• 제목/요약/키워드: treatment patterns

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건강보험 청구자료를 이용한 궤양성 대장염 치료제의 처방 양상과 전신 스테로이드 처방에 미치는 영향요인 (Patterns of Ulcerative Colitis Treatments and Factors Affecting the Prescribing of Systemic Corticosteroid using Health Insurance Claims Database)

  • 김지율;박소희;신주영
    • 한국임상약학회지
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    • 제30권2호
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    • pp.102-112
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    • 2020
  • Objective: To analyze the prescription patterns for the treatment of ulcerative colitis (UC) and to investigate factors co-occurring with systemic corticosteroid use. Methods: We used patient-level data from Korean National Health Insurance claims database to identify patients diagnosed with UC (ICD-10 code : K51) and their medications prescribed for UC between January 1 and Decemeber 31, 2017. We found that medications for UC treatment were 5-aminosalicylic acid (5-ASA), immunomodulators, biologics, and corticosteroids. We presented the prescription pattern according to the sex, age group, type of health insurance, site of UC, type of medical institution, and concomitant medication. To evaluate factors associated with prescription of systemic corticosteroids for UC, we used a multivariate logistic regression model to estimate adjusted odds ratios (aORs) and their 95% confidence intervals (CIs). Results: Of 1,469 UC patients, 74.5% used 5-ASA and 15.2% used systemic corticosteroids. 5-ASA constituted 77.5% of all prescriptions and systemic corticosteroids accounted for 13.1%. The most widely used therapy was 5-ASA monotherapy (54.8%), followed by a double therapy with 5-ASA and immunomodulators (8.2%) or 5-ASA and systemic corticosteroids (7.2%). Systemic corticosteroids were more likely to be prescribed with immunomodulators (aOR=1.88, 95% CI=1.54-2.28) and biologics (aOR=2.82, 95% CI=2.28-3.50) than without them. Conclusions: We found that 15.2% of UC patients were prescribed with a systemic corticosteroid, which is less than reported previously. Systemic corticosteroids were more likely to be prescribed with immunomodulators and biologics.

섬유근통 증후군 환자의 보완대체요법에 대한 인식과 이용행태 (The Perception and Utilization patterns of Complementary and Alternative Medicines in Patients with Fibromyalgia Syndrome)

  • 공경란;이은남;정원태
    • 근관절건강학회지
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    • 제23권3호
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    • pp.187-196
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    • 2016
  • Purpose: The purpose of this study was to investigate the perception and utilization patterns of complementary and alternative medicines (CAM) in patients with fibromyalgia syndrome. Methods: A total of 92 fibromyalgia syndrome patients participated in this study. Data were collected using a structured questionnaire and were analyzed with SPSS/WIN 23.0 program. Results: As a result, 59.8% of subjects had an experience of CAM and 33.7% of subjects have used until now. There were significant differences of the use of CAM between the group of CAM users and non-CAM users by education ($x^2$=4.04, p=.044), period of illness ($x^2$=15.03, p=.001), and period of treatment ($x^2$=12.10, p=.002). Relatively large numbers of patients understanded as that CAM was effective (58.7%) and fibromyalgia syndrome was controllable (75.0%). Moreover, there were significant differences of the use of CAM by the perception of CAM effects ($x^2$=4.15, p=.042), fibromyalgia syndrome ($x^2$=6.55, p=.038), and best treatment for fibromyalgia ($x^2$=11.03, p=.001). Conclusion: These results could be utilized as a basic data for developing nursing intervention for fibromyalgia syndrome.

Relapse Patterns and Outcomes Following Recurrence of Endometrial Cancer in Northern Thai Women

