• Journal of Korean Public Health Nursing
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• v.14 no.2
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• pp.431-445
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• 2000

In general the prevalence of old people is high and frequently have multiple diseases and symtoms requiring treatment. The nature of illness in the elderly has to be faced, and drugs do have an important part in the treatment of that illness. The purpose of this study were to describe health status and medication, and to provide some basic data for elderly's health education, especially for the right medication. Body mass index, self perceived health status, activities of daily living, disease and experience of past operation were surveyed to recognize the 249 elderly's actual health status. The degree of the elderly's understanding the way of medication, experience of side effects, experience of drug combination and incidence of drug adverse reaction along with drug combination were examined for medication. The aged $women(BMI; 10.7\pm13.3\%)$ overweighed the aged $men(BMI; 4.0\pm10.4\%)$. $69.0\%$ of them recognized their health good. Their activities of daily living were diminished following by the age group(p=0.0068) and relationship with self perceived health status were very significant(p=0.0005). They(192 elderly) suffered from multiple disease such as $osteoarthritis(49.5\%)$, $hypertension(32.0\%)$, gastric $disorder(16.1%)$, $diabetes(14.6\%)$, $osteomalacia(10.9\%)$, cardiovascular $disease(9.9\%)$, senile $cataract(5.7\%)$, skin $rash(5.2\%)$, liver $disease(4.2\%)$, kidney $disease(3.6\%)$, spinal cord $problem(3.6\%)$, respiratory $disease(2.1\%)$ $tuberculosis(1.0\%)\;etc(1.0\%).$ $28.3\%$ of them replied that they had an operation for appendictis senile cataract, peptic ulcer, spinal cord problem, pleurisy, hemorrhoid and the rest. Most of $them(87.4\%)$ knew the way very well how to use drugs, and $21.6\%$ of the replied 171 elderly experienced adverse drug reaction. Drug compliance rate were $high(83.6\%)$. In our study 56.9% of the 167 elderly took several medicine together. And $18.9\%$ of the 95 elderly who did drug combination had an experience of drug interaction. One person kept average 5.5 kinds of drugs at home among 243 elderly. They kept $digestives(79.4\%)$, $ointments(68.7\%)$, $vitamins(59.7\%)$, $analgesics(59.7\%)$, cold $medicines(45.3\%)$ antiarthritic $drugs(33.3\%)$, health $foods(27.7\%)$, antihypertensive $drugs(25.1\%)$, anti peptic ulcer $drugs(24.7\%)$, $laxatives(19.8\%)$, $antacids(16.5\%),\;antibiotics(l6.5\%)$, hypoglycemic $agents(10.3\%)$, cardiac $stimulants(7.0\%)$, $diuretics(4.5\%)$, antiarrhythmic $drugs(4.9\%)$, anti anginal $drugs(4.1\%)$, $hypnotics(3.3\%)$, $etc(38.3\%)$. With this result, we ascertain that polypharmacy in the elderly caused by multiple disease is common, which lead to drug interaction. So our task is to educate elderly how to use drugs in order to maximize their efficiency and to minimize their adverse effects.

• YAKHAK HOEJI
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• v.59 no.6
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• pp.270-277
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• 2015

There is a lack of evidence on the impact of pharmacist interventions in diabetes care in South Korea. The aim of this study was to investigate the effects of pharmacist counseling on clinical and humanistic outcomes in patients with type 2 diabetes. An uncontrolled before-and-after study was conducted at the outpatient diabetes clinic in a teaching hospital in Gyeongnam, South Korea between January 2 and November 30, 2014. A total of 37 patients were enrolled. During the study periods, the participants and pharmacists met every 2 weeks via follow-up telephone calls in addition to face-to-face meetings upon returning for care visit. At each meeting, a structured patient counseling was performed and the average duration of each meeting was 15~30 minutes. The participants were requested to record daily self-care activities. At the end of this study, patients' satisfaction on pharmacist care was evaluated using the questionnaire developed by us. Compared to baseline, significant reductions (mean${\pm}$standard deviation, p<0.05) in HbA1c were observed at each follow-up period: $-0.32{\pm}0.72%$ from baseline to 3 months; $-0.52{\pm}0.76%$ from baseline to 6 months; $-0.72{\pm}0.76%$ from baseline to 9 months. Over the same follow-up period, the proportions of patients achieving target HbA1c (defined as HbA1c<6.5%) were 3.1%, 10.3%, and 20%, respectively. The proportions of patients who never missed a dose during the same follow-up period were 43.8%, 31.0%, and 20.0%, respectively. The results from the patient satisfaction survey indicated that pharmacist counseling improved patients' knowledge about diabetes and possible drug interactions. Especially, the information on a healthy diet and lifestyle was the most satisfying. To conclude, follow-up telephone calls combined with face-to-face meetings improved clinical and humanistic outcomes in patients with type 2 diabetes mellitus.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.1001-1008
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• 2021

