• 제목/요약/키워드: Medication review

검색결과 394건 처리시간 0.027초

원발성 월경곤란증에 대한 침구치료 관련 무작위배정 임상시험의 체계적 고찰: 한국 문헌을 중심으로 (Acupuncture and Moxibustion for Primary Dysmenorrhea in Korean Literatures: A Systematic Review of Randomized Controlled Trials)

  • 김정완;박봉기;전종익;임윤경
    • Journal of Acupuncture Research
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    • 제32권2호
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    • pp.123-130
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    • 2015
  • Objectives : Primary dysmenorrhea is one of the most common female gynecological diseases. Acupuncture and moxibustion therapy have been used to treat dysmenorrhea in Korea. The aim of this review was to examine the effectiveness of acupuncture and moxibustion therapy for primary dysmenorrhea as described in studies in Korea. Methods : A total of 8 databases were searched, with the search concluding February 15, 2015. These were the Oriental Medicine Advanced Searching Integrated System, DBpia, Korean Studies Information Service System, National Digital Science Library, Korean Traditional Knowledge Portal, Research Information Sharing Service, and Pubmed. Randomized controlled Trails(RCTs) comparing acupuncture or moxibustion therapy with non acupoints stimulation or medication were selected. Data abstraction and assessment of methodology was conducted by authors and disagreements were resolved by discussion. Results : 7 trials were included in this review, with a total of 308 participants. 4 trials reported on acupuncture, 1 trial reported on acupress by magnet, 1 trial reported on pharmacopuncture, and the other trial reported on moxibustion. Quality of methodology was low. 2 trials showed that experimental therapy was effective for pain relief compared to the controlled group. However, 5 trials did not show a significant difference in pain relief. Conclusions : Acupuncture and moxibustion therapy may reduce period pain, however, it is needed for well designed RCTs in Korea.

국내 병원약사의 중재활동과 성과에 대한 체계적 문헌고찰 (A Systematic Review of Outcomes Research in the Hospital Pharmacists' Interventions in South Korea)

  • 이소영;조은
    • 한국임상약학회지
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    • 제29권3호
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    • pp.193-201
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    • 2019
  • Background and Objective: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. Methods: A literature search of the following databases was performed: Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were "hospital pharmacist", "clinical pharmacist", and "Korea". Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. Results: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians' prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). Conclusion: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists' professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.

음부-골반통/삽입질환에 대한 중의학 임상연구 동향 (Review of Clinical Studies of Traditional Chinese Medicine on Genito-Pelvic Pain/Penetration Disorder in Women)

  • 남은영
    • 대한한방부인과학회지
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    • 제32권3호
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    • pp.214-226
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    • 2019
  • Objectives: The purpose of this study is to review clinical studies of Traditional Chinese medicine (TCM) on Genito-Pelvic Pain/Penetration Disorder (GPPPD) in women. Methods: Key words "Dyspareunia", "Vaginismus" were searched on Chinese National Knowledge Infrastructure Database (CNKI) on April 21th 2019. Results: 2 case reports and 7 clinical trials were collected in accordance with the selection and exclusion criteria. Among the 7 trials, 4 were controlled trials, and 3 were single-arm trials. The types of intervention were herb medication in 8 studies, and compound TCM treatment including acupuncture, moxibustion, and cupping therapy in 1 study. All 4 controlled trials were about dyspareunia and conducted by herbal medicine of TCM. The study results and methods of intervention were analyzed. Conclusions: 2 case reports described the effectiveness of compound TCM treatments (acupuncture, moxibustion, cupping therapy) and herb medicine in dyspareunia. In 4 controlled trials, 2 trials described the effectiveness of herb medicine (oral or vaginal agent) compared to western treatment in dyspareunia, and other 2 trials described no effectiveness of herbal enema compared to danazol. In 3 single-arm trials, 1 trial of dyspareunia and 2 trials of vaginismus described the effectiveness of herb medicine. All the 9 selected studies reported improved or disappeared symptoms of GPPPD, or high effective rate after TCM treatment. There was limitation that the selected studies were retrieved from only one site of CNKI, and generalized results could not be derived, further studies should be carried out. Additional well-designed clinical studies on GPPPD in women are needed in Korea.

