identified. Results: The proportion of patients with high AB significantly decreased from 41.8% (136/328) at the time of admission to 25.0% (82/328) on discharge (p<0.001). The pre-admission AB of patients transferred from skilled nursing facilities (odds ratio[OR]: 2.85, 95% CI: 1.26-3.75), taking more than 10 medications (OR: 3.70, 95% CI: 1.55-8.82), suffering from delirium (OR: 2.80, 95% CI: 1.04-7.50), or depression (OR: 2.78, 95% CI: 1.04-7.41) were significantly high. Antipsychotics were the most frequent classes of drugs that contributed to the total KABS score at the time of admission, followed by antihistamines. Conclusions: This study demonstrated that the multidisciplinary teams for geriatric care are effective at reducing AB in older adults. The factors associated with high AB should be considered when targeting pharmaceutical care in geriatric individuals.

• The Korean Journal of Pain
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• v.36 no.2
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• pp.149-162
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• 2023

Chronic postsurgical pain (CPSP) is a multifactorial condition that affects a significant proportion of patients undergoing surgery. The prevention and management of CPSP require the identification of preoperative risk factors to screen high-risk patients and establish appropriate perioperative pain management plans to prevent its development. Active postoperative pain management should be provided to prevent CPSP in patients with severe pain following surgery. These tasks have become important for perioperative team members in the management of CPSP. This review article provides a comprehensive overview of the latest research on the role of perioperative team members in preventing and managing CPSP. Additionally, it highlights practical strategies that can be employed in clinical practice, covering the definition and risk factors for CPSP, including preoperative, intraoperative, and postoperative factors, as well as a risk prediction model. The article also explores various treatments for CPSP, as well as preventive measures, including preemptive analgesia, regional anesthesia, pharmacological interventions, psychoeducational support, and surgical technique modification. This article emphasizes the importance of a comprehensive perioperative pain management plan that includes multidisciplinary interventions, using the transitional pain service as an example. By adopting a multidisciplinary and collaborative approach, perioperative team members can improve patient outcomes, enhance patient satisfaction, and reduce healthcare costs. However, further research is necessary to establish targeted interventions to effectively prevent and manage CPSP.

• The Korean Journal of Rehabilitation Nursing
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• v.6 no.2
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• pp.137-151
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• 2003

The purpose of this study was to develop a multidisciplinary team approach program for stroke survivors, and to identify its effects on their rehabilitation. The team was composed of 7 members: a rehabilitation nurse, a physician, a physical therapist, an occupational therapist, a therapeutic recreational therapist, a nutritionist, and a researcher. A quasi-experimental study was performed with 36 subjects: 18 in the experimental group and 18 in the control group, using a noneqivalent control group pretest-posttest design. The experimental group participated 4 times in rehabilitation programsfocused on information and emotional support provided by the rehabilation team-and received telephone counseling from the researcher. The control group did not receive any treatment. The selection criteria for the subjects in this study were: (a) patients who were diagnosed as having had an ischemic stroke within the last year, (b) patients free of any communication disorder, (c) and those having a primary caregiver who could assist in filling out the form assessing the level of ADL. The data were collected from patients who had been discharged from a tertiary hospital, between October 1st, 1999 and September 30th, 2000. The data were analysed by $X^2$ test, Fisher's exact test, ANCOVA, Wilcoxon's rank sum test, and Wilcoxon's signed rank test using an SAS program. The results were as follows: 1. In terms of physical variables (blood pressure, grasp power, and ADL) 1) There was a significant difference in blood pressure between the two groups (systolic pressure P= .012, diastolic pressure P= .050). 2) There was also a significant difference in grasp power between the two groups (affected side : P= .012, unaffected side : P= .010). 3) There was no significant change in the level of ADL between the two groups. 2. In terms of psychosocial variables (depression, self-efficacy, self-esteem, and social activities) 1) There were no significant differences between the two groups. However, all four psychosocial variables showed a tendency to improve in the experimental group, while only two variables (depression and self-efficacy) showed a simalar tendency in the control group. 2) The level of social activities in the control group decreased significantly after a month (P= .050). 3. The level of life satisfaction improved in both groups, but no significant difference was found. Stroke has high recurrence rate and requires considerable follow-up care. The program used in this study was developed and designed for stimulting the rehabilitation process of stroke survivors. Through the program period of one month (meetings were held weekly), a positive effect was detected in physical variables, although the psychosocial variables did not improve significantly. In retrospect, a one month period may not be an adequate length of time to improve the psychosocial variables, as the stroke survivors were complicated cases, and most of them were elderly. Further research is therefore recommended by increasing the length of program, so that its effect can be more noticeable.

