• 보건의료기술평가
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• 제6권2호
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• pp.88-94
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• 2018

This review aims to provide implications for relevant domestic policies and researches from Patient-Centered Medical Home (PCMH), a reinforcement model for primary care and its evaluations in the United States. As chronic diseases became dominant, changes in the health care delivery system in which primary care is central was required. The United States initiated primary care-reinforcing policies based on the PCMH following the increased demand for evidence-based health care policies. The current activities of the United States such as sharing research tools used to evaluate primary care interventions and circulating evaluation findings provide examples to Korea. Systematic evaluations for primary care interventions are required and appropriate methods using various types of data to reflect the real-world settings should be prepared. It is necessary to conduct policy assessment studies of public interests considering regional context. Support for the researches to make and advance from the existing environment must be examined.

• 한방재활의학과학회지
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• 제27권1호
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• pp.27-35
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• 2017

Objectives This study aimed to review case studies on interventions of Korean medicine for hip pain. Methods We searched seven electronic databases for relevant studies up to Oct 2016. Case studies of Korean medicine interventions for hip pain were included and analysed. Results 15 case studies were included (Korean databases; n=15) and Total number of patients was 17 cases. A total of 13 types of interventions were reported, of which acupuncture (93.3%), herbal medicine (80.0%) and pharmacopuncture (40.0%) were the most frequently used. GB30 (66.7%), LR3 (41.7%), BL36 (33.3%) and ST31 (33.3%) were used in at least 4 papers. Cheongpa-jeon (25.0%) and symptom change (46.7%) were most frequently used in herbal medicine and outcome measure respectively. Conclusions Clinical studies, especially double-blinded randomized controlled trials, of Korean medicine interventions for hip pain must be conducted to obtain definite conclusions.

• 한국노년학
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• 제31권3호
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• pp.553-571
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• 2011

본 논문의 목적은 4개 국가에서 이뤄진 60세 이상 노인을 대상으로 한 우울증 관리 프로그램의 전체, 단·장기 효과성의 메타 비교 분석을 통해 효과적인 한국의 노인 우울증 관리 프로그램 개발에 정책적 함의를 제공하는 것이다. 분석 자료는 AMED, EMBASE, Ovid Medline, PsycInfo에서 두 차례에 걸쳐 체계적 검토 방법을 통해 추출된 총 10건의 RCT 연구 논문이다. Review Manager를 사용한 메타 분석 결과, 첫째, 노인 우울증 관리 프로그램은 전체적으로 효과적이었고(OR=0.47, 신뢰도 95%, 신뢰구간 0.36-0.61), 둘째, 단기적으로도 효과적이었으며(OR=0.37, 신뢰도 95%, 신뢰구간 0.26-0.54), 셋째, 장기적으로도 효과적이었다(OR=0.61, 신뢰도 95%, 신뢰구간 0.41-0.89). 본 논문의 분석 결과는 한국의 노인을 위한 효과적인 우울증 관리 프로그램 개발에 세 가지 정책적 함의를 제공해 주고 있다. 첫째, 전체적으로 높은 성공률(53%)이 입증된 외국의 노인 우울증 관리 프로그램의 한국적 응용을 모색하면서 장기적 효과성이 담보되지 못함(24% 감소)에 주의하여 한국의 노인을 위한 우울증 관리 프로그램은 장기적 효과성도 담보 될 수 있는 요소가 고려되어야 한다. 둘째, 장기적 효과성이 담보된 노인 우울증 관리 프로그램을 적용할 때 남성 노인에게는 전반기에, 여성 노인에게는 후반기 적용에 보다 더 큰 관심이 요구된다. 끝으로, 새로운 노인 우울증 관리 프로그램은 기존의 의료적 모델에 사회적 지지 모델의 핵심 요소들을 결합한 형태로 이뤄져야 할 것이다.

