• 제목/요약/키워드: Medication review

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Correlates of Cognitive Impairment of Rheumatic Disease: Systematic Review and Meta-analysis (류마티스질환 환자의 인지손상과 관련된 요인 규명: 체계적 문헌고찰 및 메타분석)

  • Mo, JinA;Park, JiSuk;Oh, HyunSoo
    • Journal of Korean Academy of Nursing
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    • v.46 no.1
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    • pp.1-18
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    • 2016
  • Purpose: This study was conducted to synthesis the results of research on relationships of cognitive impairment with multi-dimensional correlates of rheumatic disease through a systematic literature review and meta-analysis. Methods: For the study purpose, 23 studies were selected through a systematic process of searching the literature. Results: The study results showed that among general characteristics, age and education were the variables having a significant relationship with cognitive impairment. Among health risk factors, obesity appeared to have a significant positive relationship with cognitive impairment. For past history, diabetes and hypertension were shown to have a significant positive relationship with cognitive impairment. It was noted also that aPL, one of the physiological factor, had significant association with cognitive impairment. None of the medication related factors had a significant relationship with cognitive impairment. Results showed that among disease related factors, disease activity had the highest relationship with cognitive impairment. Depression, among psychological factors, was the only variable having a significant relationship with cognitive impairment. Conclusion: The findings indicate that the variables strongly impacting on cognitive impairment in rheumatic disease are depression and disease activity.

Chuna Manual Therapy for Chronic gastritis : A Systematic Review (만성 위염에 대한 추나요법의 효과: 체계적 문헌고찰)

  • Lee, Nam-Woo;Kim, Gee-Heon;Shin, Byung-Cheul
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.12 no.2
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    • pp.1-14
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    • 2017
  • Objectives: To systematically evaluate the effectiveness and safety of Chuna manual therapy (CMT) for chronic gastritis (CG). Methods: We searched twelve English, Chinese and Korean databases using relevant keywords up to September 2017. All randomized controlled trials (RCTs) of CMT for CG were considered for inclusion. The methodological quality of included RCTs was assessed by the Cochrane risk of bias tool. Results: Seven RCTs with 403 CG patients were included. The meta-analysis of 6 studies showed that CMT had statistically significant effects (p<0.0001) on effective rate for CG compared to conventional medication. Conclusions: This systematic review suggests that CMT seems effective for CG, but limited evidence from risk of bias. For future studies, high-quality RCTs such as sham-controlled studies with standardized interventions are needed to provide sufficient evidence on the effects of CMT for CG.

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A Review of the Experimental Studies on the Modulatory Effect Herbal Medicine on Gut Microbiota (한약의 장내미생물 조절 효과에 대한 국내외 실험 연구 고찰)

  • Ahn, Hye Ri;Song, Ji Hyun;Lee, Hye Lim
    • The Journal of Pediatrics of Korean Medicine
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    • v.34 no.4
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    • pp.43-58
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    • 2020
  • Objectives The purpose of this study is to analyze the effect of various herbal medicin on gut microbiota. Methods Electronic searches were performed using NDSL, OASIS, KISS, KMBASE, K-portal, Pub med, Cochrane, CNKI. Results we analyzed 25 experimental studies on the effect of herbal medicine on microbiota. Diabetes, obesity, inflammatory bowel disease have been frequently studied in micobiota-related disease. The most common experimental animal model used in the studies C57BL/7 mouse. Among the studies wherein single herbal medication were used, Gynostemma pentaphyllum was most commonly studies, and different herbal medications were used in the studies wherein complex herbal medications were studied. Next generation sequencing was performed using Illumina MiSeq system, and gut microbiota analysis was performed using QIIME and Ribosomal Database Project (RDP). In most studies, the herbal medicines exerted regulatory effects on gut microbiota and improved the symptoms of the experimental groups. Conclusions This review provides basic data on the correlation between korean medicine and gut microbiota, as well as information for the development of korean medicine.

