• 한국임상약학회지
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• 제28권3호
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• pp.216-223
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• 2018

Objective: This study aimed to assess treatment persistence in Korean children and adolescents with attention deficit hyperactivity disorder (ADHD) and the factors influencing their adherence to ADHD pharmacotherapy. Methods: The study included patients between 6 and 18 years of age with ADHD who were taking various formulations of methylphenidate and atomoxetine on June 1, 2014. Patients were dichotomized as "persistent" or "non-persistent", depending on whether they continued ADHD therapy for 6 months (therapy persistence). We also investigated if the patients were taking the same medication(s) as before and also classified the patients as "medication persistent" or "non-persistent". Patient' characteristics were correlated with therapy persistence and medication persistence. Multiple logistic regression analyses were performed to assess potential risk factors for treatment persistence. Results: Overall, 3,317 patients were included in the analysis. A majority of patients were taking stimulants (82.0%), 16.2% were taking non-stimulants and 1.8% were taking a combination therapy of stimulants and non-stimulants. After 6 months, 2,290 patients (69.0%) continued to take medication for ADHD with 1,953 patients taking the same medication(s) as 6 months previously. Common positive factors for therapy persistence and medication persistence were identified as younger age, retardation, and developmental delay, and long-acting formulations of methylphenidate as either monotherapy or in a combination therapy may be used. Conclusion: ADHD medications were proven to improve academic performance and social skills of children. Collaboration between patients, parents, school staffs, and prescribers is required to improve the persistent use of ADHD medications.

• 한국임상약학회지
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• 제26권2호
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• pp.128-136
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• 2016

Objective: This study was to explore the association between having a usual source of care and adherence to medicines in patient with chronic diseases. Methods: The 2012 Korea Health Panel was used as a data source. We analyzed 4,418 respondents that were diagnosed with chronic diseases and utilized health care services. Non-adherence to medication, a dependent variable, was defined as "not taking the medicines that were prescribed for treating chronic disease" or "not following the direction for medication". Whether having a usual source of care or not was used as a key independent variable, which was defined as having a regular site or a regular doctor for medical test, treatment, and consultation. Sex, age, education level, marital status, income, the type of health insurance, the number of chronic disease and CCI (Charlson Comorbidity Index) were included as covariates in the analysis. We conducted a multivariate logistic regression. Results: Totally, 30 percent of respondents reported to experience non-adherence to medication. Having a usual source of care was significantly associated with lower non-adherence to medication regardless its type, which is a regular doctor (OR=0.61, 95% CI=0.53-0.70) or a regular site (OR=0.67, 95% CI=0.58-0.78). Furthermore, having a usual source of care was associated with both of medication persistence (OR=0.66, 95% CI=0.54-0.81) and compliance (OR=0.65, 95% CI=0.56-0.76). Conclusion: Our results showed the possibility that usual source of care is able to conduct a positive role in improving adherence to medication with better management of chronic disease.

• 농촌의학ㆍ지역보건
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• 제40권1호
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• pp.9-20
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• 2015

지역사회 뇌졸중환자들의 치료 지속률과 약물 순응도에 대한 연구는 아직 많이 실시되지 않았다. 그러나 치료 지속률과 약물 순응도가 뇌졸중의 재발 및 사망과 밀접한 관련이 있다는 것은 많이 알려진 사실이다. 이에 본 연구는 지역에 거주하고 있는 뇌졸중환자들을 임의 추출하여 이들의 치료 지속률과 약물 순응도를 평가하고 이에 영향을 미치는 요인을 찾기 위하여 실시되었다. 연구대상자는 429명으로 이들의 뇌졸중 치료율과 현재 복용하고 있는 약물의 순응률을 파악하였으며 약물 순응도는 의도적 비순응군과 비의도적 비순응군으로 구분하여 조사하였다. 연구 결과 치료 지속률은 86.5%였으며 이들 중 약물 순응도는 41.2%였다. 치료 지속률에 영향을 미치는 요인으로는 보건교육 경험뿐이었으며, 비의도적 약물 비순응에 영향을 미치는 요인은 mRS와 보건교육 경험 그리고 의도적 약물 비순응에 영향을 미치는 요인은 mRS와 우울감 정도 그리고 약물에 대한 신념(필요성, 염려)이었다. 결론적으로 지역사회 뇌졸중환자의 재발방지와 사망률감소를 위하여 약물복용을 중요하게 교육하여야 할 것이며 순응도 향상을 위해서는 약물에 대한 필요성은 올리고 염려 수준을 낮추도록 교육하여야 할 것이다.

• 한국임상약학회지
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• 제21권2호
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• pp.81-89
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• 2011

Medication adherence is an important public health issue. This study is conducted to explore non-adherence of elderly with hypertension and/or diabetes mellitus and to better understand its' influencing factors. To explore non-adherence, 605 elderly patients in community were surveyed with Modified Morisky Scale (MMS), from Aug 18 to Sept 19, 2008. MMS is designed to predict medication-taking behavior and outcomes, and also to explain persistence of the patient's long-term continuation of therapy, which is a significant factor in the long-term management of chronic diseases. Also, MMS is designed to classify patients into a high/low continuum for knowledge and motivation. Patients self reported medication adherence were average 4.66 with MMS (range 0-6), only 78% of patients hold high motivation of medication adherence although 95.5% of patients hold high knowledge of medication adherence. This study explores which factors influence to high motivation of medication adherence and it proved that patients' participation in work, education level, participation in private health insurance, number of medication and medication frequency per day, pharmacists' explanation, experience of non adherence due to cost are important factors to explain high motivation of medication adherence of elderly with hypertension and/or diabetes mellitus.

