• Journal of Preventive Medicine and Public Health
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• 제40권3호
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• pp.249-258
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• 2007

Objectives : The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. Methods : The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. Results : The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence $(CMA{\geq}80%)$ rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. Conclusions : The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.

• 대한본초학회지
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• 제24권4호
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• pp.17-23
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• 2009

Objectives : This study aimed to provide basic data for future policies regarding the expansion of health insurance, through investigating the current status of Oriental herbal medicine insurance as perceived by the public. Methods : Questionnaire was developed through literature searches, in-depth interviews, item generation and item reduction. The questionnaires were further refined by a focus group. 221 surveys were retrieved from the general public. Results : The in-depth interviews, reveal that the public is aware of the various forms of Oriental herbal medicine formulas, except for the use of mixture of which are soluble granules covered by insurance. The public awareness of the soluble granules turned out to be so low that enhanced awareness of it is required. The public identified decoctions as the most preferred formula as well as the most effective formulas out of all Oriental herbal medical formulas. They also suggested that it should be the first to be included when the insurance policy expands in the future. The public had frequent experienced not choosing Oriental herbal prescription due to the high cost. Insurance coverage of Oriental herbal prescription is much needed. The public indicated that they will make frequent visits to the KMD if the insurance covers Oriental herbal prescriptions. Conclusions : The current status quo of Oriental herbal medicine insurance showed that the public identified decoctions as the most preferred, most effective and the top priority to be covered by insurance.

• 대한불안의학회지
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• 제4권1호
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• pp.42-48
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• 2008

현재 PTSD와 관련한 여러 병태생리 기전들이 밝혀지고 있으며 이에 초점을 둔 다양한 약물치료가 행해지고 있다. 본 연구에서는 일 대학병원에서 PTSD로 진단된 환자들의 의무기록을 검토하여 약물치료의 경향에 대해 알아보았다.1998년 1월부터 2007년 12월까지 DSM-IV에 의해 PTSD로 진단된 입원 환자 75명이 대상군이 되었으며, 이들의 인구학적 요인들, 입원기간, 외상의 종류, 외상 후 경과시간 및 정신과적 공존병리 및 처방 받은 약물을 조사하였다. 조사 결과, 75명 중 남자는 33명, 여자는 42명이었다. 정신과적 공존병리는 총 50명(66.7%)에서 존재하였으며, 우울장애, 인지장애, 정신장애 및 불안장애 순이었다.73명(97%)의 대상군은 항우울제를 처방 받았으며, 그 중 paroxetine이 54.7%로 가장 많았고 두 가지 이상의 항우울제를 처방 받은 경우도 24%였다. 또 거의 대부분의 환자에서 비정형 항정신병약물(33.3%), 기분안정제(17.3%),항불안제(94.7%)가 항우울제와 병용 처방된 것으로 조사되었다. 여러 제한점에도 불구하고 본 연구에서 얻어진 약물 처방 경향은 향후 국내 실정에 맞는 치료 지침을 수립하는 데에 하나의 근거 자료가 될 수 있을 것이다.

• Journal of Preventive Medicine and Public Health
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• 제55권5호
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• pp.424-427
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• 2022

A retrospective record-linkage study (RLS) based on medical records containing drug prescription histories involves immortal time bias (ITB). Thus, it is necessary to control for this bias in the research planning and analysis stages. Furthermore, a summary of a meta-analysis including RLSs that did not control for ITB showed that specific drugs had a preventive effect on the occurrence of the disease. Previous meta-analytic results of three systematic reviews evaluating the association between statin intake and gastric cancer risk showed that the summary hazard ratio (sHR) of the RLSs was lower than 1 and was statistically significant. We should consider the possibility of ITB in the sHR of RLSs and interpret the results carefully.

• 동의생리병리학회지
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• 제23권1호
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• pp.15-26
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• 2009

The purpose of this report was to provide the information about activity and safety of Yukmijihwang-tang by analyzing domestic/international papers and theses about Yukmijihwang-tang. Domestic/international papers and theses related to Yukmijihwang-tang were reviewed and analyzed. These papers were then classified by year, experimental method, and activity subject. The following results were obtained in this study. The study of Yukmijihwang-tang started from 1978 and was rapidly increased after 1990s. The study of Yukmijihwang-tang was continuously increased now and was mainly forcused on experimental model rather than clinical study. The paper of SCI journal or non-SCI journal was 27 volume and the other domestic paper was 64 volume. The total papers of Yukmijihwang-tang, 91 volume was analysed in this study. Allatoin, gallic acid, loganin, morroniside, paeoniflorin, paenol, urosolic acid were determined in Yukmijihwang-tang by using HPLC and HPLC-MS-MS. In classified Yukmijihwang-tang paper by experimental method and animal, more than a half study was in vivo experiment used rat. Furthermore clinical experiments were performed variously. As these studies were classified by subject, papers related to renal function were most abundant by 16 papers. Besides there were several papers related to cognitive vitality, anti-diabetic effect, immuno-regulation, reproductive activity, anti-oxidant effect, liver function, anti-cancer and blood pressure depress. According to basic research and clinic research data, it is supported that Yukmijihwang-tang was useful prescription in renal function, cognitive vitality, anti-diabetic effect and reproductive activity. Many study of basic and clinic research were performed and reported variously on Yukmijihwang-tang in domestic/international journal. According to basic research and clinic research data, it is supported that Yukmijihwang-tang was useful prescription in renal function, cognitive vitality, anti-diabetic effect and reproductive activity. However, studies on efficacy and mechanism of Yukmijihwang-tang should be conducted at the molecular biology level and studies on safety of Yukmijihwang-tang need to be completed at the clinical level.