A Review of the Korean Experimental Studies on the Antidepressant Effect of Herbal Medicines (한약의 항우울 효과에 대한 국내 실험연구 고찰)

  • Han, Da-Young;Kim, Sang-Ho;Chung, Dae-kyoo
    • Journal of Oriental Neuropsychiatry
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    • v.30 no.2
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    • pp.71-88
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    • 2019
  • Objectives: The present study aims to review the antidepressant effect of herbal medicines reported in Korean local journals. Methods: We searched in electronic databases (Koreantk, KISS, OASIS, NDSL) for studies, published in Korean national journals, that assessed herbal medicine effect of depression model. The search term was 'depression' in the abstract or whole text. Depression model, herbal material, experimental results, mechanisms were extracted. Results: We included 43 articles in which 38 studies were in vitro experiments, and the rest 5 were in vivo experiments. The most common experiment subject model was a rat and the most widely used method to induce depression was Despair behavior test. 21 studies used simple herbal medicines, and 22 studies used complex herbal medication. Glycyrrhizae Radix was the most commonly used herbal material to improve depression model. The most common mechanisms of herbal medicine with antidepressant effect were inhibition of Monoamine activation mechanism and depression related neurohormone secretion. Conclusions: Herbal medicines may be a promising resource for treating depression.

A Study on the Relationship between Patient Safety and Patient-Centeredness in Hospitals (의료기관 환자안전과 환자중심성 간 관계 연구)

  • Kook, Sun-Pyo;Kang, Jegu;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.27 no.3
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    • pp.39-49
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    • 2022
  • Purposes: This study purposed to analyze the relationship between patient safety and patient-centerendess. Methodology: The comprehensive scores from patient safety assessment program and patient experience survey conducted by Health Insurance Review & Assessment Service were used as independent variables and dependent variables. This study analyzed the relationship between 4 patient safety-related areas(i.e. risk standardized readmission ratio, intensive care unit, preventive antibiotic, the drug evaluation) and 6 patient experience areas(i.e. nurse services, doctor services, medication & treatment, hospital environment, patient's right, overall experience) by using robust regression analysis. Findings: According to results, the score in 'patient's right' and 'risk standardized readmission ratio' areas were found to have a significant relationship, and 'overall experience' and the 'preventive antibiotic' areas. The ratio of senior beds and specialists was a general characteristics of hospitals that had a significant relationship on patient experience assessment. Practical Implication: The relationships between patient safety and patient experience assessment were varied depending on areas. Further study is needed to make clear the supposed relationship.

Post Discharge Nursing Needs of Patients with Open Heart Surgery (개심술 환자의 퇴원후 간호요구에 대한 조사연구)

  • 김명희
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.664-677
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    • 1993
  • The purpose of this study was to provide basic data for the development of educational material in Korean for patient3 being discharge after open heart surgery. The subjects were 45 adult patients who were seen in the out -patient department of the thoracic surgery unit of P University hospital between February 1993 and May 1993. The data were collected through a chart review and interview. Nursing needs, and the patients status related to diet, activity, medication, physical and psychoemotional limitations were analyzed. The results are summarized as follows ; 1. Mitral valve replacement was the most frequent type of surgery(91.2%). In most cases, a mechanical valve was used (91.0%) . The duration of admission after the operation was two to four weeks for most of the patients(48.9%). The follow-up period was between one and two years for 28.9% of the patients and below 6 years for all of the patients. 2. Many Patients didn’t know the importance of a low salt diet(57.8%), and did not get any education on low salt diet (66.7%). Gimchi was included as one of the most commonly ingested foods (77.8%). All of the patients indicated nursing needs related to education about low salt diets and further they indicated a major interest in foods that are harmful (57.7%) or foods that are safe(51.1% ). 3. Most patients did not recognize the need for limitations on physical activity(84.4%). Further, 31.1% of them could not return to work at the time of the study. All patients had nursing needs related to physical activity, with the most frequent questions being about the permissble degree of activity and special cautions dictated by their illness (60.0%). 4. Many patients were ignorant of the necessity of medication(55.6%) . Forty percent of the patients were taking additional drugs, usually herb drugs. The time and duration of medication and the side effects of drugs were common concerns (57.7%) related to nursing. needs about medication and were mentioned by all of the patients. 5. All of the patients complained of physical discomfort including the following : memory disturbance(62.2%), weight gain(60.0%), chest tightness (55.6%), hair loss(51.1%), sleep disturbance(46.7%) and other symptoms in that order of frequency. Nursing needs related to physical condition were a concern for all of them. The viability and function of the replaced valve(53.3%) and weight gain(60.0%) were mal or concerns. 6. Looking at their psychoemotional condition it was found that 36 patients(80.0%) were emotionally unstable. The causes were physical discomfort(17 patients), insufficient knowlege of open heart surgery(6 patients), fear of death(6 patients), familial over protection(2 patients ) and lack of support (5 patients).

