• Title/Summary/Keyword: meta multidisciplinary analysis

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A Systematic Review on Nurse-Led Transitional Care Programs for Discharged Patients from Hospital to Home (퇴원환자를 위한 간호사 주도 전환 프로그램의 내용과 효과에 관한 체계적 문헌고찰)

  • Lee, Hyun Joo;Kim, Yukyung;Oh, Eui Geum
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.3
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    • pp.376-387
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    • 2017
  • Purpose: This study was to systematically review the contents and effects of nurse-led transitional care programs for discharged patients from hospital to home. Methods: Randomized controlled trials published between 2005 and 2015 were searched in Pubmed, Embase, Cochrane(Central Register of Controlled Trials) and CINAHL. Data were analyzed using Cochrane Review Manager(Revman) software 5.3. Results: Nine studies were selected and analyzed. Patient assessment, education and discharge planning were included in pre-discharge phase. Referring, communication and care planning were performed by nurses in transition phase. Home and phone visits, monitoring and multidisciplinary advices were included in post-discharge phase. Various outcome measures such as hospital utilization(30 days readmission and emergency department visit), quality of life, and cost were used to identify effectiveness of nurse-led transitional care programs. 30 days readmission(OR=.73, 95% CI 0.54, 0.98; p=.03) and emergency department visit(OR=.67, 95% CI 0.50, 0.88; p=.005) were statistically significant in meta-analysis. However, participant blinding was not done in seven studies which put at the risk of performance bias. Conclusion: The results indicated that nurse-led transitional care program is effective in reducing unnecessary hospital utilization. Nevertheless, small sample size and risk at performance bias are the limitation of this study. Thus, we suggest that well-designed randomized controlled trials need to be conducted.

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

  • Lee, So Young;Cho, Eun
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.3
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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.

Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach

  • Tae-Han Kim;In-Ho Kim;Seung Joo Kang;Miyoung Choi;Baek-Hui Kim;Bang Wool Eom;Bum Jun Kim;Byung-Hoon Min;Chang In Choi;Cheol Min Shin;Chung Hyun Tae;Chung sik Gong;Dong Jin Kim;Arthur Eung-Hyuck Cho;Eun Jeong Gong;Geum Jong Song;Hyeon-Su Im;Hye Seong Ahn;Hyun Lim;Hyung-Don Kim;Jae-Joon Kim;Jeong Il Yu;Jeong Won Lee;Ji Yeon Park;Jwa Hoon Kim;Kyoung Doo Song;Minkyu Jung;Mi Ran Jung;Sang-Yong Son;Shin-Hoo Park;Soo Jin Kim;Sung Hak Lee;Tae-Yong Kim;Woo Kyun Bae;Woong Sub Koom;Yeseob Jee;Yoo Min Kim;Yoonjin Kwak;Young Suk Park;Hye Sook Han;Su Youn Nam;Seong-Ho Kong;The Development Working Group for the Korean Practice Guidelines for Gastric Cancer 2022 Task Force Team
    • Journal of Gastric Cancer
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    • v.23 no.1
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    • pp.3-106
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    • 2023
  • Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

Research Trend of the Healthcare and Medical Care for Elders in the Journal of the Korea Gerontological Society (한국노년학의 보건·의료·건강영역 연구동향)

  • Kim, Hyun Sook;Park, Yeon-Hwan;Kim, Young Sun
    • 한국노년학
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    • v.38 no.3
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    • pp.705-723
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    • 2018
  • In this study we review the selected articles on elderly health and medical care published in the Journal of the Korea Gerontological Society (JKGS) in the last 40 years, and make suggestions for future research directions for gerontological health and medical care issues. Of all the 40 year publications from volume 1 (1980) to 38 (2017), we first examined the 30th anniversary review on the subject of gerontological nursing care and healthcare policies published in JKGS from 1980 (vol. 1, No. 1) to 2008 (vol. 28, No. 2), and reviewed recent 237 researches of this decade (out of all 655 articles from 2008, vol. 28, No. 3 to 2017, vol. 38, No. 4). We could find the following trends. Firstly, the analysis of the primary authors in the past 10 years revealed that those in public health, nursing and other health-related including physical education areas have dealt the subjects focusing on physical health while those in social welfare mostly on mental health. That is, physical health has been the prime subject of researches in the health and medical care area. Secondly, in the same period quantitative researches were accounted for 89.9%, which is similar to the trend of the first 30 years 81.5 %. On the other hand, qualitative studies were only 11 cases and the focus group interview were the most frequently used method comprising 33.3% among them. Thirdly, the non-experimental researches in the past 10 years comprise 65.4%, which was 82.7% in 1980 2008 period, indicating the increasing trend in experimental researches to deal with the issues in medical and healthcare fields. Lastly, the subjects of the researches were mostly the elders who are healthy, residents of city areas, or home dwellers, and 60% of them were over 65 years old in the past 10 years while the proportion was 42.7% in the previous review period. 81.6 % of the researches in the past 10 years was dealing both genders, slightly decreased trend compared to 88.5% of the previous review period. This study reveals that the researches in non-experimental physical health remains the main stream of JKGS despite the efforts by some researchers to diversify the methods and subjects. Systematic and in-depth researches employing multidisciplinary, qualitative, longitudinal and meta-analytical approaches are called for to guide the gerontolgical health issues with preventive and proactive perspectives.