  • Kaewpangchan, Phakdee;Cheewakriangkrai, Chalong
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권9호
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    • pp.3861-3866
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    • 2015
  • Background: The aim of this study was to analyze the patterns of relapse and survival outcomes in Northern Thai women with recurrent endometrial cancer (EC). Materials and Methods: Medical records were abstracted from EC patients who underwent primary surgery from 1999 to 2012. Data on clinicopathologic variables, sites of first recurrence, time to relapse of disease, and overall survival (OS) was analyzed. Associations between the clinicopathological variables and the rates of disease recurrence were determined. Results: Among 1,204 reviewed records, 42 eligible patients were identified with recurrent disease. The median age was 55 years and the median follow-up time was 26.0 months. The median times to recurrence (TTR) after completion of the initial treatment in the group of local relapse (LR) and distant/combined sites of recurrence (DCSR) was 6.6 (95% CI=4.6 to 8.6 months) and 16.9 months (95% CI=5.6 to 28.2 months), respectively (p=0.36). The 2-year survival and 3-year survival probability in the group of LR was 54.2% (95% CI=27.2 to 81.3%) and 34.7% (95% CI=9.2 to 60.2%), compared to 50.4% (95% CI=41.1 to 59.7%) and 42.1% (95%CI= 24.1 to 60.1%) for those with DCSR. Distant recurrence was the most frequent pattern of relapse. Overall survival was not significantly different in patients with local relapse when compared to those with DCSR (p=0.69). Conclusions: Patients with recurrence of EC after primary treatment had a worse prognosis and clinical aggressiveness. LR and DCSR occurred most during the first three years. The common sites of relapses were vaginal cuff, pelvis, and lungs. No significant clinicopathological predictor for survival outcomes was identified.

Feasibility Study of Robotics-based Patient Immobilization Device for Real-time Motion Compensation

  • Chung, Hyekyun;Cho, Seungryong;Cho, Byungchul
    • 한국의학물리학회지:의학물리
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    • 제27권3호
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    • pp.117-124
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    • 2016
  • Intrafractional motion of patients, such as respiratory motion during radiation treatment, is an important issue in image-guided radiotherapy. The accuracy of the radiation treatment decreases as the motion range increases. We developed a control system for a robotic patient immobilization system that enables to reduce the range of tumor motion by compensating the tumor motion. Fusion technology, combining robotics and mechatronics, was developed and applied in this study. First, a small-sized prototype was established for use with an industrial miniature robot. The patient immobilization system consisted of an optical tracking system, a robotic couch, a robot controller, and a control program for managing the system components. A multi speed and position control mechanism with three degrees of freedom was designed. The parameters for operating the control system, such as the coordinate transformation parameters and calibration parameters, were measured and evaluated for a prototype device. After developing the control system using the prototype device, a feasibility test on a full-scale patient immobilization system was performed, using a large industrial robot and couch. The performances of both the prototype device and the realistic device were evaluated using a respiratory motion phantom, for several patterns of respiratory motion. For all patterns of motion, the root mean squared error of the corresponding detected motion trajectories were reduced by more than 40%. The proposed system improves the accuracy of the radiation dose delivered to the target and reduces the unwanted irradiation of normal tissue.

Evaluation of Anti-Toxoplasma IgG, IgM, and IgA in Mothers with Spontaneous Abortion in Zanjan, Northwest Iran

  • Amin, Abbas;Mazloomzadeh, S.;Haniloo, A.;Mohammadian, F.;Fazaeli, Asghar
    • Parasites, Hosts and Diseases
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    • 제50권4호
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    • pp.371-374
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    • 2012
  • Toxoplasma gondii is one of the major agents of infectious abortions and due to its worldwide distribution can threat healthy pregnant women who had no previous exposure to this parasite. The present study was designed to investigate the contribution of T. gondii to spontaneous abortions in Zanjan, Northwest of Iran, using ELISA method. Blood Samples were collected from 264 mothers referred to the provincial hospitals of Zanjan due to spontaneous abortion. The sera were isolated and subjected to evaluate the anti-Toxoplasma IgG, IgM and IgA antibodies. The results showed IgG positive ($IgG^+$) in 99 cases (37.5%). A total of 68 women (25.8%) showed seroconversion with IgM or IgA or both IgM and IgA. They included: $IgM^+$ in 21 (8.0%), $IgA^+$ in 23 (8.7%) and both $IgM^+$ and $IgA^+$ in 24 (9.1%) subjects. In 23 cases, positive titers of IgM and IgG were accompanied. In general, the analysis of anti-Toxoplasma antibody patterns, showed that about 17% of the spontaneous abortions were associated with serological patterns of acute infection. According to these findings, a considerable proportion of spontaneous abortions can be attributed to T. gondii in the study area.