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Effectiveness of Telemonitoring Intervention in Children and Adolescents with Asthma: A Systematic Review and Meta-Analysis (천식 아동 및 청소년에서 원격모니터링 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Jung, Youjin;Kim, Jimin;Park, Dong Ah
    • Journal of Korean Academy of Nursing
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    • v.48 no.4
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    • pp.389-406
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    • 2018
  • Purpose: This review aimed to evaluate the effectiveness of telemonitoring (TM) in the management of children and adolescents with asthma. Methods: We searched Ovid-MEDLINE, Ovid-EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL (Cumulative Index to Nursing and Allied Health Literature), and 5 domestic databases to identify randomized controlled trials (RCTs) published through December 2017. Two reviewers independently selected relevant studies, assessed methodological quality and extracted data. We performed a meta-analysis of TM versus usual care and summarized the intervention characteristics of included studies. Results: Of the 3,095 articles identified, 8 RCTs (9 articles) were included in this review. The type of TM intervention of included studies was varying across studies (transmitted data, transmission frequency, data review, etc.). The pooled asthma control score was not significantly different between TM and usual care (standardized mean difference 0.04, 95% confidence interval (CI) -0.20~0.28). Another pooled analysis demonstrated no statistically significant difference in asthma exacerbation between TM and usual care (odds ratio 0.95, 95% CI 0.43~2.09). Overall, the pooled results from these studies revealed that TM did not lead to clinically significant improvements in health outcomes, but some studies in our analysis suggested that TM increased patient medication adherence and intervention adherence. Conclusion: The current evidence base does not demonstrate any differences between TM intervention and usual care, but TM intervention might be considered a promising strategy for the delivery of self-management support for children and adolescents with asthma. Further well-designed studies are needed to assess the effects on clinical outcomes.

Long-Term Efficacy of Anti-Tumor Necrosis Factor Agents in Pediatric Luminal Crohn's Disease: A Systematic Review of Real-World Evidence Studies

  • Rheenen, Hanna van;Rheenen, Patrick Ferry van
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.2
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    • pp.121-131
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    • 2020
  • Purpose: To determine the long-term efficacy of the anti-tumor necrosis factor (TNF) agents, infliximab (IFX) and adalimumab (ADA), in pediatric luminal Crohn's disease (CD) by performing a systematic literature review. Methods: An electronic search was performed in Medline, Embase, and the Cochrane Library from inception to September 26, 2019. Eligible studies were cohort studies with observation periods that exceeded 1 year. Studies that reported time-to-event analyses were included. Events were defined as discontinuation of anti-TNF therapy for secondary loss of response. We extracted the probabilities of continuing anti-TNF therapy 1, 2, and 3 years after initiation. Results: In total, 2,464 papers were screened, 94 were selected for full text review, and 13 studies (11 on IFX, 2 on ADA) met our eligibility criteria for inclusion. After 1 year, 83-97% of patients were still receiving IFX therapy. After 2 and 3 years the probability of continuing IFX therapy decreased to 67-91% and 61-85%, respectively. In total, 5 of the 11 studies subgrouped by concomitant medication consistently showed that the probabilities of continuing IFX therapy in patients with prolonged immunomodulator use were higher than those in patients on IFX monotherapy. Conclusion: This review of real-world evidence studies confirms the long-term therapeutic benefit of IFX therapy in diverse cohorts of children with luminal CD. Moreover, it supports the view that combination therapy with an immunomodulator prolongs the durability of IFX therapy in patients who previously failed to recover following first-line therapy. The limited number of time-to-event studies in patients on ADA prevented us from drawing definite conclusions about its long-term efficacy.

