• Title/Summary/Keyword: medication review

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Concomitant Medication by Multiple Prescriptions Causing Duplication and Severe drug Interaction: During DUR Pilot Projects in Goyangsi and Jejudo (다처방에 의한 의약품의 병용으로 인한 중복 및 병용금기의 문제: 고양시 및 제주도 DUR 시범사업을 중심으로)

  • Shin, Kwang-Shik
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.2
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    • pp.106-114
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    • 2011
  • While multiple medication is an important global medication safety issue, ununified concomitant medication by multiple prescriptions may cause more severe problems by the fact that those are neither intended nor watched. This could cause therapy duplication and severe drug interaction and etc. Korean Government made region wide scale programs twice to detect such problems and give warnings to pharmacists and doctors through the internet system in 2009-2010, which are called Drug Use Review Services Pilot Project. This study is an analysis and comparison of the results of the two DUR pilot projects. There were 5.0 and 4.2 cases of severe drug interaction by the concomitant medication of multiple doctors' prescriptions per 10 thousand prescriptions, while only 0.37 and 0 cases by the medication of same doctor's prescription(s). There were 426 and 381 cases of drug duplication by the concomitant medication of multiple doctors' prescriptions per 10 thousand cases, while only 197 and 23 cases by medication of same doctors' prescription(s). Doctors' participation to those projects improved at Jejudo the later one compared to Goyangsi the former, which means the efforts of them to make less prescription problems succeeded to decrease the number of cases caused from same doctor's prescription. But they could not decrease the number of problem cases caused from concomitant medication by multiple doctors prescriptions enough. The findings support the issue of strengthening and widening the project nation wide and the issue of recommending the patients to designate their own pharmacy, which can provide them counseling for unified and safety controlled medication.

Dysmenorrhea and Relief Methods in Woman Nursing Students (간호대학 여학생의 월경통증 및 완화방법)

  • Suh, Boo-Deuk;Choi, Eun-Hee
    • Research in Community and Public Health Nursing
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    • v.17 no.2
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    • pp.235-241
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    • 2006
  • Purpose: This study was to review dysmenorrhea and its relief methods in nursing students by using base data for reducing dysmenorrhea. Method: The subjects were 92 students, data were collected by questionnaire surveys using convenience sampling and analyzed by the SPSS 12.0 program. Results: Medium amount of menstruation was most frequently answered and massage on painful sites was the most frequently used relief method(p<0.05). Frequency of medication was once a day during menstrual period, and methods that the most wanted to use when pain got severe was alternative methods(aroma, massage, and acupuncture)(p<0.05). Amount of menstruation showed a negative correlation with the duration(r=-0.32), dysmenorrhea was correlated with the severest days of dysmenorrhea(r=0.24) and the frequency of medication(r=-0.23). Conclusion: These results suggested that dysmenorrhea was correlated with the severest days of dysmenorrhea and the frequency of medication, but other variables showed no relations with menstrual characteristics.

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Pseudo-Resistant Schizophrenia: Non-Adherence to Treatment (치료 위저항성 조현병: 치료 비순응을 중심으로)

  • Kim, Hyerim;Lee, Seung Jae
    • Korean Journal of Schizophrenia Research
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    • v.23 no.2
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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.

Effectiveness of Auricular Blood-letting Therapy for Headaches: A Systematic Review and Meta-Analysis (두통에 대한 이혈 방혈요법의 유효성 분석: 체계적 문헌고찰 및 메타분석)

  • Kyoungeun Lee;Min-Ryeong Park;Ji-Won Lee;In-Jun Hwang;Boram Lee;Jong Cheol Seo;Chan-Young Kwon
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.3
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    • pp.259-274
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    • 2023
  • Objectives: The purpose of this study was to provide clinical evidence to support the use of auricular blood-letting therapy (ABT) for headaches. Methods: Studies were identified by a comprehensive search of five databases. Randomized controlled trials (RCTs) that investigated the effects of the ABT for headaches were included. Two authors independently extracted the data and assessed the methodological quality of the included studies using Cochrane's risk-of-bias tool. If two or more studies reported the same outcome, a meta-analysis was performed. Meta-analysis results for dichotomous variables are expressed as risk ratios (RRs) and 95% confidence intervals (CIs). Results: A total of eight RCTs were included in this review. The total effective rate (TER) was the most commonly used outcome measurement. Among the eight RCTs, five were included in the metaanalysis. The TER was not statistically significantly different in the ABT group compared to the medication group (two studies, n=55, RR=1.24, 95% CI: 0.78 to 1.96, p=0.36, I2 =86%). However, the TER of the combined ABT and medication group was significantly different compared to the medication alone group (four studies, n=159, RR=1.23, 95% CI: 1.12 to 1.35, p<0.0001, I2 = 0%). Pain and mental health-related outcomes in the combined ABT and medication group were significantly different from the control groups. The methodological quality of the included RCTs was generally low. Conclusions: ABT combined with medication may be effective for treating headaches. However, the number of studies included was small, so the results were insufficient, and statistically significant effects were not confirmed for a single implementation of ABT. Thus, well-designed further studies based on the findings of this study are recommended.

Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis

  • Ibrahim, Ahmed Mohamed;Zakhary, Siza Yacoub;Amin, Suzan Abdul Wanees
    • Restorative Dentistry and Endodontics
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    • v.45 no.3
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    • pp.26.1-26.18
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    • 2020
  • Objectives: This study aimed to systematically review the pain and flare-up effects of calcium hydroxide (CH) as intracanal medication (ICM) in non-vital mature teeth. Materials and Methods: Electronic-databases searching for published and grey literature and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing CH to other ICMs in non-vital mature teeth. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The main outcomes were pain and flare-up. Qualitative and quantitative analysis, wherever applicable, was performed. The certainty of evidence (CoE) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Sixteen articles were included in 6 comparisons at different time points for different outcomes. CH reduced pain risk than no ICM within the 1-14-days interval (p < 0.05) and than triple-antibiotic paste within the first day (p < 0.05) and was similar to corticosteroid/antibiotics combination (p > 0.05). Chlorhexidine (CHX) or CH/CHX, however, reduced pain levels than CH alone (p < 0.05). CH showed higher flare-up risk than CHX (p < 0.05). CoE, however, ranged from very low to moderate. Conclusion: Most comparisons for different outcomes are based on very few studies, mostly low-powered, with an overall low CoE. Thus, the available evidence is considered insufficient to either support or refute CH effectiveness or to recommend one ICM over another. Therefore, further well-designed, larger RCTs are required.

Priority Therapeutic Groups to Expand Development of Prescribing Indicators using a Consensus Group of Health Care Professionals (전문가 조사를 활용한 약제급여 적정성 평가 항목 및 지표 확대방안 도출)

  • Jeon, Ha-Lim;Kim, Dong-Sook;Kim, Bo-Yun
    • YAKHAK HOEJI
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    • v.59 no.4
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    • pp.190-200
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    • 2015
  • Evaluation Project on Appropriate Prescribing (EPAP) which is analysing prescribing pattern and providing physicians feedback has begun in 2001. EPAP indicators are related to antibiotics for acute respiratory tract infections, overuse of injection, polypharmacy (no. of drugs prescribed together, no. of prescriptions with 6 or more drugs), prescribing of specific medication group (drugs for acid related disorders, NSAIDs, corticosteroids) and medication expenditure per prescription day. The aim of this study was to suggest a development plan for EPAP indicators suitable for domestic situation. A consensus group consisting of seventeen health care professionals evaluated significance of each therapeutic class for EPAP indicators expansion considering information such as magnitude of issue, prescribing indicators of foreign countries, reimbursement criteria by each therapeutic class. Based on the data and group survey, 5 classes were selected as candidates for prescribing indicators and we presented 24 indicators regarding 5 classes. The results suggested that we need to augment evaluation indicators of additional area.

Chuna Manual Therapy for Irritable Bowel Syndrome; A Systematic Review (과민성 장 증후군의 추나 치료에 대한 체계적 문헌 고찰)

  • Seo, Ha-Ra;Lee, Hye-Yoon;Hwang, Man-Suk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.11 no.2
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    • pp.1-9
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    • 2016
  • Objectives: To evaluate the effectiveness of Chuna manual therapy for irritable bowel syndrome. Methods: The researcher conducted search across the 3 electronic databases (Pubmed, Wanfang data(included CAJ) and Oasis) to find all of randomized controlled clinical trials(RCTs) that used Chuna manual therapy for irritable bowel syndrome. Results: Eight RCTs met inclusion criteria. The meta-analysis showed positive results for the use of Chuna manual therapy in terms of the therapeutic effects or symptom score compared to west medication, herbal medication, acupucture and moxa treatment alone. Conclusions: The review found encouraging but limited evidence of Chuna manual therapy for irritable bowel syndrome. More highquality clinical trials research is needed on Chuna, manipulative therapy of irritable bowel syndrome.

