• Title/Summary/Keyword: Follow up medication

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The Effect of a Clinic Based Incentive Program on Medication Adherence among Patients with Hypertension or Diabetes Mellitus in Incheon (인천광역시 의원기반 건강포인트제도가 고혈압·당뇨병 환자의 지속치료에 미치는 영향)

  • Cheong, Won;Yim, Jun;Oh, Dae-Kyu;Im, Jeong-Soo;Ko, Kwang Pil;Park, Ie Byung
    • Health Policy and Management
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    • v.23 no.4
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    • pp.427-433
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    • 2013
  • Background: This study was conducted to evaluate the factors affecting adherence in patients with hypertension and type 2 diabetes mellitus before and after a clinic based patient incentive program in Incheon. Methods: An observational follow-up study was done for 28,355 patients in one registered group and 245,598 patients in a non-registered group from March 16th 2009 to December 31th 2010 in Incheon. The registration, mandatory laboratory tests and number of clinic visits were collected by merging the Incheon Chronic Disease Management System data and the National Health Insurance Corporation (NHIC) data. As a measure of patient adherence, we used a variable of prescription days from the NHIC and defined above 80% of average prescription days as an appropriate patient adherence. Repeated measures analysis of variance and logistic regression were used to analyze the differences in patient adherence and factors affecting adherence. Results: The changes in prescription days for the registered group are larger than for the non-registered group. In the logistic regression model, including the variables with sex, age, income status and number of clinic visits, the registered group exhibited a higher Odds ratio in the patient adherence. Conclusion: This study revealed the association between registration and appropriate patient adherence in patients with hypertension or type 2 diabetes mellitus.

Implementing a Smoking Cessation Clinic at a Public Health Center in Korea: Evaluating the Outcomes and the Smokers' Perceptions (보건소 금연클리닉 활성화를 위한 방문자 이용현황과 금연성공 및 만족도 조사)

  • Yoo, Hye-Ra
    • Journal of Korean Public Health Nursing
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    • v.22 no.1
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    • pp.62-73
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    • 2008
  • Purpose: To examine the outcomes of a smoking cessation clinic at a public health center, in Hwasung city in 2006 and to examine the perceptions of the users regarding the clinic services. Method: 620 smokers who visited the smoking cessation clinic from January, 2006 to November, 2006 were enrolled. An instrument developed by the researcher was used to collect their perceptions. The instrument comprised 24 questions, on a 5-point Likert scale investigating the clinic services in terms of counseling time, environment, readiness of the counselors, counseling information, campaign method, medication use, and follow-up services. The general characteristics of the participants were collected from the database developed by the Ministry of Health & Welfare. The data were analyzed with frequencies, percentage, mean and standard deviation methods. Results: The outcomes of the smoking cessation clinic in Hwasung city in 2006 showed some limitations in terms of low-income group, female smokers, and young adult smokers. Conclusion: Strategies for solving these limitations were necessary to increase the effectiveness of the smoking cessation clinic. Clinic services focused on cognitive-behavioral therapy needed to be developed in accordance with chemotherapy. More effective publicizing campaigns of the clinic services also needed to be developed for more people to know about the clinic. Strategies to increase the accessibility for the people living far from the clinic were also necessary. Assessment of the smokers who did not visit clinic was also recommended in order to determine their intentions, or barriers to visit the clinic.

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A Case of Tuberculous Meningoencephalitis Presenting as Prominent Psychotic Features (현저한 정신증상으로 발현된 결핵성 뇌수막뇌염 1예)

  • Yu, Hyun-Jung;Oh, Jee-Young;Kim, Jee-Hyun;Kim, Jung-Eun;Park, Kee-Duk
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.603-608
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    • 2001
  • Intracranial vasculitis is a rare and disastrous complication of tuberculous meningitis if not treated properly. Focal neurologic deficits according to the vessels involved are common manifestation. Here, we report a 29-year-old man who suffered abrupt, bizarre behavioral changes caused by vasculitis complicating tuberculous meningoencephalitis. The diagnosis of tuberculous meningitis is based upon both the CSF findings and a chest X-ray. His systemic symptoms disappeared by after being administered antituberculous medication but various psychotic features such as hypersomnia, hyperphagia and aggressive behavior continued. A brain MRI showed multiple small parenchymal tuberculous nodules, and the brain MR angiography revealed a narrowing of the proximal middle cerebral arteries and a reduced visualization of the cerebral vessels, suggesting widespread vasculitis. Intravenous dexamethasone successfully ameliorated his behavioral changes. In addition both the follow up brain MRI and angiography showed a normalization of the previous findings.