• 대한조현병학회지
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• 제23권2호
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• pp.51-57
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• 2020

Treatment-resistant schizophrenia (TRS) has been defined as the persistence of positive symptoms despite two or more trials of antipsychotic medication of adequate dose and duration. TRS is a serious clinical problem and occurs in approximately 30% of patients with schizophrenia. It is important that patients who do not adequately respond to antipsychotics be reevaluated to exclude or address causes other than non-responsiveness to medication, that is, the possibility of pseudo-resistance. In particular, non-adherence to oral antipsychotic treatment should be monitored to rule out pseudo-resistant cases of TRS. Moreover, patients with TRS who take their medication as required may have subtherapeutic antipsychotic plasma levels, secondary to pharmacokinetic factors. In this paper, we review the concept and exclusion of pseudo-resistance, especially owing to non-adherence or pharmacokinetic factors, and present methods to enhance drug adherence.

• 약학회지
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• 제55권6호
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• pp.500-509
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• 2011

This study was to identify factors influencing drug compliance based on the subjects' interview regarding community pharmacy utilization for 2 weeks, in 2005 KNHANES. Good compliance was regarded as important factors in improving the effectiveness and minimizing adverse drug reaction, resulting in reducing the medical costs. 83% of total 11,208 pharmacy visits in 7,066 subjects showed good compliance. Good satisfaction for pharmacist's medication counseling (OR=2.23, 95% CI 1.92-2.58), higher out-of-pocket money (OR=1.32, 95% CI 1.14-1.54), and users of prescription drugs than non-prescription (OR=2.21, 95% CI 1.91-2.57) drugs were significant factors for better compliance. Disease of nervous system and mental and behavioral disorders showed lower drug compliance.

• 대한수의학회지
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• 제44권2호
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• pp.201-206
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• 2004

Norfloxacin (NFX) is a fluorquinolone antibacterial agent with a high antimicrobial activity and might have great potential for treating common infections in poultry. The objective of this study was to obtain comparative pharmacokinetic data after a single oral administration and medication with drinking water of norfloxacin-glycine acetate (NFX-GA) at the dose rate of 10 mg/kg bw in broilers. Fifty minutes following oral administration of NFX-GA, serum concentrations peaked at $1.32{\mu}g/mL$ (range $1.03-1.45{\mu}g/mL$). Serum concentration of NFX declined with a half-life of $7.21{\pm}1.81$ h. On the third day after administration of medicated drinking water, steady-state was reached, with mean concentrations of NFX of $0.70{\pm}0.35{\mu}g/mL$. The concentration of NFX after medication of NFX-GA with drinking for 3 days provides sufficient levels to obtain maximum therapeutic effects and maintains the serum persistence of concentration exceeding MIC.

• 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.

• 수면정신생리
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• 제2권1호
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• pp.3-12
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• 1995

In the International Classification of Sleep Disorders(ICSD), REM sleep behavior disorder(RBD) and nightmares are classified as 'parasomnias usually associated with REM sleep'. RBD can be defined as the intermittent absence of REM sleep EMG atonia and the appearance of the elaborate motor activity associated with dream mentation. Bilateral pontine tegmental lesions in cats induce RBD-like behavior, but in human cases, more than 60% are idiopathic. Polysomnograpy shows characteristic findings in REM sleep and treatment with clonazepam is highly effective. With nightmares as long, frightening dream decreasing with age, their persistence or apperance in adults is related with certain drugs, trauma, personality and psychotic episode. Psychotherapy, behavior techniques or medication is used for treatment, but all of nightmares do not require treatment.

• 대한두경부종양학회지
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• 제18권2호
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• pp.192-196
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• 2002

Objectives: Tuberculous cervical lymphadenitis is a frequently recurring disease when treated with chemotherapy alone without enough surgical removal of the tuberculous lesions. Authors reviewed retrospectively the treatment result of antituberculous chemotherapy following almost complete surgical removal of tuberculous foci in the neck. Materials and Methods: A retrospective clinical review and analysis was made in 127 cases of tuberculous cervical lymphadenitis patients treated during the past 10 years from 1989 to 1998 at the Department of General Surgery, Inje University Paik Hospital, Pusan. Results: 1) The peak age incidence was the 2nd decade(37.8%), and female was predominated over male by 2.3:1. 2) The time interval from the onset of symptoms to the first visit was less than 3 months in 60.6% of the patient. 3) The location of lymphadenitis was the right neck in 60%, the left neck 34%, and bilateral in 6% of the patient. 4) Signs on the first visit showed solitary masses(60%), abscess(25%) and both mixed(15%). 5) 25 patients(19%) had present or past history of tuberculosis; pulmonary tuberculosis 12 patients, tuberculous lymphadenitis 10 patients, and others 3 patients. 6) Locations of tuberculous lymphadenitis were posterior cervical triangle 70, supraclavicular 51, submandibular 19, anterior triangle 16 and others 4 cases. 7) The principle of treatment of cervical lymphadenitis was surgical management followed by chemotherapy. Surgical procedures were excision(s), curettage and drainage of abscess, combination of both, and biopsy in 60%, 22%, 12% and 6% respectively. Mean duration of antituberculous medication was 9 months after surgery. 8) The rate of recurrent and persistent tuberculous lymphadenitis was 9% in 4 years follow up. Conclusion: Tuberculous cervical lymphadenitis is a frequently recurring disease in young adult when only antituberculous chemotherapy was employed without almost complete removal of the lesions. It is considered that antituberculous medications for 6-9 months after removing the foci at a maximal extent by surgical excision and curettage will reduce the recurrence rate or persistence of tuberculous lymphadenitis.