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Chuna Manual Therapy for Rheumatoid Arthritis : A Systematic Review and Meta-analysis (류마티스 관절염에 대한 추나요법의 효과 : 체계적 문헌고찰과 메타분석)

  • Heo, In;Han, In-Sik;Cha, Yun-Yeop
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.13 no.1
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    • pp.1-10
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    • 2018
  • Objectives: To evaluate the evidence supporting the effectiveness of Chuna manual therapy for rheumatoid arthritis. Methods: We conducted a search across 9 electronic databases to find all randomized controlled clinical trials (RCTs) that used Chuna manual therapy as a treatment for rheumatoid arthritis. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. Results: Our inclusion criteria were met by 5 RCTs. The meta-analysis showed positive results for the use of Chuna manual therapy combined with oriental usual care (UC) in terms of the efficacy rate, pain, and duration of morning stiffness when compared to western UC. Positive results were also obtained in terms of the efficacy rate, when Chuna manual therapy combined with medication was compared to medication treatments alone. Conclusions: Our systematic review found encouraging, but limited evidence of Chuna manual therapy for rheumatoid arthritis. However, to obtain stronger evidence without the drawbacks of trial design and the quality of studies, we recommend a comparative research to test the effectiveness of Chuna manual therapy.

Review of Nursing Research on Psychotropic Drugs in Korea (정신약물 복용과 관련된 국내 간호연구의 고찰)

  • Lee, Jongeun;Bae, Jeongyee;Im, Sookbin
    • Journal of Korean Public Health Nursing
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    • v.27 no.2
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    • pp.338-356
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    • 2013
  • Purpose: This study critically reviewed nursing research psychotropic drugs that has been published in Korean journals. Another aim of this study was to identify trends in nursing research on psychotropic drugs and make suggestions for further study in Korea. Methods: Data were collected from degree theses and original articles on psychotropic drugs published in Korean journals from 1992 to 2013. Thirty-four articles were analyzed of which at least one nursing author participated in the study. Search keywords were "psychotropic drug" and "mentally ill patient & medication". Results: For the research design, quasi-experimental study was 58.8%, descriptive study was 17.7%, descriptive correlational study was 8.8%, qualitative study was 8.8% and model development research was 5.9%. Variables measured were knowledge of medication & symptom management, knowledge of disease, side effects, drug attitude, medication pattern, diet & activity, quality of life, and self-care. Conclusion: Despite recent increased interest in psychiatric medication, research on psychotropic drugs remains very limited, particularly regarding findings from a nurse's perspective. More research project should be designed to develop programs for the treatment of side effects from a nursing view-point.

Review of Experimental Studies on Estradiol Valerate-induced Polycystic Ovarian Syndrome in Herbal Medicine (Estradiol Valerate로 유발된 다낭성 난소 증후군의 한약치료에 대한 국내 실험연구 고찰)

  • An, Tteul-E-Bom;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.4
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    • pp.25-42
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    • 2014
  • Objectives: To observe the effects of Herb medication on Polycystic Ovary (PCO) in rats. Methods: Riss (Research Information Sharing Service) was searched for Oriental medicine about PCO on 2000~2014. So, Experimental studies using PCO model induced by Estradiol Valerate (EV) was selected to analyze how effects they were. Consequently, 10 studies published on 2000~2014 were selected to analyze about weight of model and both ovaries, the number aries, the number of follicle and corpus of follicle and corpus luteum, the level of serum Androstenedione (ADD) and total estrogen, the level of Nerve Growth Factor (NGF) and Corticotropin Releasing Factor (CRF), the crossover rate and the number of implantation. Results: Among them, there was significantly difference between treatment group and control group in weight of both ovaries, the number of follicle and corpora lutea, the crossover rate and the number of implantation. Conclusions: The effects of Herb medication was observed on making weight of ovaries with PCO to promote. The study about effect of Herb medication on NGF and CRF with PCOS had to be conducted. The further research have to focus on treatment of subfertility and infertility, that is field showing the advantage of Oriental medicine.