1.Prescribing patterns for childhood asthma treatment in general practice.
The Medical Journal of Malaysia 2003;58(4):475-481
The treatment preferences of 109 general practitioners (GPs) for childhood asthma were determined. Availability and adherence to clinical practice guidelines (CPG) for the treatment of childhood asthma was also assessed. Ninety eight (90%), 60 (55%) and 33 (30%) GPs considered nocturnal symptoms > 2 times/week, exercise induced wheeze and cough respectively as indications for preventer therapy. An oral preparation was preferred for relief medication [72 (66%) for 2-5 years, 60 (55%) for > 5 years]. An inhaled preparation was however preferred for preventer medication [60 (55%) for 2-5 years, 85 (78%) for > 5 years]. The oral form was more likely prescribed for asthmatic children 2-5 years (p < 0.001). Corticosteroids and ketotifen were the commonest inhaled and oral preventer treatment prescribed respectively. Only 36(33%) GPs have a CPG copy for reference. Children with asthma symptoms that require preventer therapy may not always be identified in general practice. The oral route remains important for asthma medication especially in young children. The accessibility to the CPG among GPs is disappointing.
Anti-Asthmatic Agents/*therapeutic use
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Asthma/*drug therapy
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Chi-Square Distribution
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Family Practice/*statistics & numerical data
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Guideline Adherence
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Pediatrics/*statistics & numerical data
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Physician's Practice Patterns/*statistics & numerical data
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Practice Guidelines
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Questionnaires
2.Cost is a Barrier to Widespread Use of Liquid-Based Cytology for Cervical Cancer Screening in Korea.
Hyun Hoon CHUNG ; Jae Weon KIM ; Soon Beom KANG
Journal of Korean Medical Science 2006;21(6):1054-1059
This study aimed to document current cervical cancer screening practices of physicians in Korea. Questionnaires were distributed to 852 Korean obstetricians and gynecologists, who attended the 91st Conference of the Korean Society of Obstetrics and Gynecology held during May, 2005. Questionnaires were returned by 30.6% (260/852) of the recipients and 254 of these were eligible for analysis. Sixty-seven percent started cervical cancer screening women at age 20, and 65% replied that they would continue annual screening in a 35-yr-old woman with three consecutive normal cytologic tests. Over 65% of respondents preferred conventional cytologic screening to liquid-based cytology. The cost was a major determinant for selecting screening method. Fifty-three percent used the human papillomavirus DNA test as a triage for atypical squamous cells of undetermined significance. Our findings suggest that majority of Korean obstetricians and gynecologists in hospital prefer annual conventional cytologic testing to liquid-based cytology for financial reason.
Uterine Cervical Neoplasms/*economics/epidemiology/*pathology
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Questionnaires
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Physician's Practice Patterns/*statistics & numerical data
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Mass Screening/*economics/*statistics & numerical data
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Male
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Korea/epidemiology
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Humans
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Health Care Costs/statistics & numerical data
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Female
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Cytological Techniques/*statistics & numerical data
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*Attitude of Health Personnel
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Adult
3.Attempts to Reduce the Progression of Myopia and Spectacle Prescriptions during Childhood: A Survey of Eye Specialists.
Jong Jin JUNG ; Eun Hae LIM ; Seung Hee BAEK ; Yong Ran KIM ; Sang Mook GONG ; Ungsoo Samuel KIM
Korean Journal of Ophthalmology 2011;25(6):417-420
PURPOSE: To determine methods tried in clinical trials to reduce the progression of myopia in children, and spectacle prescribing patterns of hospital ophthalmologists. METHODS: A multi-sectioned survey composed of Likert items relating to the methods of reducing myopia progression (orthokeratology lenses [O-K lenses], undercorrected glasses, and topical atropine) and the patterns of prescribing spectacles for children (including two cases involving a 5-year-old girl and an 8-year-old boy) were distributed to members of the Korean Ophthalmological Society, and the collected data was statistically analyzed. RESULTS: A total of 78 out of 130 ophthalmologists returned the survey. On a scale of 1 to 5, the mean rates of whether the ophthalmologists think O-K lenses arrest myopia progression, and whether they recommend their patients to wear O-K lenses if indicative, were 3.06 and 2.75, respectively. Moreover, the mean rates of whether they consider that wearing glasses which are undercorrected would slow down the progression of the myopia, or if they think topical atropine helps in arresting myopia progression in children, were 2.34 and 1.27, respectively. In response to the case studies, the majority of practitioners preferred to prescribe the full amount found in cycloplegic refraction to pediatric patients with myopia. CONCLUSIONS: Ophthalmologists in clinical practice encouraged children to wear O-K lenses more than undercorrected glasses as a way to retard myopia progression. However, the application of atropine is rarely tried in clinical trials. In managing pediatric patients with myopia (case specific), the majority of the practitioners chose to prescribe glasses with full cycloplegic correction.
Atropine/administration & dosage
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Child
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Child, Preschool
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Data Collection
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Disease Progression
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Eyeglasses/classification/*utilization
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Female
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Health Knowledge, Attitudes, Practice
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Humans
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Male
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Myopia/physiopathology/*prevention & control
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Physician's Practice Patterns
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Prescriptions/*statistics & numerical data
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Republic of Korea
4.Physician Factors Associated with the Blood Pressure Control among Hypertensive Patients.
So Young KIM ; In Sook CHO ; Jae Ho LEE ; Ji Hyun KIM ; Eun Jung LEE ; Jong Hyock PARK ; Jin Seok LEE ; Yoon KIM
Journal of Preventive Medicine and Public Health 2007;40(6):487-494
OBJECTIVES: Little is known about the physician-related factors that are associated with the management of hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. METHODS: We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do. Forty-one physicians completed the survey (response rates: 26.6%) and 31 physicians were finally included as the study subjects. Using the information obtained from the selfreported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center's information system. We compared the physicians' perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25% of the median degree of hypertension control rate overestimation) among the physicians. The physicians' antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physicianrelated factors. RESULTS: The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5% perceived vs. 57.8% actual). The percentage of physicians with high overestimation was 35.5% (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients' control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensinconverting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95% CI: 1.17-1.48). CONCLUSIONS: Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians' overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician' awareness regarding the management of patients with hypertension are needed.
Adult
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Aged
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Aged, 80 and over
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Antihypertensive Agents/*therapeutic use
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Drug Utilization Review
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Female
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Health Care Surveys
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Humans
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Hypertension/*drug therapy/prevention & control
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Korea
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Male
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Medical Audit
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Middle Aged
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Physician's Practice Patterns/*statistics & numerical data