양.한방 협진병원 뇌졸중 입원환자 진료이용실태와 협진에 대한 태도에 관한 연구 (Utilizing Patterns and Attitude on Collaborating Care of Korean Traditional Medicine and Western Medicine among Cerebral Apoplexy Patients)

  • 김대환;이기효
    • 한국병원경영학회지
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    • 제9권2호
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    • pp.76-101
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    • 2004
  • The primary purpose of this study was to provide the basic information for improving collaborating care of Korean traditional medicine and western medicine by surveying utilization and attitude on it among cerebral apoplexy(CA) patients hospitalized at a general hospital with both the western and Korean traditional medical department in Busan metropolitan city, Korea. The survey was conducted on 170 patients, 80 from Korean traditional medical department, and 90 from western medical department. The major results of this study were as below: First, CA patient's medical utilization patterns including selecting medical institution, term of treatment and type of medical institution at first-aid were significantly variated by their socio-demographic characteristics such as religion and job. Second, the perceptions of collaborating care, such as effectiveness and reduction of treatment period, were better at respondents who were hospitalized at oriental medical department and had been experienced with collaborating care. Third, the major contents of collaborating care which utilized by respondents in side of western medicine were physical therapy, x-ray, pathologic diagnosis, and medication, and in side of Korean traditional medicine were acupuncture, herbal medication, moxa cautery, cupping a boil therapy. Fourth, overall satisfaction on collaborating care was good(3.5 of 5.0) and was significantly variated by age and religion. Fifth, respondents perceived that collaborating care was most helpful for rehabilitation and the major problem of current duplicate medical system was increasement of medical expenditures, and the major obstacle of collaborating care was prejudice against each other medicine. The results of this study imply that effective marketing for collaborative care suitable for age and religion of customers and patient satisfaction strategy is needed to activate collaborating care.

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사상체질 병증별 월경 양상의 임상 연구 (Clinical Study of Menstruation Pattern according to Sasang Constitutional Diseases)

  • 임성락;김구;오승윤;권영미;주종천
    • 사상체질의학회지
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    • 제21권1호
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    • pp.217-226
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    • 2009
  • 1. Objective To investigate characteristics of menstrual patterns according to Sasang Constitutional disease, and to utilize for diagnosis and treatment of Sasang Constitutional disease. 2. Method The recruited subjects were 430 women who convinced their Sasang Constitution by taking herbal medicine and improving of chief complaint. The items of data contain age at menarche, age at menopause, menstrual cycle, menstrual duration, cyclic regularity of menstruation, severity of menstrual pain, the worst day of menstrual pain, type of menstrual pain, amount of menstruation. 3. Results 1) Severity of menstrual pain, the worst day of menstrual pain, menstrual pain accompanied with nausea were significant among Sasang Constitutional diseases. 2) In Bae-chu-pyo-byeong disease (背椎表病證), Wi-wan-han disease (胃院寒證), So-eum disease (少陰證) and Tae-eum disease (太陰證), menstrual pain was severer than other diseases. 3) In Hae-yeok disease and So-yang-sang-pung disease (少陽傷風證), the worst day of menstrual pain was a day before menstruation. In Hyung-gyeok-yeol disease (胸膈熱證), Tae-eum disease (太陰證), So-eum disease (少陰證), the frequency of a day after menstruation in the worst day of menstrual pain was higher than other diseases. In Wi-wan-han disease (胃院寒證), Mang-yang disease (亡陽證), the frequency of two day after menstruation in the worst day of menstrual pain was higher than other diseases. 4) In So-yang-sang-pung disease (少陽傷風證), Mang-eum disease (亡陰證), Eum-heo-o-yeol diasese (陰虛午熱證), Ul-gwang disease (鬱狂證), Tae-eum disease (太陰證), So-eum disease (少陰證), the frequency of menstrual pain accompanied with nausea were higher than other diseases. 4. Conclusion Menstrual patterns, especially menstrual pain is different among Sasang Constitutional diseases. Assessing menstrual pain can be used for diagnosing Sasang Constitutional diseases, deciding treatment course, determinating prognosis.

