• Title/Summary/Keyword: Patient Prescription

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Regional Difference of Chronic Periodontal Care Services in Korea (의료기관 종별 만성 치주염 진료의 지역 간 차이)

  • Yoon, Young-Ju;Lee, Kyeong-Soo;Kim, Chang-Suk;Kim, Chang-Yoon;Hwang, Tae-Yoon
    • Journal of Korean society of Dental Hygiene
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    • v.15 no.5
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    • pp.899-905
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    • 2015
  • Objectives: This study aimed to investigate the regional difference of chronic periodontal care services in Korea by the analysis of 2010 raw data from Health Insurance Review and Assessment Service. Methods: The subjects were the chronic periodontitis patients over 35 years old from dental care facilities in Korea. The study population was 278,319 including 264,994 claims made by dental clinics, 8,084 by dental hospitals, 3,509 by general hospitals, and 1,732 by tertiary hospitals. Results: There was a significant difference in medical care cost benefit between the provinces(p<0.0001). The age groups showed a clear difference in the patient charge, cost of insurance, and medical care cost benefit(p<0.0001). In consideration of the first visit or revisit, there were differences in the rate of prescription, dental examination, and surgical procedures of the chronic periodontal patients from dental facilities. The radiographic use rate in the tertiary hospitals was 2.6 times higher than that of the dental clinic in the treatment of the new chronic periodontal patients. Conclusions: The use of dental services in the periodontitis is influenced by the types of medical services facility, cost of medical insurance, and patient charge. In consideration of cost benefit analysis, prevention is the most important care for the periodontitis. Regional difference in peridontitis is cause by the use of medical services and quality of treatment.

Bleeding after Taking Dual Antiplatelets and NSAID Concurrently (항혈소판제와 비스테로이드성소염진통제의 동시 투약으로 인한 출혈 사례)

  • Seo, Jeongmin;Choi, Joonghyuk;Son, Pyoungwoo;Lee, Seungmin;Chae, Hyunwoo;Kang, Geunhyung;Ji, Eunhee
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.3
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    • pp.250-253
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    • 2018
  • When stenting is applied to treat myocardial infarction, antiplatelet agents are administered to prevent thrombosis, which increases the risk of bleeding. Patients with myocardial infarction are also more likely to have osteoarthritis simultaneously, because both diseases occur frequently in elderly patients. Patients with osteoarthritis often use analgesics, especially nonsteroidal anti-inflammatory drugs (NSAIDs); hence, patients with both diseases use analgesics and antiplatelet agents simultaneously. The risk of bleeding increases with the use of antiplatelet agents and this is further increased when NSAIDs are added. We would like to report a case that reflects this situation. A 60-year-old man underwent stenting after ST-elevation myocardial infarction, and was treated with aspirin and clopidogrel. This patient also received a pelubiprofen prescription from another physician to treat osteoarthritis. After the patient took pelubiprofen twice, he found a bruise on his wrist and reported it to the pharmacist. It is unlikely that this is rare in community pharmacies, so pharmacists should pay careful attention to the concomitant administration of analgesics to patients receiving antiplatelet agents and should provide appropriate education to patients.

Prescription Errors with Chemotherapy: Quality Improvement through Standardized Order Templates

  • Saad, Aline;Der-Nigoghossian, Caroline A.;Njeim, Rachel;Sakr, Riwa;Salameh, Pascale;Massoud, Marcel
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2329-2336
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    • 2016
  • Background: Despite the existence of established guidelines advocating the use and value of chemotherapy order templates, chemotherapy orders are still handwritten in many hospitals in Lebanon. This manuscript describes the implementation of standardized chemotherapy order templates (COT) in a Lebanese tertiary teaching hospital through multiple steps. Initial Assessment: An initial assessment was conducted through a retrospective appraisal of completeness of handwritten chemotherapy orders for 100 adult patients to serve as a baseline for the project and identify parameters that might afford improvement. Choice of solution: Development of over 300 standardized pre-printed COTs based on the National Comprehensive Cancer Network templates and adapted to the practice culture and patient population. Implementation: The COTs were implemented, using Kotter's 8-step model for leading change, by engaging health care providers, and identifying and removing barriers. Evaluation: Assessment of physicians' compliance with the new practice (122 orders assessed) was completed through two phases and allowed for the identification of areas of improvement. Lessons Learned: Overall, COT implementation showed an average improvement in order completion from 49.5% (handwritten orders) to 77.6% (phase 1-COT) to 87.6% (phase 2-COT) reflecting an increase of 38.1% between baseline and phase 2 and demonstrating that chemotherapy orders completeness was improved by pre-printed COT. As many of the hospitals in Lebanon are moving towards standardized COTs and computerized physician order entry (CPOE) in the next few years, this study provides a prototype for the successful implementation of COT and demonstrates their role in promoting quality improvement of cancer care.

