• Journal of Korean Clinical Nursing Research
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• v.16 no.3
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• pp.25-37
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• 2010

Purpose: The purpose of this study was to examine potential factors related to the management of cancer pain, that is, hospital institutional factors as well as personal aspects of nurses. Methods: This study was a descriptive research study in which 229 RNs working in 2 tertiary medical institutions in Seoul and 4 secondary medical institutions in Seoul, Incheon and Gyeonggi were surveyed. Results: It was found that nurses' knowledge about pain intervention, their working division and their knowledge about the use of analgesics had different effects on their pharmacologic interventions. These 3 variables explained 14.5% of the variance regarding pharmacologic interventions. On the other hand, nurses' knowledge about pain interventions and nursing organization were variables affecting non-pharmacologic interventions by the nurses. These two variables explained 22.1% of the variance regarding non-pharmacologic interventions by the nurses. Conclusion: The findings indicate that nursing organization, one of hospital institutional factors, had significant effects on non-pharmacologic interventions. Therefore, to increase effective pain management by nurses, an organizational system should be established such as placement of nurse practitioners, improvement of nurses' autonomy in pain management, and development and distribution of standardized guidelines.

• Health Policy and Management
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• v.9 no.3
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• pp.70-94
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• 1999

This paper was performed for a cost-effectiveness analysis of pharmacologic treatment of hypercholesterolemia. Agents modeled were cholestyramine, gemfibrozil. bezafibrate, lovastatin, pravastatin, simvastatin. Pharmacologic effectiveness was estimated by regression from reported clinical trials. Pharmacologic effects were expressed as the percent change of blood cholesterol level. Cost estimates included patients' travel expenses and time loss as well as resource consumption in the health care sector. Bezafibrate was the most efficient agent for reducing total cholesterol levels, having an cost over 1 year of ￦31.400 per percent reduction in total cholesterol. Simvastatin (10mg/d) was also efficient(￦33,100 per percent reduction). Chole styramine(8g/d) was least efficient at ￦90,200. For low-density lipoprotein cholesterol. simvastatin(10mg/d) was most efficient, at ￦23,200 per percent reduction, followed by lovastatin(20mg/d) at ￦28,000. Gemfibrozil was least efficient at ￦77,800 per percent reduction. For high-density lipoprotein cholesterol. bezafibrate(400mg/d) was most efficient at ￦39,300 per percent increase of high-density lipoprotein cholesterol. Cholestyramine was least efficient at ￦514,700. Analyses combining low-density lipoprotein cholesterol and high-density cholesterol effects suggest that bezafibrate(600mg/d) and simvastatin (10mg/d) were most efficient for reducing cardiovascular risk. The cost-effectiveness analysis results show that both simvastatin and bezafibrate could be efficient treatment. Simvastatin provide more effective treatment at higher cost, whereas bezafibrate is more cost-effective, as it may be less effective, at lower cost. Therefore, clinicians should choose reasonable treatment according to the patient's needs This pharmacoeconimc analysis will provide a guideline for efficient pharmacologic treatment and also be reference data for pricing new drugs.

• 대한치과교정학회:학술대회논문집
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• 2002.11a
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• pp.24.3-25
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• 2002

• The Korean Journal of Pain
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• v.23 no.2
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• pp.99-108
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• 2010

Chronic pain is a multifactorial condition with both physical and psychological symptoms, and it affects around 20% of the population in the developed world. In spite of outstanding advances in pain management over the past decades, chronic pain remains a significant problem. This article provides a mechanism- and evidence-based approach to improve the outcome for pharmacologic management of chronic pain. The usual approach to treat mild to moderate pain is to start with a nonopioid analgesic. If this is inadequate, and if there is an element of sleep deprivation, then it is reasonable to add an antidepressant with analgesic qualities. If there is a component of neuropathic pain or fibromyalgia, then a trial with one of the gabapentinoids is appropriate. If these steps are inadequate, then an opioid analgesic may be added. For moderate to severe pain, one would initiate an earlier trial of a long term opioid. Skeletal muscle relaxants and topicals may also be appropriate as single agents or in combination. Meanwhile, the steps of pharmacologic treatments for neuropathic pain include (1) certain antidepressants (tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors), calcium channel ${\alpha}2-{\delta}$ ligands (gabapentin and pregabalin) and topical lidocaine, (2) opioid analgesics and tramadol (for first-line use in selected clinical circumstances) and (3) certain other antidepressant and antiepileptic medications (topical capsaicin, mexiletine, and N-methyl-d-aspartate receptor antagonists). It is essential to have a thorough understanding about the different pain mechanisms of chronic pain and evidence-based multi-mechanistic treatment. It is also essential to increase the individualization of treatment.