Association Between Persistent Treatment of Alzheimer's Dementia and Osteoporosis Using a Common Data Model

  • Seonhwa Hwang;Yong Gwon Soung;Seong Uk Kang;Donghan Yu;Haeran Baek;Jae-Won Jang
    • 대한치매학회지
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    • 제22권4호
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    • pp.121-129
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    • 2023
  • Background and Purpose: As it becomes an aging society, interest in senile diseases is increasing. Alzheimer's dementia (AD) and osteoporosis are representative senile diseases. Various studies have reported that AD and osteoporosis share many risk factors that affect each other's incidence. This aimed to determine if active medication treatment of AD could affect the development of osteoporosis. Methods: The Health Insurance Review and Assessment Service provided data consisting of diagnosis, demographics, prescription drug, procedures, medical materials, and healthcare resources. In this study, data of all AD patients in South Korea who were registered under the national health insurance system were obtained. The cohort underwent conversion to an Observational Medical Outcomes Partnership-Common Data Model version 5 format. Results: This study included 11,355 individuals in the good persistent group and an equal number of 11,355 individuals in the poor persistent group from the National Health Claims database for AD drug treatment. In primary analysis, the risk of osteoporosis was significantly higher in the poor persistence group than in the good persistence group (hazard ratio, 1.20 [95% confidence interval, 1.09-1.32]; p<0.001). Conclusions: We found that the good persistence group treated with anti-dementia drugs for AD was associated with a significant lower risk of osteoporosis in this nationwide study. Further studies are needed to clarify the pathophysiological link in patients with two chronic diseases.

한국, 미국, 유럽의 혁신적 의약품 개발 및 허가제도 비교 연구 (Comparison of the Expedited Programs for Innovative Drug Development and Approval among United States, European Union, and Republic of Korea)

  • 박지연;신혜원;이장익
    • 한국임상약학회지
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    • 제34권1호
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    • pp.39-61
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    • 2024
  • Background: The Food and Drug Administration (FDA), the European Medicines Agency (EMA), and the Ministry of Food and Drug Safety (MFDS) have been implementing the expedited programs that promote the innovative approval of new medications to be used for serious diseases. The authors comprehensively investigated, analyzed, and compared the regulations and guidelines associated with the expedited programs. Methods: The expedited programs for innovative drug development and approval were searched from the homepages of FDA, EMA and MFDS. The detailed information on the regulations and guidelines associated with the programs was comprehensively extracted from various electronic repositories of each regulatory authority. The information on each program was analyzed, categorized, and compared from the points of benefits, applicability with scientific rationale, application procedure, and maintenance. Results: FDA's programs include Fast Track Designation, Breakthrough Therapy Designation, Priority Review Designation, and Accelerated Approval. EMA's regulation implements PRIority MEdicines (PRIME), Accelerated Assessment, Marketing Authorization under Exceptional Circumstances (MAEC), and Conditional Marketing Authorization (CMA). MFDS has a single Expedited Program. These programs are broadly categorized into those that 1) facilitate early and proactive communication with regulatory authorities, 2) shorten the review time after submitting a marketing application, and 3) temporarily approve a marketing authorization under certain conditions. Conclusion: Each expedited program requires a different level and amount of safety and efficacy evidence to be submitted to each regulatory authority. This article will likely provide the comprehensive information on which program provides scientific and regulatory advantages to be taken for innovative medication development.