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건강보험 청구자료를 이용한 전립선염 환자의 의료 이용 및 항생제 처방 현황 (Medical Utilization and Antibiotics Use of Prostatitis Patients in Korea)

  • 이보람;최윤정;최연송;공나영;최민선
    • 한국임상약학회지
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    • 제28권2호
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    • pp.117-123
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    • 2018
  • Background: Prostatitis, one of the most common diseases of the prostate, is a complex disease with various clinical features. This study aims to analyze the utilization and prescribing patterns of antibiotics in Korean patients with prostatitis between 2008 and 2015. Methods: We used the National Health Insurance Database complied from the Health Insurance Review and Assessment Service (HIRA). The outcomes included the number of claims, number of patients, medical cost, and length of stay for each year. In addition, the prescribing patterns of antibiotics, including fluoroquinolone, and low-dose use of ciprofloxacin and levofloxacin were investigated. Results: The total number of patients and medical cost increased by 9.5% and 51.7% from 2008 to 2015, respectively. Most prostatitis patients were classified as chronic prostatitis patients. The prescribing proportion of antibiotics for chronic prostatitis outpatients decreased from 71.0% to 66.9% from 2008 to 2015, and fluoroquinolone accounted for more than half of the total antibiotics. Over 80% of prescription of levofloxacin and ciprofloxacin was identified to be for low-dose use. Conclusion: Most of the patients with prostatitis experienced pain relief and condition improvement after antibiotic treatment; however, chronic prostatitis and chronic pelvic pain syndrome recur easily. Therefore, active disease management and further studies are needed to enhance our understanding of effective treatment for prostatitis.

Shoulder and Elbow Injury Rates and Patterns in Korean Rookie Professional Baseball Pitchers

  • Park, Jin-Young;Lee, Seung-Jun;Kim, Yong-Il;Heo, Gu-Yeon
    • Clinics in Shoulder and Elbow
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    • 제19권1호
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    • pp.15-19
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    • 2016
  • Background: To investigate how many rookie pitchers suffered from injuries while playing in the amateur league without guidelines for prevention of excessive pitching, we analyzed their amateur pitching patterns based on the pitch count, use of breaking balls, and pitches during winter camp. Methods: Forty-one rookie pitchers who graduated from high school or university in 2013 and joined professional baseball teams. Participants were interviewed by a trainer using our questionnaire. Injury inclusion criteria were 1) history of shoulder surgery, 2) history of elbow surgery, 3) shoulder pain requiring treatment, and 4) elbow pain requiring treatment. Results: Mean number of pitches per game and warm-up pitches for practice was 84.5 pitches (range, 15 to 130 pitches) and 16.4 pitches (range, 2 to 210 pitches), respectively. Mean number of pitches during the last year was 906.9 (range, 80 to 2,000). Mean number of maximal pitches was 127 pitches (range, 50 to 210 pitches). Fourteen pitchers had pitched over 150 pitches. Twenty-seven pitchers (65.9%) had pitched in spite of enduring pain. During winter training (mean 1.8 months), mean number of pitches per day was 162.5 pitches, and 20 pitchers (48.8%) had practiced pitching excessively despite the cold weather. Twenty-six rookies (63.4%) had shoulder pain or history of shoulder surgery, and 31 pitchers (75.6%) had elbow pain or history of elbow surgery. Only four participants (9.8%) did not have pain and history of surgery. Conclusions: For young baseball pitchers, guidelines for prevention of excessive pitching and for regulating the winter training program may be needed.

견갑골 운동장애 (Scapular Dyskinesis)

  • 박진영;이상훈;오정환;김홍겸
    • Clinics in Shoulder and Elbow
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    • 제12권2호
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    • pp.271-277
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    • 2009
  • 목적: 그동안 견관절과 견봉하 관절에 대한 연구는 전세계적으로 매우 많은 연구가 이루어져 왔고 많은 의사들의 관심분야로 각광받아왔다. 그러나 그에 비해서 견갑골과 그 주위근육들은 상대적으로 관심의 대상이 되어오지 못한 것이 사실이다. 이에 저자들은 견갑골의 운동장애에 대하여 기술해 보고자 하는 것이 목적이다. 대상 및 방법: 기본적으로 견관절의 움직임은 언제나 견갑골의 운동을 동반하게 되어있고, 견관절의 운동에 이상이 발생하면 이는 직접적으로 견관절 움직임에도 영향을 미칠 수 밖에 없다는 것은 이미 널리 알려진 사실이다. 결과 및 결론: 특히 운동선수에 있어서는 견갑골의 움직임과 견고한 고정이 매우 중요한 역할을 차지하게 된다. 이에 저자들은 견갑골의 움직임과 중요성에 대해서 조명해보고자 한다.