Case of seropositive allergic bronchopulmonary aspergillosis in a 10-year-old girl without previously documented asthma

  • Shin, Jeong Eun;Shim, Jae Won;Kim, Deok Soo;Jung, Hae Lim;Park, Moon Soo;Shim, Jung Yeon
    • Clinical and Experimental Pediatrics
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    • v.58 no.5
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    • pp.190-193
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    • 2015
  • Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity lung disease due to bronchial colonization of Aspergillus fumigatus that occurs in susceptible patients with asthma or cystic fibrosis. A 10-year-old girl was referred to the Department of Pediatric Pulmonology for persistent consolidations on chest radiography. Pulmonary consolidations were observed in the right upper and left lower lobes and were not resolved with a 4-week prescription of broad-spectrum antibiotics. The patient had a history of atopic dermatitis and allergic rhinitis but no history of asthma. She had no fever but produced thick and greenish sputum. Her breathing sounds were clear. On laboratory testing, her total blood eosinophil count was $1,412/mm^3$ and total serum IgE level was 2,200 kU/L. Aspergillus was isolated in the sputum culture. The A. fumigatus-specific IgE level was 15.4 kU/L, and the Aspergillus antibody test was also positive. A chest computed tomography scan demonstrated bronchial wall thickening and consolidation without bronchiectasis. An antifungal agent was added but resulted in no improvement of pulmonary consolidations after 3 weeks. Pulmonary function test was normal. Methacholine provocation test was performed, revealing bronchial hyperreactivity ($PC_{20}=5.31mg/mL$). Although the patient had no history of asthma or bronchiectasis, ABPA-seropositivity was suspected. Oral prednisolone (1 mg/kg/day) combined with antifungal therapy was started. Pulmonary consolidations began decreasing after 1 week of treatment and completely resolved after 1 month. This is the first observed and treated case of seropositive ABPA in Korean children without previously documented asthma.

Gamma Knife Radiosurgery after Stereotactic Aspiration for Large Cystic Brain Metastases

  • Park, Won-Hyoung;Jang, In-Seok;Kim, Chang-Jin;Kwon, Do-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.360-364
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    • 2009
  • Objective : Several treatment options have proven effective for metastatic brain tumors, including surgery and stereotactic radiosurgery. Tumors with cystic components, however, are difficult to treat using a single method. We retrospectively assessed the outcome and efficacy of gamma knife radiosurgery (GKRS) for cystic brain metastases after stereotactic aspiration of cystic components to decrease the tumor volume. Methods : The study population consisted of 24 patients (13 males, 11 females; mean age, 58.3 years) with cystic metastatic brain tumors treated from January 2002 to August 2008. Non-small cell lung cancer was the most common primary origin. After Leksell stereotactic frame was positioned on each patient, magnetic resonance images (MRI)-guided stereotactic cyst aspiration and GKRS were performed (mean prescription dose : 20.2 Gy). After treatment, patients were evaluated by MRI every 3 or 4 months. Results : After treatment, 13 patients (54.2%) demonstrated tumor control, 5 patients (20.8%) showed local tumor progression, and 6 patients (25.0%) showed remote progression. Mean follow-up duration was 13.1 months. During this period, 10 patients (41.7%) died, but only 1 patient (4.2%) died from brain metastases. The overall median survival after these procedures was 17.8 months. Conclusion : These results support the usefulness of GKRS after stereotactic cyst aspiration in patients with large cystic brain metastases. This method is especially effective for the patients whose general condition is very poor for general anesthesia and those with metastatic brain tumors located in eloquent areas.

Traditional Korean Medicine Diagnosis System Based on Basic Ontology (기초 온톨로지 기반 한의 진단 시스템)

  • Kim, Sang-Kyun;Jang, Hyun-Chul;Kim, Jin-Hyun;Oh, Young-Taek;Kim, Chul;Yea, Sang-Jun;Song, Mi-Young
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.6
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    • pp.1111-1116
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    • 2010
  • We in this paper design and implement a traditional korean medicine diagnosis system based on basic ontology. If doctors put the symptoms or tongues or pulses of a patient in the diagnosis system, they can be recommended for the diagnosis results. To support the doctors decision, the diagnosis system make the inference based on the basic ontology and compute the similarity between symptoms of patient and those of ontology. The diagnosis systems also provide the learning mechanism about diagnosis results which save the results in the ontology and reuse them in the next diagnosis. Thus, doctors can share their knowledge for the diagnosis by exchanging their ontology each other. In future, we will expand the knowledge of the basic ontology continuously so that doctors can get the more accurate diagnosis results. We also implement the prescription function and integrate it to the diagnosis system.