Thermal imaging and computer vision technologies for the enhancement of pig husbandry: a review

  • Md Nasim Reza;Md Razob Ali;Samsuzzaman;Md Shaha Nur Kabir;Md Rejaul Karim;Shahriar Ahmed;Hyunjin Kyoung;Gookhwan Kim;Sun-Ok Chung
    • Journal of Animal Science and Technology
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    • 제66권1호
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    • pp.31-56
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    • 2024
  • Pig farming, a vital industry, necessitates proactive measures for early disease detection and crush symptom monitoring to ensure optimum pig health and safety. This review explores advanced thermal sensing technologies and computer vision-based thermal imaging techniques employed for pig disease and piglet crush symptom monitoring on pig farms. Infrared thermography (IRT) is a non-invasive and efficient technology for measuring pig body temperature, providing advantages such as non-destructive, long-distance, and high-sensitivity measurements. Unlike traditional methods, IRT offers a quick and labor-saving approach to acquiring physiological data impacted by environmental temperature, crucial for understanding pig body physiology and metabolism. IRT aids in early disease detection, respiratory health monitoring, and evaluating vaccination effectiveness. Challenges include body surface emissivity variations affecting measurement accuracy. Thermal imaging and deep learning algorithms are used for pig behavior recognition, with the dorsal plane effective for stress detection. Remote health monitoring through thermal imaging, deep learning, and wearable devices facilitates non-invasive assessment of pig health, minimizing medication use. Integration of advanced sensors, thermal imaging, and deep learning shows potential for disease detection and improvement in pig farming, but challenges and ethical considerations must be addressed for successful implementation. This review summarizes the state-of-the-art technologies used in the pig farming industry, including computer vision algorithms such as object detection, image segmentation, and deep learning techniques. It also discusses the benefits and limitations of IRT technology, providing an overview of the current research field. This study provides valuable insights for researchers and farmers regarding IRT application in pig production, highlighting notable approaches and the latest research findings in this field.

Drug Use Evaluation of Letrozole in Breast Cancer Patients at Regional Cancer Hospitals in Thailand

  • Ketkaew, Chaninun;Kiatying-Angsulee, Niyada
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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    • pp.6055-6059
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    • 2015
  • Background: Medication policy development in Thailand is continually promoting rational drug use. Letrozole, an endocrine therapy drug, is usually prescribed for post-menopausal status early and advanced stage breast cancer. After Ministry of Public Health announced Letrozole as compulsory licensed drug in 2009, more breast cancer patients can access to this drug at low cost especially those within universal coverage schemes. To ensure that Letrozole is rationally prescribed, the drug utilization study was conducted. Objectives: The aim of this study was to describe the appropriate use of Letrozole in breast cancer and the relationship between appropriate use and health benefit schemes. Materials and Methods: A retrospective study to evaluate use of Letrozole in breast cancer patients was performed for six months between January - June 2010 in seven regional cancer hospitals, Thailand. All prescriptions of Letrozole were identified from pharmacy dispensing databases and prescription papers. A medical record review was also performed to evaluate appropriate use referring to the drug use evaluation criteria. The approved criterion of this study was referred from the guideline of Thai National Formulary version 2010. Results: There were 681 prescriptions of Letrozole for 254 breast cancer patients with an average age of $58.6{\pm}10.0years$. The patients in universal coverage scheme (UCS), civil servant medication benefit scheme (CSMBS) and social security scheme (SSS) were 77.7%, 18.5% and 8.7% respectively. 10.6% were prescribed Letrozole for the first time. Letrozole were prescribed by oncologists (82.8%). The average number of tablets per prescription was $58{\pm}10$. Calcium supplements were prescribed concomitant with Letrozole for 19.4%. To assess drug use evaluation criteria, 45 prescriptions were excluded because of uncompleted clinical data, 636 prescriptions were evaluated. The study showed 86 prescriptions (13.5%) with inappropriate use including 6 (0.9%) not prescribed for estrogen receptor (ER) and/or progesterone receptor (PR) positive, 31 (4.9%) not prescribed for post-menopausal and 49 (7.7%) not prescribed for an appropriate duration. Appropriate use percentages in different health benefit schemes were similar, 85.7% of CSMBS, 86.4% of SSS and 86.7% of UCS. The relationship between health benefit scheme and appropriate use of Letrozole was not significantly different, ${\chi}^2$ (2, N = 636) = 0.081, p > 0.05. Conclusions: The study showed inappropriate use in breast cancer patients because of non-compliance with duration, menopausal status and hormone receptor requirements. To prescribe appropriate indication did not referred to the appropriate practice along the treatment. Drug use evaluation proved very useful for detecting the sign of inappropriate use and allows immediate feedback to the stakeholder for developing medication policy in the future. Importantly, there was no significantly difference in appropriate use of Letrozole across health benefit schemes.

