ABSTRACT
BACKGROUND: In Japan, there have been few reports about drug compliance, which is an important determinant of effectiveness, in the management of bronchial asthma patients. To clarify drug compliance and its relationship with various aspects of asthma management, a questionnaire survey was performed on asthmatic patients and their pharmacists.<BR>METHODS: This survey was carried out, from October to November in 2001. The subjects were limited to the regular inhaled corticosteroid (ICS) users, and were restricted to patients whose medication had not been changed for at least 6 months before the survey. The questionnaires inquired about asthma status, various factors that have been reported to be associated with drug compliance and asthma management. Patients' pharmacists were asked about prescribed medications and drug compliance based on the pharmaceutical records.<BR>RESULTS: Completed questionnaires were received from 610 patients. ICS compliance was not lower than that of anti-allergic drug but lower than that of oral sustained-released theophylline (OSRT) . Multiple regression analysis revealed a significant correlation between ICS and OSRT compliance.<BR>CONCLUSION: These results might suggest that OSRT could improve patient's compliance to drug therapy through its bronchodilatory effect, thus resulting in better compliance to ICS. If this were the case, OSRT would play an important role in asthma management.
ABSTRACT
The effects of psychosocial education on undergraduate medical students were evaluated in an open trial. Undergraduate medical students were exposed to psychosomatic medicine and, in particular, holistic medicine as part of their undergraduate medical education. Almost all students (94.9%) reported addressing “extramedical” clinical problems with a holistic approach (n=98). Psychological, social, and economic problems were mentioned in 64.3%, 50.0%, and 5.1% of reports, respectively. Problems in relationships between members of the medical staff and patients were included in 37.8% of reports. Self-evaluation with the Egogram Check Lists by students who had undergone clinical practice revealed scores of “Critical Parent, ” “Nurturing Parent, ” “Adult, ” “Free Child, ” and “Adapted Child” of 2.59 1.57, 4.59±1.89, 4.79±1.54, 4.85±1.64, and 4.65±1.64, respectively (n=82). “Adult” scores were higher after clinical practice than before (n = 32, p<0.02, Student's paired t-test). Clinical practice seemed to help students mature and become better able to cope with problems objectively. Education in psychosomatic medicine is an important component of undergraduate medical education.
ABSTRACT
Objective: Bakumondo-to (Mai men dong tang, B), a traditional Chinese blended medicine, has notable antitussive activity in bronchitic guinea-pigs. In this study, we examined whether or not B was effective in treating postinfectious cough.<br>Methodology: Consenting, non-smoking patients who met the following diagnostic criteria were selected as subjects: (1) those who had been coughing continuously for more than two weeks postinfectiously; (2) who did not use angiotensin-converting enzyme (ACE) inhibitors orally; (3) who had no history of nasal and/or paranasal disease, chronic pulmonary disease, atopy or gastroesophageal reflux disease; and (4) who had normal chest X-rays, respiratory function, peripheral eosinophil counts, levels of C-reactive protein, and serum IgE concentrations. Subjects were randomized into two groups: those given a daily dose of 9g of B extract granules orally for one week, and those given a daily dose of 60mg dextromethorphan hydrobromide (D) orally for one week. Using a cough diary (in which cough was scored from 0 to 9 points), we compared and studied the antitussive effects between the two groups.<br>Results: Group B was comprised of thirteen patients, and Group D, twelve. There were no significant differences between the two groups with respect to age, sex, cough scores at the time of hospital visits, duration of continuous coughing, and test results. Significant antitussive effects were seen in both groups. However, cough scores decreased significantly from the second day for the B group, and on the third, sixth and seventh day for the D group. Compared with the D group subjects, those in the B group showed higher antitussive effects on the second days (P<0.05). No serious side effects were observed for either group.<br>Conclusion: In this randomized open trial, we concluded that Bakumondo-to is an effective treatment in non-smoking patients with postinfectious cough, and it appears to demonstrate an antitussive action immediately after administration.