Analysis of medical service utilization for post-stroke sequelae in Korea between 2016 and 2018: a cross-sectional study

Lee, Hyun Jun; Lim, Yu-Cheol; Lee, Ye-Seul; Kwon, Seungwon; Lee, Yoon Jae; Ha, In‐Hyuk

doi:10.1038/s41598-022-24710-8

Cited by 7 publications

(4 citation statements)

References 68 publications

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“…This is considered a limitation of RWD studies because, in retrospective studies based on health insurance data or hospital EMRs, the exact treatment procedure cannot be accurately determined. That the treatment was not mentioned in the paper does not imply non-administration [ 54 , 55 ]. Thus, a more comprehensive evaluation of various East Asian traditional medicine interventions is needed through registries, prospective cohorts, and other forward-looking research.…”

Section: Discussionmentioning

confidence: 99%

Current Research Status and Implication for Further Study of Real-World Data on East Asian Traditional Medicine for Heart Failure: A Scoping Review

Park,

Bak,

Chu

et al. 2023

Healthcare

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This study used real-world data (RWD) to explore the long-term effects of East Asian traditional medicine (EATM) on heart failure (HF). A comprehensive search was conducted across five databases to identify relevant studies, which were then reviewed using the Arksey and O’Malley scoping review framework. The analysis focused on a descriptive examination of the long-term outcomes associated with EATM intervention. Methodologically, the study explored various aspects, including study subjects, interventions, applied clinical outcomes, and statistical methods. Out of 258 studies, 12 were selected. Eight studies involved patients with HF, while the others used HF as an outcome. Datasets from the National Health Insurance Research Database were used in Taiwan, while electronic medical record data were used in China and Japan. EATM interventions have been found to be associated with lower mortality and readmission rates. One study indicated that an increased dose of Fuzi, a botanical drug, or prompt use of Fuzi after diagnosis led to a decreased mortality hazard ratio. In two studies examining readmission rates, a significant increase was observed in the non-exposed group, with odds ratios of 1.28 and 1.18. Additionally, in patients with breast cancer, the subdistribution hazard ratio for the occurrence of doxorubicin-induced HF was reduced to 0.69. Although cohort studies with survival analysis were common, methodological flaws, such as issues with statistical methods and HF diagnosis, were identified. Despite these challenges, the study observed an association between EATM and improved clinical outcomes in patients with HF, emphasizing the potential of RWD studies to complement randomized controlled trials, especially for longer-term follow-ups. These results provide foundational data for future RWD research.

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Section: Discussionmentioning

confidence: 99%

Current Research Status and Implication for Further Study of Real-World Data on East Asian Traditional Medicine for Heart Failure: A Scoping Review

Park,

Bak,

Chu

et al. 2023

Healthcare

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“…Relieving limb spasticity effectively is crucial to promote motor recovery in spastic hemiplegia after ischemic stroke ( 48 ). Increasing evidence showed that acupuncture and noninvasive acupuncture related therapies such as Acu-TENS are widely used for post-stroke spasticity with satisfied results ( 34 , 35 , 49 ). Meanwhile, tDCS also showed positive effects for post-stoke spasticity ( 28–30 ).…”

Section: Discussionmentioning

confidence: 99%

Effects of acupoints-based TENS combined with tDCS on spasticity and motor function in ischemic stroke with spastic hemiplegia: study protocol for a randomized controlled trial

Qian,

Ma,

et al. 2023

Front. Neurol.

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BackgroundSpastic hemiplegia following ischemic strokes seriously impedes the recovery of motor function posing a vast rehabilitation challenge. As the uncertain effects of recommended conventional treatments such as botulinum toxin injections on active functional improvement and potential adverse effects cannot be bypassed, there is an increasing need in alternative, more effective and safer modalities. Acupoints-based transcutaneous electrical nerve stimulation (Acu-TENS) and transcranial direct current stimulation (tDCS) are effective non-invasive modalities for stroke rehabilitation, particularly showing anti-spastic effect and functional improvements as well. However, the optimal stimulation frequency of Acu-TENS and whether combination of Acu-TENS and tDCS exert synergistic effect remain to be investigated.ObjectiveTo evaluate the effects of Acu-TENS combined with tDCS on spasticity and motor function in ischemic stroke patients with spastic hemiplegia and screen the optimal frequency of Acu-TENS.MethodsA total of 90 post-ischemic stroke patients with spastic hemiplegia will be intervened for 4 weeks and followed up for 4 weeks. They will be randomly assigned to three groups including two observation groups and a standard care control group in a 1:1:1 ratio. All patients will receive standard care and regular rehabilitation accordingly. In addition, the two observation groups will receive 12 sessions of Acu-TENS at 20 Hz or 100 Hz for 30 min combined with 1 mA tDCS for 20 min, three times a week, for 4 weeks. The primary outcome is the change in total modified Ashworth scale (MAS) score from baseline to week 4. Secondary outcomes include changes in surface electromyography (SEMG), Fugl-Meyer Motor Function Scale, Modified Barthel Index (MBI), and 10-meter walk test from baseline to week 4. MAS score will also be measured after 4 weeks of follow-up. Adverse events throughout the study will be recorded.DiscussionThis trial will evaluate, for the first time, the therapeutic potentials and safety of Acu-TENS combined with tDCS on spasticity and motor function in stroke patients. It will provide evidence for frequency-dependent anti-spastic effect of Acu-TENS, and a reference for rated parameter setting of new mixed transcutaneous and transcranial stimulation system for stroke rehabilitation, thereby promoting proactive healthcare consequently.Trial registration:Chinese Clinical Trials Register ChiCTR2200067186.

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“…A study of almost 20 000 stroke patients from 2016 to 2018 in Korea found that poststroke rehabilitation services and medications were more frequently used in standard care, and injection procedures and acupuncture were more frequent in Korean medicine, drawing attention to inequities and complexities that may arise with 2 medical models. 24 Perspectives on postacute stroke management were explored in Indonesia to establish a foundation of evidence supporting the need for home care services and the welfare of healthcare personnel. 25 Workforce capacity was also a focus in a report on Japan’s insurance reform for the proposed community-based integrated care system aimed to improve postacute to long-term stroke care continuity.…”

Section: Research To Inform Policy Redesignmentioning

confidence: 99%

Advances in Stroke: A Focus on Health Policy Literature From 2022

Prvu Bettger,

Cadilhac

2023

Stroke

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Analysis of medical service utilization for post-stroke sequelae in Korea between 2016 and 2018: a cross-sectional study

Cited by 7 publications

References 68 publications

Current Research Status and Implication for Further Study of Real-World Data on East Asian Traditional Medicine for Heart Failure: A Scoping Review

Current Research Status and Implication for Further Study of Real-World Data on East Asian Traditional Medicine for Heart Failure: A Scoping Review

Effects of acupoints-based TENS combined with tDCS on spasticity and motor function in ischemic stroke with spastic hemiplegia: study protocol for a randomized controlled trial

Advances in Stroke: A Focus on Health Policy Literature From 2022

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