A Critical Evaluation and International Comparison of Pharmaceutical Consumption and Sales Statistics (국내 2018년 의약품 소비량 및 판매액 통계 산출 및 국제 비교)

  • Kim, Jihye;Lee, Dahee;Kim, Sooyon;Kim, Dong-Sook
    • Health Policy and Management
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    • v.30 no.3
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    • pp.311-325
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    • 2020
  • Background: Health statistics of pharmaceutical use and expenditure are essential to make and implement evidence-based pharmaceutical policy. This study aims to demonstrate the methods and results of pharmaceutical consumption and sales in 2018 according to the sources and methods given by the Organization for Economic Cooperation and Development (OECD). Methods: The medication list contains 39,346 medicines both reimbursed and non-reimbursed by the National Health Insurance in 2018. We used the therapeutic categories based on Anatomic Therapeutic Chemical Classification of World Health Organization. This study analyzed National Health Insurance claims data and supply data generated from wholesalers to health care facilities. The indicators are defined daily dose (DDD), per 1,000 inhabitants per day and US$ per capita. Results: In South Korea, the number of medications to which DDD were assigned was 18,055 and it was 45.9% of the total number of medications on the list. The consumption in anti-infective for systemic use (J) and musculo-skeletal system (M) was higher than the mean consumption among the OECD countries. The pharmaceutical sales per person in Korea was also higher than the mean sales per person across the OECD countries. Conclusion: We sought to explain the methods to produce pharmaceutical consumption and sales statistics which we had submitted annually to OECD. Considering the characteristics of pharmaceutical statistics, a direct comparison should be approached with caution. Since the growth in pharmaceutical spending has greatly increased over the past decade, we need to monitor pharmaceutical consumption and expenditure consistently.

A Systematic Review and Meta-Analysis of Randomized Controlled Trials on Acupuncture for Improving Post-Operative Cognitive Dysfunction (POCD) and Chemotherapy-Related Cognitive Impairment (CRCI)

  • Kim, Ju-Young;Cho, Han-Byul;Kim, Man-Gi;Koo, Byung-Su;Kim, Geun-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.33 no.1
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    • pp.49-78
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    • 2022
  • Objectives: This study was conducted to evaluate the efficacy of Korean Medicine Therapy (KMT) for the treatment of Chemotherapy-induced Cognitive Impairment (CICI) through systematic review and meta-analysis of randomized controlled trials (RCTs) as proceeding research to further research the efficacy of KMT for CICI patients. Methods: We conducted a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA). The RCTs on the efficacy of KMT for treatment of CICI were searched by structured search strategies in MEDLINE, EMBASE, Cochrane library, CAJD, KISS, NDSL, KoreaMed, and OASIS. The searched RCTs were screened by inclusion and exclusion criteria. We evaluated the quality of the method in the included studies using the Jadad score and Cochran ROB tool. The efficacy outcomes were the Visual Analogue Scale (VAS) and the Clinical total Effective Rate (CER) of CICI. They were analyzed using mean difference for continuous variable or Relative Risk (RR) for Dichotomous variable in the random-effect model. The RevMan 5.3 program was used for meta-analysis. Results: We included 19 RCTs, including 653 participants, in the systematic review and meta-analysis. There were favorable results for the KMT group after the intervention compared with the pharmacotherapy group, physiotherapy group, and combined treatment group. KMT group showed improvement using CER and VAS compared with exercises, but their heterogeneities were slightly significant. KMT was more effective compared to the Rehabilitation program in CER and the subgroup analysis results showed that KMT had a significant difference compared to other therapies in VAS, to Medication therapy in CER. Conclusions: KMT presented reasonable evidence on improving the Clinical total Effective Rate and Visual Analogue Scale in CICI patients. However, further evaluation in future research is required.