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The Prognostic Factors of Selective Transforaminal Epidural Block in Patients with Low Back Pain (요하지통 환자에서 선택적 경추간공 경막외강 블록의 예후 인자)

  • Choi, Byung In;Han, Jeong Mi;Kweon, Tae Dong;Lee, Youn-Woo
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.54-59
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    • 2007
  • Background: Selective transforaminal epidural block (STEB) has showen effectiveness as a diagnostic and therapeutic option for the management of patients with low back pain or sciatica. This study was carried out in order to determine the short-term effects and prognostic factors associated with STEB in patients with low back pain or sciatica. Methods: Ninety-seven patients were selectedfor participation in this study. Their diagnosis were based werewason the clinical symptoms and MRI findings. We performed STEB under fluoroscopic guidance and injected 3 ml of radio opaque dye in order to confirm the technical success of the procedure. We then injected 20 mg of triamcinolone mixed into 3 ml of 0.5% mepivacaine. One month later, we classified the patient outcomes as excellent, good, moderate or poor, according to the degree of reduction in VAS score from baseline. The independent variables assessed included symptom duration, block level, number of blocks, primary diagnosis, prior caudal block, anterior epidural space filling of dye, medication history, demographic data, radiating pain, back surgery and spondylolisthesis. Results: At a mean follow-up period of 1 month after STEB, excellent results were noted in the patients diagnosed with herniated lumbar disc (70%), non-specific spondylosis (54%), spinal stenosis (44%), and failed back syndrome (28%). The patients with epidural adhesion and combined spondylolisthesis were associated with poorer outcomes. Combined caudal block, symptom duration and the extent of epidural spread of the drug were not related to the effectiveness of the treatment. Conclusions: Selective transforaminal epidural block is effective in treating patients with radiculopathy, such as herniated lumbar disc, but it isrelatively ineffective in treating patients with structural deformities, such as failed back syndrome and spondylolisthesis.

A Review of the Domestic Study Trends on Adenomyosis Treated with Korean Medicine (자궁샘근증의 한의학적 치료에 대한 국내 연구 동향 고찰)

  • Lee, Sung-Yub;Lee, Yoon-Jae;So, Min-Ji;Moon, Hye-Yeon;Kim, No-Hyeon;Suh, Chang-Yong;Do, Ho-Jeong;Song, Hyun-Seop;Shin, Jae-Kwon
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.4
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    • pp.89-99
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    • 2017
  • Objectives: The purpose of this study is to examines the domestic study trends on adenomyosis treated with Korean medicine. Methods: We investigated the studies on Korean medicine treatment for adenomyosis via searching 8 online databases. Results: As a result, 12 records (14 cases) were found to be analyzed according to their modes of diagnosis, symptoms, interventions, treatment period, follow up period and relevant outcomes. In diagnosis of adenomyosis, the most used method was ultrasonography. The most common complaint for patients with adenomyosis was dysmenorrhea. The most applied intervention for adenomyosis was herbal medication. Acupuncture was the second most used. Conclusions: Analyzing the domestic study trends would be helpful to establish a basic knowledge of the future study. It is anticipated that this review benefits the future in-depth study to confirm the efficacy of Korean medicine treatments for adenomyosis.

Upper eyelid platinum weight placement for the treatment of paralytic lagophthalmos: A new plane between the inner septum and the levator aponeurosis

  • Oh, Tae Suk;Min, Kyunghyun;Song, Sin Young;Choi, Jong Woo;Koh, Kyung Suk
    • Archives of Plastic Surgery
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    • v.45 no.3
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    • pp.222-228
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    • 2018
  • Background The most common surgical treatment for paralytic lagophthalmos is the placement of a weight implant in the upper eyelid; however, this technique confers the risks of implant visibility, implant extrusion, and entropion. In this study, we present a new technique of placing platinum weight implants between the levator aponeurosis and inner septum to decrease such complications. Methods A total of 37 patients with paralytic lagophthalmos were treated between March 2014 and January 2017 with platinum weight placement (mean follow-up, 520.1 days). After dissecting through the orbicularis oculi muscle, the tarsal plate and levator aponeurosis were exposed. The platinum weights (1.0-1.4 g) were fixed to the upper margin of the tarsal plate and placed underneath the orbital septum. Results Five patients could partially close their eye after surgery. The average distance between the upper eyelid and the lower eyelid when the eyes were closed was 1.12 mm. The rest of the patients were able to close their eye completely. Three patients patient developed allergic conjunctivitis after platinum weight insertion, which was managed with medication. None of the patients complained of discomfort in the upper eyelid after surgery. Visibility or extrusion of the implant were observed in three patients. Conclusions Postseptal weight placement is a safe and reproducible method in both primary and secondary upper eyelid surgery for patients with paralytic lagophthalmos. It is a feasible method for preventing implant visibility, implant exposure, and entropion. Moreover, platinum is a better implant material than gold because of its smaller size and greater thinness.