• Journal of Clinical Nutrition
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• v.10 no.2
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• pp.45-50
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• 2018

Purpose: Intense multidisciplinary team effort is required for the intestinal rehabilitation of patients afflicted with the short bowel syndrome (SBS). These include enteral and parenteral nutrition (PN) support, monitoring of complications related to treatment, and considering further medical or surgical options for intestinal adaptation. Methods: In the Intestinal Rehabilitation Team (IRT) at the Samsung Medical Center, we have experienced 20 cases of adult SBS requiring multidisciplinary intestinal rehabilitation. This study is a retrospective review of the collected medical records. Results: Of the 20 subjects treated, 12 patients were male and 8 patients were female. At the time of referral to the IRT, the mean age was 51.5 years, and the mean body weight was 50.1 kg, which was 90% of the usual body weight. The diseases or operative managements preceding massive bowel resection were malignancy in 11 cases, cardiac surgery in 2 cases, trauma in 2 cases and one case, each of tuberculosis, corrosive esophagitis, atrial fibrillation, simultaneous pancreas and kidney transplantation, and perforated appendicitis. Of these, there were 14 survivals and 6 mortalities. The fatalities were attributed to progression of disease, intestinal failure-associated liver disease, and sepsis (unrelated to intestinal failure) (2 cases each). Among the 14 surviving patients, 8 patients have been weaned off PN, whereas 6 are still dependent on PN (mean PN dependence 36%). Conclusion: This paper reports the results of multidisciplinary intestinal rehabilitation of adult short bowel patients treated at the Samsung Medical Center. Further studies are required to improve survival and enteral tolerance of these patients.

• International Journal of Heart Failure
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• v.6 no.1
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• pp.1-10
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• 2024

Heart failure (HF) stands as a prevalent chronic ailment, imposing a substantial burden on global healthcare systems due to recurrent hospitalizations, intricate management, persistent symptoms, and polypharmacy challenges. The augmentation of patient safety and treatment efficacy across various care stages, facilitated by a multidisciplinary HF team inclusive of a clinical pharmacist, emerges as paramount. Evidence underscores that the collaborative engagement of a physician and a clinical pharmacist engenders proficient and secure management, forestalling avoidable adversities stemming from drug reactions and prescription inaccuracies. This synergistic approach tailors treatments optimally to individual patients. Post-discharge, the vulnerability of HF patients to re-hospitalization looms large, historically holding sway as the foremost cause of 30-day readmissions. Diverse strategies have been instituted to fortify patient well-being, leading to the formulation of specialized transitional care programs that shepherd patients effectively from hospital to outpatient settings. These initiatives have demonstrably curtailed readmission rates. This review outlines a spectrum of roles assumed by clinical pharmacists within the healthcare cohort, spanning inpatient care, transitional phases, and outpatient services. Moreover, it traverses a compendium of studies spotlighting the affirmative impact instigated by integrating clinical pharmacists into these fields.

• The Journal of Korean Physical Therapy
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• v.12 no.1
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• pp.113-118
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• 2000

The purpose of this study was to review the Japanese home care service and analyse the necessity for the home care service and the team approaching. The subjects of this study were 23 Korean students who visited on the Japanese home n due to the curriculum of university. The data were collected from sep. 1 to nov. 30, 1999. The main results of this study were as follows : 1. There was consisted of some nurses, physical therapists, medical doctors, occupational therapists as a team of home care service. They visited patients as multidisciplinary team. 2. The qualities of service was good, and the attitude of patient was positive. 3. There was necessity for rehabilitation home care service in Korea. 4. There was necessity for team work through the rehabilitation home care service in Korea.

• Korean Journal of Radiology
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• v.23 no.7
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• pp.732-741
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• 2022

Objective: To determine the impact of dedicated subspecialized radiologists in multidisciplinary team (MDT) discussions on the management of lower gastrointestinal (GI) tract malignancies. Materials and Methods: We retrospectively analyzed the data of 244 patients (mean age ± standard deviation, 61.7 ± 11.9 years) referred to MDT discussions 249 times (i.e., 249 cases, as five patients were discussed twice for different issues) for lower GI tract malignancy including colorectal cancer, small bowel cancer, GI stromal tumor, and GI neuroendocrine tumor between April 2018 and June 2021 in a prospective database. Before the MDT discussions, dedicated GI radiologists reviewed all imaging studies again besides routine clinical reading. The referring clinician's initial diagnosis, initial treatment plan, change in radiologic interpretation compared with the initial radiology report, and the MDT's consensus recommendations for treatment were collected and compared. Factors associated with changes in treatment plans and the implementation of MDT decisions were analyzed. Results: Of the 249 cases, radiologic interpretation was changed in 73 cases (29.3%) after a review by dedicated GI radiologists, with 78.1% (57/73) resulting in changes in the treatment plan. The treatment plan was changed in 92 cases (36.9%), and the rate of change in the treatment plan was significantly higher in cases with changes in radiologic interpretation than in those without (78.1% [57/73] vs. 19.9% [35/176], p < 0.001). Follow-up records of patients showed that 91.2% (227/249) of MDT recommendations for treatment were implemented. Multiple logistic regression analysis revealed that the nonsurgical approach (vs. surgical approach) decided through MDT discussion was a significant factor for patients being managed differently than the MDT recommendations (odds ratio, 4.48; p = 0.017). Conclusion: MDT discussion involving additional review of radiology examinations by dedicated GI radiologists resulted in a change in the treatment plan in 36.9% of cases. Changes in treatment plans were significantly associated with changes in radiologic interpretation.