5 Cases of Acute Pyelonephritis (급성(急性) 신우신염(腎盂腎炎)의 임상적(臨床的) 고찰(考察))

  • Kwon, Jeong-Nam;Kim, Young-Kyun;Ryu, Ju-Yeol
    • Journal of Sasang Constitutional Medicine
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    • v.13 no.2
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    • pp.194-204
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    • 2001
  • Purpose: In general, Acute Pyelonephritis is effectively treated with the use of antibiotics. However, some antibiotics are reported to cause side effects, and the abuse of antibiotics results in the increase of the disease's tolerance to antibiotics. Recently, I have effectively treated five cases of Acute Pyelonephritis by using only Constitution - Acupuncture and Herb, and therefore I would like to report about these cases. Methods: I diagnosed Acute Pyelonephritis of these five patients by confirming symptoms and employing a urine analysis with reagent strip(Multi $stix{\circledR}$). I used Kuon's method of constitutional diagnosis for the purpose of the diagnosis of the constitutional 8 morbidities. I relied on Sungjeong(性情) and Chehyungkisang(體刑氣像) in diagnosing Sasang Constitutions(四象人). I performed acupuncture on the left and right sides, depending on 8 constitutions, by employing Chang - temperament Inflammation Formula(臟系炎症方) that is used for the treatment of all kinds of chang-temperament inflammation diseases, as well as Bactericidal Formula(殺菌方) that is used for the treatment of all kinds of bacterially caused diseases. I prescribed by consulting the appearance of disease and general symptoms of each case with Dongyi Soose Bowon(東醫壽世保元)'s prescription symptoms. Result: Two of them showing severe symptoms were hospitalized, while three others took OPD treatment. The patient who was PANCREOTONIA and Soyangin improved through hospitalization for three days, another patient who was PULMOTONIA and Taeyangin with severe symptoms, improved through hospitalization for seven days, and completely recovered through OPD treatment later. The three others took only OPD treatment, and improved within 5-7 days. Conclusion: I confirmed that each of 8-constituions and Sasang Constitutions were all treated effectively without antibiotics.

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A Study on Smart Medical Treatment System and Security (스마트 진료시스템과 보안에 관한 연구)

  • Song, Eun-Jee
    • Convergence Security Journal
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    • v.12 no.3
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    • pp.107-113
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    • 2012
  • Due to the development of communications technology, it is now possible to be offered online from remote places. This kind of communications technology can be applied to the medical field. The medical treatment appointments in hospitals can be its typical example. But still, in most of hospitals, patient or guardian have to physically visit or call to the hospital to set up an appointment for the medical treatment. In addition, they have to wait in line in order to pay after receiving the medical treatment. The patient or guardian, after paying, receive a paper prescription and they go to a nearby pharmacy to take the medicines. They must wait in line again there in order to receive the medicine from the pharmacy. In this paper, we would like to suggest a smart medical treatment system in order to solve the problems discussed above. With this proposed system, the user will be able to make an appointment, make payments and receive medication quickly and easily without spending extra time. Also, there will be no need for paper prescriptions with this system. We discuss about the security of medical information for this proposed smart medical treatment system proposed.

A Concept Analysis of Slow Nursing (느린 간호의 개념 분석)

  • Woo, Hyeon-Mi;Park, Jeong-Sook
    • Journal of the Korea Convergence Society
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    • v.11 no.5
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    • pp.381-389
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    • 2020
  • Patients, particularly elderly patients, need nursing appropriate to their characteristics and pace, whereas 'fast nursing' is actually emphasized in Korea. Hence, this study attempts to identify the characteristics of 'slow nursing' in Korea. Walker & Avant's approach to concept analysis was performed through a literature review on the concept of 'slow nursing.' A literature search and concept analysis, using the keywords of 'slow,' 'slow nursing' and 'slow prescription' in Pubmed, Riss, NDSL, DBPIA, and Google Scholar from 2000 to 2019, yielded the following attributes of 'slow nursing': 'respect for the speed of the subject,' 'carefulness,' 'comfort in the process,' 'participation' and 'consideration of the meaning of life.' Model cases were derived based on these attributes. Predisposing factors involved in 'slow nursing' include patient malfunction, psychological deflection, indifference, fear of treatment, and lack of willingness to live. The outcomes were a discovery of patients' potential capacities, recovery of confidence, health promotion, improved communication with medical staff, confidence, and self-integrity. It is expected that the development of measurement tools using the attributes of 'slow nursing' would contribute to patient nursing and research in the future.

The Design and Implementation of Telemedicine System for Emergency Patients in a Ship (해상응급환자를 위한 원격진료 시스템의 설계 및 구현)

  • Lee, Dong-Hoon;Kwon, Jang-Woo;Kim, Gyu-Dong;Hong, Jun-Eui;Lee, Sang-Min
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.13 no.3
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    • pp.537-545
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    • 2009
  • Though there were many research and development about telemedicine on land recently, not yet applied to that on the shore. In this paper, when emergency clinic situation were generated in a ship on shore, the telemedicine system was designed and implemented for transfer and clinic service to doctors on the land by measuring basic body signals of patients. Presently, wireless communication and inmarsat telephone are usually used by simple questions and clinic consults to remote doctors when emergency situation were happened in the ship. In this paper, the telemedicine system on the shore were developed for improving this problems by measuring patient's fundamental conditions such as the blood pressure, pulse, the respiratory condition, electrocardiogram, body temperature, patient image and sending these information to remote doctors on land for more accurate prescription. The developed system can supply the high level clinic service to emergency patients on the shore and cope with the emergency situation in ship.