• 대한근관절건강학회:학술대회논문집
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• 1998.04a
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• pp.123-131
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• 1998

• The Korean Journal of Pain
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• v.6 no.1
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• pp.1-22
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• 1993

• The Korean Journal of Nuclear Medicine
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• v.39 no.2
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• pp.87-93
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• 2005

Coronary artery disease (CAD) has been increasing during the last decade and is the one of major causes of death. The management of patients with coronary artery disease has evolved considerably. There are two main strategies in the management of CAD, complementary, not competitive, each other; the pharmacologic therapy to prevent and treat CAD and the percutaneous coronary Intervention (PCI) to restore coronary flow. Antiplatelet drugs and cholesterol lowering drugs have central roles in pharmacotherapy. Drug eluting stent (DES) bring about revolutional changes in PCI. In the management of patients with 57 segment elevation acute myocardial infarction (AMI), there has been a debate on the better strategy for the restoration of coronary flow. Thrombolytic therapy is widely available and easy to administer, whereas primary PCI is less available and more complex, but mote complete. Recently published evidences in the pharmacologic therapy including antiplatelet and stalin, and PCI including DES and reperfusion therapy in patients with ST segment elevation AMI were reviewed.

• Journal of East-West Nursing Research
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• v.26 no.1
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• pp.1-16
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• 2020

Purpose: The purpose of this study was to evaluate the effectiveness of non-pharmacologic interventions for chronic nonspecific low back pain (CLBP) in adults aged 18-64 years. Methods: We searched for potentially relevant randomized controlled trials and non-randomized controlled trials through five Korean electronic databases (i.e., Korean Studies Information Service System, Research Information Sharing Service, Korean Medical Database, KoreaMed, and National Assembly Library) published from January 2010 to May 2019. Two investigators independently selected the studies based on the criteria and assessed risk of bias in the included studies. We estimated the effect size of interventions using Comprehensive Meta Analysis 3.3. Results: Of 10,151 studies, 26 studies met the inclusion criteria and 15 studies were included in the meta-analysis. Exercise reduced low back pain (Hedges's g=-1.53, 95% CI: -2.22 to -0.85) and pain-related disabilities (Hedges's g=-0.92, 95% CI: -1.40 to -0.45). We found that taping was effective in decreasing low back pain (Hedges's g=-1.12, 95% CI: -1.51 to -0.73) and pain-related disabilities (Hedges's g=-0.50, 95% CI: -0.93 to -0.07). Manual therapy yielded a marginally significant reduction in low back pain (Hedges's g=-2.32, 95% CI: -4.64 to 0.00), the therapy was not effective in decreasing pain-related disabilities. Conclusion: Although there was little evidence for the effectiveness of manual therapy in adults with CLBP, exercise and taping were effective to relieve pain and pain-related disabilities. Based on these findings, we suggest the development of non-pharmacologic interventions or a nursing intervention protocol for the CLBP management. Also, nurses should consider implementation of effective non-pharmacologic interventions for CLBP.

• Korea Journal of Hospital Management
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• v.26 no.2
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• pp.56-67
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• 2021

Background: Regular doctor visits are vital for hypertension patients, especially for who have never received hypertension medication or non-pharmacologic therapy. This study purposed to study factors affecting outpatient visits for patients diagnosed with hypertension. Methods: This study included 59,009 respondents with hypertension over 30 from 2019 Community Health Survey data. Outpatient visits were defined by having hypertension treatments such as medication or non-pharmacologic therapy. Logistic regression was used to examine the factors affecting outpatient visits using SAS ver. 9.3. Results: 57,081(96.73%) patients with hypertension were identified as those having a outpatient visit for hypertension treatments, whereas 1,928(3.27%) patients did not have visits. Patient's characteristics such as gender, age, periods of hypertension, education level, perception of the blood pressure, hypertension management education, place of living, body mass index, depression and diabetes were found to have statistically significant relationship with the outpatient visits. Practical Implications: There is a need to select patients with high blood pressure who are unlikely to visit for hypertension treatments based on the study results. For those, establishing a personalized management plan such as health education and counseling programs will be helpful for the successful implementation of national chronic disease management program.

• Journal of Korean Neurosurgical Society
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• v.56 no.1
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• pp.71-74
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• 2014

Cancer-related facial pain refractory to pharmacologic management or nondestructive means is a major indication for destructive pain surgery. Stereotactic mesencephalotomy can be a valuable procedure in the management of cancer pain involving the upper extremities or the face, with the assistance of magnetic resonance imaging (MRI) and electrophysiologic mapping. A 72-year-old man presented with a 3-year history of intractable left-sided facial pain. When pharmacologic and nondestructive measures failed to provide pain alleviation, he was reexamined and diagnosed with inoperable hard palate cancer with intracranial extension. During the concurrent chemoradiation treatment, his cancer-related facial pain was aggravated and became medically intractable. After careful consideration, MRI-based stereotactic mesencephalotomy was performed at a point 5 mm behind the posterior commissure, 6 mm lateral to and 5 mm below the intercommissural plane using a 2-mm electrode, with the temperature of the electrode raised to $80^{\circ}C$ for 60 seconds. Up until now, the pain has been relatively well-controlled by intermittent intraventricular morphine injection and oral opioids, with the pain level remaining at visual analogue scale 4 or 5. Stereotactic mesencephalotomy with the use of high-resolution MRI and electrophysiologic localization is a valuable procedure in patients with cancer-related facial pain.