• 한국의료질향상학회지
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• 제12권2호
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• pp.93-112
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• 2006

This study reviewed published studies on interventions used by hospitals, health insurance programs, or governments to improve use of medicines in foreign countries. Interventions to improve use of medicines are classified into two categories: 1) information strategies-dissemination of educational materials, group education, one-to-one educational outreach, drug utilization review, and feedback; 2) managerial strategies- formularies, prior authorization, and financial incentives. Dissemination of educational materials, which is a common intervention, was unsuccessful in changing physicians' prescribing behaviors. Problem-based small group education was more likely to change behaviors than didactic large group education. One-to-one educational outreach(academic detailing) was among the most effective strategies used to change prescribing behaviors. Prospective drug utilization review (DUR) program was more successful in improving use of medicines than retrospective DUR program. Feedback intervention has been reported to be ineffective to change behaviors. Formularies are frequently used to control medication use by most health insurance programs. Financial incentives provide physicians economic incentives according to appropriateness of prescribing. However, few published studies have assessed the efficacy of formularies or financial incentives. Prior authorization requires physicians to get authorization from health insurers before prescribing a certain group of drugs which is usually of high costs or risk. There is no magic bullet for quality use of medicines. Multifaceted interventions that help to predispose, enable, and reinforce desired behaviors are more likely to be successful.

• 한방안이비인후피부과학회지
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• 제29권4호
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• pp.95-113
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• 2016

Objectives : The purpose of this review is to introduce the recent advance in allergic rhinitis and to provide help in establishing strategy and selection of drugs for Korean medical treatment of allergic rhinitis. Methods : We searched articles about allergic rhinitis comprehensively in PubMed, CNKI, JStage, KISTI. And in order to reflect clinical situation, we also reviewed some profession's writing for practitioners. Results : This review discussed allergic rhinitis's epidemiology, pathophysiology, diagnosis, treatment, prognosis. We found many standardized clinical practice guideline have been published in this field. And some guideline reflected accumulation of medical evidence on interventions in Korean medicine. It suggested that acupuncture, herbal medicine, herbal patch are useful to prevention and alleviate allergic symptoms. But some interventions have heterogeneity due to each nation's medical background. Conclusions : Acupuncture therapy is now recommended world widely for treating allergic rhinitis. But other interventions of Korean medicine are not well recognized in the same manner. We need more research to identify mechanism and rigorous clinical trials to clarify efficacy and safety of Korean medicine intervention.

• Journal of Preventive Medicine and Public Health
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• 제54권4호
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• pp.230-237
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• 2021

Objectives: This study explored changes in individuals' behavior in response to social distancing (SD) levels and the "no gatherings of more than 5 people" (NGM5) rule in Korea during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Using survey data from the COVID-19 Behavior Tracker, exploratory factor analysis extracted 3 preventive factors: maintenance of personal hygiene, avoiding going out, and avoiding meeting people. Each factor was used as a dependent variable. The chisquare test was used to compare differences in distributions between categorical variables, while binary logistic regression was performed to identify factors associated with high compliance with measures to prevent transmission. Results: In men, all 3 factors were significantly associated with lower compliance. Younger age groups were associated with lower compliance with maintenance of personal hygiene and avoiding meeting people. Employment status was significantly associated with avoiding going out and avoiding meeting people. Residence in the capital area was significantly associated with higher compliance with personal hygiene and avoiding venturing out. Increasing SD levels were associated with personal hygiene, avoiding going out, and avoiding meeting people. The NGM5 policy was not significantly associated with compliance. Conclusions: SD levels, gender, age, employment status, and region had explanatory power for compliance with non-pharmaceutical interventions (NPIs). Strengthening social campaigns to inspire voluntary compliance with NPIs, especially focused on men, younger people, full-time workers, and residents of the capital area is recommended. Simultaneously, efforts need to be made to segment SD measures into substrategies with detailed guidance at each level.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.867-872
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• 2016