• 디지털콘텐츠학회 논문지
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• 제4권1호
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• pp.57-66
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• 2003

본 논문에서는 인터넷 기반에서의 3자(환자, 의사, 약사)간의 상호대화형 원격진료 시스템 구현으로서, 효율적인 진료와 빠른 처리를 위한 전자진료차트 및 자료처리에 관한 내용을 제시하고 있다. 즉, 고가형 시스템, 비호환성 등 기존 원격진료시스템의 문제점을 해결한 저가형이면서, 누구나 참여할 수 있는 웹상에서의 시공간을 초월한 on-line 및 off-line 겸용모드의 지능형 원격진료시스템이다. 데이터베이스는 IIS 4.0 웹서버상에서 ASP와 SQL을 연동한 구현하여 효율적인 자료처리를 위한 시스템 통합과 환자와 의사간의 on-line 상담, 그리고 off-line상에서의 진료와 환자가 지정한 약사로의 처방전 전송 및 조제, 그리고 진료데이터의 저장 및 검색으로 인한 반영구적인 진료데이터저장, 환자 및 의사의 본 진료데이터를 이용한 보다 정확한 진료 및 처방등이 가능하다.

• 대한한의학회지
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• 제41권2호
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• pp.58-79
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• 2020

Objectives: The purpose of this study is to predict the weight loss by applying machine learning using real-world clinical data from overweight and obese adults on weight loss program in 4 Korean Medicine obesity clinics. Methods: From January, 2017 to May, 2019, we collected data from overweight and obese adults (BMI≥23 kg/m2) who registered for a 3-month Gamitaeeumjowi-tang prescription program. Predictive analysis was conducted at the time of three prescriptions, and the expected reduced rate and reduced weight at the next order of prescription were predicted as binary classification (classification benchmark: highest quartile, median, lowest quartile). For the median, further analysis was conducted after using the variable selection method. The data set for each analysis was 25,988 in the first, 6,304 in the second, and 833 in the third. 5-fold cross validation was used to prevent overfitting. Results: Prediction accuracy was increased from 1^st to 2^nd and 3^rd analysis. After selecting the variables based on the median, artificial neural network showed the highest accuracy in 1^st (54.69%), 2^nd (73.52%), and 3^rd (81.88%) prediction analysis based on reduced rate. The prediction performance was additionally confirmed through AUC, Random Forest showed the highest in 1^st (0.640), 2^nd (0.816), and 3^rd (0.939) prediction analysis based on reduced weight. Conclusions: The prediction of weight loss by applying machine learning showed that the accuracy was improved by using the initial weight loss information. There is a possibility that it can be used to screen patients who need intensive intervention when expected weight loss is low.

• 대한의사협회지
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• 제61권11호
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• pp.687-698
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• 2018

Inappropriate antibiotic use significantly contributes to antibiotic resistance, resulting in reduced antibiotic efficacy and an increased burden of disease. The objective of this study was to investigate the characteristics of prescribers whose antibiotics use was high and to explore factors affecting the use of antibiotics by medical institutions. This study analyzed the National Health Insurance claims data from 2015. Antibiotic prescription data were analyzed in terms of the number of defined daily doses per 1,000 patients per day, according to the World Health Organization anatomical-therapeutic-chemical classification and methodologies for measuring the defined daily dose. We investigated the characteristics of prescribers and medical institutions with high antibiotic use. Multivariate regression analyses were performed on the basis of characteristics of the medical institution (number of patients, type of medical institution [hospital or clinic], age of the physician, etc.). The number of patients and number of beds were found to be significant factors affecting antibiotic use in hospitals, and the number of patients, region, and medical department were significant factors affecting antibiotic use at the level of medical institutions. These findings are expected to help policy-makers to better target future interventions to promote prudent antibiotic prescription.

• 한방안이비인후피부과학회지
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• 제22권3호
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• pp.132-144
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• 2009

Objectives : The object of this literature study is to investigate the external treatment of seborrheic dermatitis. Methods : We have selected data related to the external treatment of seborrheic dermatitis on the literature of Oriental medicine. And we analyzed the study. Results : 1. The external treatment of seborrheic dermatitis is fundamental treatment. There are several external treatment, these are paint-treatment, shampoo-treatment and pillow-treatment. 2. Prescription used in external treatment of seborrheic dermatitis is Yungi-go(潤肌膏), Okgi-san(玉肌散), Yongnoe-go(龍腦膏), Johyub-tang(皂莢湯). 3. Herb used in external treatment of seborrheic dermatitis is Angelicae dahuricae Radix(白芷), Lysimachia foenumgraecum Hance(零陵香), Veratri Nigri Rhizoma Et Radix(藜蘆), Cannabis Fructus(大麻). Conclusions : Through literatual Study, we basically understood the external treatment of seborrheic dermatitis. In the study of external treatment, it seems that further clinical studies on seborrheic dermatitis treatment.

• 동의생리병리학회지
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• 제22권5호
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• pp.1192-1195
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• 2008

Sipjeondaebo-tang has been traditionally prescribed a medicine as a restorative. In this study, we investigated the acute toxicity about water-extracted Sipjeondaebo-tang. Thirty rats completed 14 days of oral Sipjeondaebo-tang at the respective doses of 0(control group), 2000 and 5000 mg/kg. We observed survival rates, general toxicity, change of body weight and autopsy. To be confirmed the data for the toxicity and safety problems of oriental medicine prescription. Compared with the control group, we could not find any toxic alteration in all treated groups (2000 and 5000 mg/kg). LD50 of Sipjeondaebo-tang was over 5000 mg/kg and it is very safe to SD rats.