제2형 당뇨병 환자에서 혈당강하제와 보중익기탕 병용 투여가 혈당 변화에 미치는 영향 및 안전성 연구 (A Retrospective Study of the Safety and Effect of Co-administration of Glucose-lowering Medication and Bojungikgi-tang on Blood Glucose Level in Patients with Type 2 Diabetes Mellitus)

  • 오승현;정우녕;송미령;노지원;안영민;안세영;이병철
    • 대한한방내과학회지
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    • 제44권3호
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    • pp.354-365
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    • 2023
  • Objective: This study aimed to assess the safety and effect on glucose level of Bojungikgi-tang in patients with type 2 diabetes mellitus. Methods: To review patients' clinical characteristics and laboratory tests retrospectively, we investigated 15 hospitalized patients with type 2 diabetes mellitus who took Bojungikgi-tang at Kyung Hee University Korean Medical Hospital for at least one day between January 2012 and December 2022. The blood glucose levels, including fasting blood sugar (FBS), 2-hour postprandial glucose (PP2) levels, and glycated hemoglobin level, were collected to determine the effect of the Bojungikgi-tang on blood sugar changes. Furthermore, to evaluate the safety of Bojungikgi-tang, hepatic function and renal function tests were implemented, including aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, γ-glutamyltransferase, blood urea nitrogen, creatinine, and Modification of Diet in Renal Disease estimated glomerular filtration rate. Results: When Bojungikgi-tang and a standard treatment for diabetes were administered for patients with type 2 diabetes, it was confirmed that there were no statistically significant changes in FBS and PP2 levels in the analysis of each medication taken. There was no significant difference in the safety profile after taking Bojungikgi-tang. Conclusions: The combined administration of Bojungikgi-tang with standard hypoglycemic medication for patients with type 2 diabetes may not affect blood glucose levels and safety.

한국인 턱관절장애 환자의 유병률과 진료 양태 (Prevalence and Treatment Pattern of Korean Patients with Temporomandibular Disorders)