A Clinical Case Report of Soeumin Patient with Chronic Hand Eczema (만성 수부 습진을 호소하는 소음인 환자 치험 1례)

  • Lee, Jiyeon;Lee, Min-jung;Hwang, Min-woo
    • Journal of Sasang Constitutional Medicine
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    • v.33 no.3
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    • pp.161-170
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    • 2021
  • Introduction Hand eczema is dermatitis that occurs on the hand and fingers. In this case, the patient had chronic hand eczema that had relapsed for 3 years, worsened for 6 months, and did not improve even with standard dermatological treatment. We report significant improvement of the patient with chronic hand eczema, diagnosed with Soeunmin Greater Yin Symptomatology based on Sasang Constitutional Medicine. Methods We prescribed herbal medicine, Sibimigwanjung-tang(十二味寬中湯), and the western medications were continued throughout the treatment period. To evaluate the treatment progression, we observed objective and subjective symptoms and took pictures of the patient's hands. Results At the first time of the outpatient visit, the patient complained of pain, oozing, scaling and severe itching even though she had taken dermatological medication for over 6 months. After 8 weeks of Korean medicine treatment, most symptoms showed improvement, and after about 47 weeks of treatment, the symptoms maintained 90% improvement even after stopping western medications and herbal medications. Conclusion The patient in this case showed a significant improvement of chronic hand eczema and the improvements have been maintained even stopping western medications and herbal medications during follow-up for 15 weeks. In addition, the patient showed improvement and maintenance of general conditions as well as skin-related symptoms. In this case, we can concern the effect of the Sasang Constitutional Medicine focused on treating the patient's general pathology as well as the patient's chief complaint at chronic hand eczema not responding to standard dermatological treatment.

A Blood Pressure Lowering Effect Only through Complex Korean Medical Treatment, without Antihypertensive Drugs, for Patients with Stress Induced Hypertension - A Case Report (스트레스성 고혈압 환자에서 고혈압 약물 복용 없는 복합한의치료만의 강압 효과 - 증례보고)

  • Lee, Ji-hyun;Roh, Min-yeong;Yoon, Seok-yeong;Jun, Hyung-sun;Han, Yang-hee;Leem, Jung-tae
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.808-819
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    • 2021
  • Objectives: This study considered the effectiveness of integrative Korean medical treatment for stress-induced hypertensive patients without the use of conventional medication. Methods: A 62-year-old female with stress-induced hypertension (HTN) was hospitalized for 33 days. Her pattern identification was ascendant hyperactivity of liver yang (Ganyangsanghang)-type HTN. Herbal medicine and acupuncture were used for the treatment: Cheonggansoyo-san for 33 days and Chunwangbosim-dan for 15 days, together with acupuncture for 20 minutes twice a day. Blood pressure was checked daily during hospitalization with a digital sphygmomanometer in the brachial artery. Results: After 33 days of treatment, blood pressure decreased. The Handicap Inventory (DHI) scale and Pittsburg Sleep Quality Index (PSQI) scores both decreased. The patient also reported fewer complaints. A five-month follow-up after discharge, with no further treatment, confirmed stable blood pressure. Symptom improvements continued with no significant side effects. Conclusions: This study indicates that Korean medical treatment is effective for stress-induced hypertensive patients.

A case of Cluster Headache treated with Traditional Korean Medicine (군발 두통 환자에게 한의치료를 적용했던 1례)

  • Lee, Hyunku;Bae, In-hu;Ha, Won Jung;Kim, Soo-hyun;Cho, Ki-Ho;Moon, Sang-Kwan;Jung, Woo-Sang;Kwon, Seungwon;Jin, Chul
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.21 no.1
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    • pp.39-46
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    • 2020
  • ■ Objectives The purpose of this case report is to show the effect of Traditional Korean Medicine(TKM) on a patient with Cluster Headache. ■ Methods A patient diagnosed as Cluster Headache was treated with herbal medication(Sihogyejitang plus Oryungsan), acupuncture, electro-acupuncture. Then we evaluated the improvement with NRS(Numeral Rating Scale) of headache, number of headache attack and O2 inhalation. ■ Results We could observe decrease NRS of headache and number of headache and O2 inhalation after 10 days of the TKM treatment and there was no reattack after treatment for 43days follow up period. ■ Conclusion This case showed the effect of TKM treatment on Cluster headache.

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A Case Report of Patient with Restless Legs Syndrome Improved by Gami Ssanghwa-tang (가미쌍화탕으로 호전된 하지불안증후군 환자 치험 1례)

  • Yim, Tae-Bin;Jeon, Gyu-Ri;Lee, Hye-Jin;Kim, Seo-Young;Cho, Seung-Yeon;Park, Seong-Uk;Ko, Chang-Nam;Park, Jung-Mi
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.22 no.1
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    • pp.1-10
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    • 2021
  • ■ Objectives The purpose of this case study is to report the effectiveness of Gami Ssanghwa-tang on the restless legs syndrome patient. ■ Methods The patient was treated with Korean medicine, including herbal medication Gami Ssanghwa-tang for 26 days and acupuncture for once a week as an out patient. The evaluation was performed using the Korean versions of the International Restless Legs Scale(K-IRLS). ■ Results After 34 days of treatment, the K-IRLS total score improved from 24 to 8. And at the follow up session(7 days after end of treatment), the K-IRLS total score improved to 0. ■ Conclusion This study suggested that herbal medicine, Gami Ssanghwa-tang might be effective in Restless legs syndrome.