Background: Esophageal cancer is one of the most serious malignancies. Due to the aggressive nature of this cancer, the prognosis is poor. A network meta-analysis with simultaneous comparison of multiple treatments can help determine better treatment options that have higher effects on overall survival of patients with lower adverse events. The aim of this review is to simultaneously compare efficacy and adverse events of treatment interventions for esophageal cancer. Materials and Methods: In this review, only randomized control trials (RCT) will be considered for network meta-analysis. All international electronic databases including Medline, Web of Sciences, Scopus, Cochran's library, EMBASE and Cancerlit will be searched to find randomized control trials which compared two or more treatment interventions for esophageal cancer. A network plot will be drawn for visual representation of all available treatment interventions. Bayesian approach will be used to combine the direct and indirect evidence. Treatment effects (e.g. hazard ratio for time to event outcomes, risk ratio for binary outcomes, and rate ratio for count outcomes with 95% credible interval) will be reported. Moreover, cumulative probability of the treatment ranks will be reported using the surface under the cumulative ranking (SUCRA) graphs. Consistency assumption will be assessed by the loop-specific and design-by-treatment interaction approaches. Conclusions: The results of this study may be helpful for the patients, clinicians and health policy makers in selecting treatments that have the best effect on survival and lowest adverse events.

• 대한한방부인과학회지
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• 제32권4호
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• pp.102-115
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• 2019

Objectives: This study aimed to review randomized controlled trials (RCTs) on the effects of interventions of Korean medicine for chronic pelvic pain (CPP). Methods: We searched eleven electronic databases from inception up to Apr 2018. RCTs evaluating the effects of Korean medicine interventions for CPP were retrieved. Results: 11 RCTs were included and total number of experimental group was 390 cases. A total of 4 types of interventions were used, of which acupuncture (45.5%), electro-acupuncture (18.2%), electro-acupuncture + auricular acupuncture + moxibustion (18.2%) were the most frequently utilized. 關元 (CV4) (100.0%), 會陰 (CV1) (80.0%), 三陰交 (SP6) (80.0%), 陰陵泉 (SP9) (80.0%) were most frequently used acupoint in acupuncture treatment. Conclusions: For evidence-based treatment of korean medicine intervention for CPP, high quality RCTs must be conducted.

• Journal of Preventive Medicine and Public Health
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• 제54권2호
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• pp.103-109
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• 2021

Objectives: The aim of this study was to calculate the burden of stroke in Kurdistan Province, Iran between 2011 and 2017. Methods: Incidence data extracted from the hospital information system of Kurdistan Province and death data extracted from the system of registration and classification of causes of death were used in a cross-sectional study. The World Health Organization method was used to calculate disability-adjusted life years (DALYs). Results: The burden of stroke increased from 2453.44 DALYs in 2011 to 5269.68 in 2017, the years of life lost increased from 2381.57 in 2011 to 5109.68 in 2017, and the years of healthy life lost due to disability increased from 71.87 in 2011 to 159.99 in 2017. The DALYs of ischaemic stroke exceeded those of haemorrhagic stroke. The burden of disease, new cases, and deaths doubled during the study period. The age-standardised incidence rate of ischaemic stroke and haemorrhagic stroke in 2017 was 21.72 and 20.72 per 100 000 population, respectively. Conclusions: The burden of stroke is increasing in Kurdistan Province. Since health services in Iran are based on treatment, steps are needed to revise the current treatment services for stroke and to improve the quality of services. Policy-makers and managers of the health system need to plan to reduce the known risk factors for stroke in the community. In addition to preventive interventions, efficient and up-to-date interventions are recommended for the rapid diagnosis and treatment of stroke patients in hospitals. Along with therapeutic interventions, preventive interventions can help reduce the stroke burden.

• 한국보건간호학회지
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• 제36권1호
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• pp.75-89
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• 2022

Purpose: Domestic violence is an important issue encountered in nurses' home visitation programs. This study analyzed the types of domestic violence and associated interventions provided by nurses in a prenatal and early childhood home visitation program in Korea. Methods: For 24 families who experienced domestic violence in the Seoul Healthy First Step Project, registration information and home visit nursing records were analyzed through directed qualitative content analysis. Results: Physical violence was found in all 24 cases, followed by emotional violence, coercive control, financial abuse, and sexual violence. Twenty-two interventions derived from existing nurse-family partnership (NFP) program strategies were identified in the nursing practices of the Seoul Healthy First Step Project. Conclusion: In a prenatal and early childhood nurses' home visitation program in Korea, various approaches and interventions were provided to nurses to address domestic violence. However, differences in the level of interventions provided by nurses were found, implying a need to educate and support nurses to address domestic violence in-home visitation programs.