  • 양희영;김미은
    • Journal of Oral Medicine and Pain
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    • 제34권1호
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    • pp.63-79
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    • 2009
  • 본 연구는 건강보험심사평가원(Health Insurance Review and Assessment Service, 이하 심평원)에서 전산화되어 관리되는 보험대상 환자들의 진료기록을 이용하여 턱관절장애(temporomandibular disorders, TMD)로 인해 병원을 찾고 있는 환자의 유병률과 진료양태를 파악하고자 하였다. 연구를 위하여 심평원 전산시스템에 등록된 국내 보험대상 환자 중 2003년, 2004년, 2005년의 3년에 걸친 환자 자료를 사용하여 턱관절장애 (K07.6)를 주상병으로 하여 진단과 치료를 받은 환자에 대하여 성별 및 연령별 진료인원, 지역별 진료인원, 요양기관종별 진료인원, 치료기간 및 진료건수, 진료과목별 진료건수와 평균치료기간, 진료과목별 1인당 소요비용, 원외처방 치료약제 약효분류코드(효능군)별 연간 투약일수, 외과적 수술 실시 횟수 등을 분석조사한 연구결과는 다음과 같다. TMD로 인해 병원을 찾는 평균 환자수는 전체인구의 0.15%이었으며, 3년간 매년 증가하는 추세를 보였다. 그 중 99.8%가 여자였고, 20대의 유병률이 가장 높고 연령이 증가하면서 감소하는 양상을 보였다. 3년간의 변화추이를 볼 때 20대의 유병률은 감소하고 40대 이후 증가하는 양상을 보였다는 점이 특징적이었다. 16개 시도별 분포에서는 인구가 많은 서울, 경기 지역의 환자수가 많았고, 매년 전체 환자수가 증가하면서 각 지역별로 유사한 비율로 증가하였다. 그러나 부산과 대구에서는 감소세가 뚜렷하였고 울산, 경기, 전남의 증가세가 관찰되었다. 의료기관별로 내원한 환자 수는 치과를 포함한 일차의료기관에 내원하여 진료한 경우가 평균 56.8%로 전체의 과반수를 차지하였고 TMD와 관련한 입원건수는 치과 입원(86.6%)이 의과전체(13.4%) 보다 훨씬 많았다. 외래내원건수에서는 치과가 전체 건수의 38.4%로서 가장 많았으며, 정형외과(28%), 이비인후과(13.6%)의 순서였다. 약물치료에서는 해열소염진통제가 가장 빈번하게 투여되었고 정신신경용제, 골격근이완제의 순서였다. 심평원의 자료는 TMD때문에 병원을 찾는 환자들의 역학적 특성과 진료양태에 대한 포괄적이고 광범위한 정보를 제공하고 있지만, 진료실에서 정확한 진단과 표준화된 치료가 이루어지고 있는지에 대한 평가가 함께 이루어질 때 더욱 신뢰할 수 있는 정보가 될 것으로 생각된다.

전립선 비대증에 대한 뜸치료의 효과 : 체계적 문헌고찰과 메타분석 (Moxibustion for Benign Prostatic Hyperplasia: A Systematic Review and Meta-analysis)

  • 배고은;이승환;홍진우;이인;김소연;최준용;한창우;윤영주;박성하;권정남
    • 대한한방내과학회지
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    • 제39권3호
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    • pp.372-388
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    • 2018
  • Objective: This study evaluates the effectiveness and safety of moxibustion for benign prostatic hyperplasia (BPH). Methods: Using the keywords "benign prostatic hyperplasia", "benign prostatic hypertrophy", "benign prostatic enlargement", "prostatic hyperplasia", and "moxibustion", we searched papers in numerous databases, including National Discovery for Science Leaders (NDSL), Korean Traditional Knowledge Portal (KTKP), Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS), PubMed, Embase, and CENTRAL. The search range included randomized controlled trials (RCTs). Papers not matched with inclusion criteria were excluded. The methodological quality of each RCT was assessed using the Cochrane risk-of-bias tool. Where appropriate, meta-analyses were performed. Results: Initially, 77 studies were found. Of these, 11 duplicate studies were removed and 27 were excluded following title and abstract screening. After the remaining 39 papers were scanned, 13 RCTs were selected and analyzed. Among these 13 RCTs, five compared moxibustion therapy and oral medication, seven compared moxibustion plus acupuncture therapy and oral medication, and one compared moxibustion plus acupuncture therapy and sham-moxibustion. The meta-analysis showed positive results for the use of moxibustion therapy in terms of International Prostate Symptom Score (IPSS), Quality Of Life (QOL), Maximum Flow Rate (Qmax), Prostate Volume (PV), and the efficacy rate. The meta-analysis showed positive results for the use of moxibustion plus acupuncture therapy in terms of IPSS, QOL, and the efficacy rate. Conclusions: This meta-analysis of clinical trials suggests that moxibustion is effective intreating BPH patients. The results of this study could be applied to clinical treatment of BPH. However, additional large-scale clinical researches should be conducted.