Objective: The aim of this case study was to describe a case of iris diagnosis of primary hyperhidrosis and the use of Korean medicine. Methods: A patient with symptoms of hyperhidrosis was diagnosed as having Taeeumin after assessment using the four basic Korean diagnostic methods. Iris diagnosis was used for further examination. The images obtained showed a remarkably defined collarette and increased nerve rings, which suggested an overactive sympathetic nerve system. Under the diagnosis of Taeeum, a Korean herbal medicine was prescribed with additional herbs to help alleviate the hyperactivity of the sympathetic nervous system. Results: The patient had been receiving treatment for hyperhidrosis for >30 years, with various medical attempts to relieve her symptoms, which were ineffective. She showed signs of improvement from day 4 into the treatment, and 80% of her symptoms were improved after completing a 6-week treatment course. Conclusion: The herbal medicine prescribed to the patient proved effective for reducing her chronic symptoms that had been unresponsive to previous medical treatments.

• Journal of Korean Society of Health-System Pharmacists
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• v.35 no.4
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• pp.418-429
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• 2018

Background : To improve medication adherence in elderly patients, the role of pharmacists in teambased services has been highlighted in the literature. However, not much is known about the role and the service elements involved in comprehensive geriatric programs in South Korea. This study was designed to describe the current status of medication adherence in geriatric patients based on the comprehensive geriatric assessment program and analyze the predictive factors for medication adherence in a tertiary teaching hospital. Methods : A retrospective cohort study was performed using electronic medical records of 247 patients from March 1st, 2015 to August 31st, 2015. Medication adherence and the types of non-adherence were also collected. Predictive factors for adherence were evaluated by including factors related to demographics, medications, illness, and patterns of medical usage. Results : The mean age of the study population was 81.2 years (range 65~98 years) and they were taking 9.7 drugs on an average (SD 5.0 drugs). The overall rate of non-adherence was 34%. About 48% of the patients had any forms of assistance in the medication administration. The most common type of non-adherence was "self-adjustment". The multivariate analyses revealed that age (adjusted odds ratio, 0.87 [95% CI, 0.80-0.96]; p 0.05) and the number of inappropriate medications (adjusted odds ratio, 0.59 [95% CI, 0.40-0.89]; p 0.05) were strong predictors for non-adherence. Conclusions : These results indicate that strategic considerations of the predictors of non-adherence should be improved in medication counseling services targeting elderly patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.3
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• pp.323-332
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• 2021

This study was undertaken to develop a new combination tablet containing silodosin and solifenacin succinate for treating urination disorders, for which a simultaneous analytical method of silodosin and solifenacin succinate was established. The aqueous solubility of silodosin and solifenacin succinate was determined to be higher than 1 mg/ml in various buffers, and dissolution of the silodosin and solifenacin succinate commercial products was accomplished within 30 minutes. The drug-excipients compatibility test was subsequently evaluated using differential scanning calorimetry. Excipients without compatibility were selected, and various combination formulations were prepared applying the wet granulation method. Of these, the formulation comprising silodosin, solifenacin succinate, lactose hydrate, MCC PH101, sodium lauryl sulfate (SLS), Povidone K30, crospovidone and magnesium stearate, having a weight ratio of 8/10/56/112/2/6/6/2, respectively, showed equivalence comparative to the dissolution achieved with the commercial products of silodosin (Thrupas tab) and solifenacin succinate (Vesicare tab). Thus, we propose that compared to the currently available commercial products, this novel combination tablet containing silodosin and solifenacin succinate is an effective alternative for the treatment of urination disorders.

• 한국노년학
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• v.39 no.4
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• pp.741-762
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• 2019

The purpose of this study is to identify the Nutrition Quotient for Elderly(NQ-E) of the elderly living in the community and to investigate the characteristics of living conditions affecting the nutritional status of the elderly. The subjects of the survey were 1,970 elderly single elderly households aged 65 and over in the nationwide through convenience sampling method. A survey cooperative system was established with Comprehensive Support Center for Elderly Living Alone, and the 25 social welfare institutions. 385 Life Managers for Elderly Living Alone participated as a survey agent. As a result, NQ-E was 51.14 points, which is the lowest level in the NQ-E, and the explanatory power was 20.1% in multiple regression analysis. Significant variables were age, sex, subjective health status, low number of medication, non-smoker, non-alcoholic, satisfactory economic status, academic status, and the interaction with family and neighbors. Based on this result, this study explains that comprehensive measures of nutritional management for the elderly living alone needs to be sought.

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.761-772
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• 2005

Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objective of this study was to suggest a practical dosing guideline for Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997 to September, 2000. Patients who were at least 6 months post-valve replacement and had nontherapeutic INR value (less than 2.0 or greater than 3.0) were included. The data on 688 patients (1,782 visits) requiring dosing adjustment without any known drug or food interaction with warfarin were analyzed. The amount of adjusted dose and INR changes based on the INR at the time of the event were calculated. Aortic valve replacements (AVR) patients and mitral or double valve replacement (MVR/DVR) patients were evaluated separately. Result: Two methods for the warfarin dosage adjustment were suggested: Guideline I (mg-based total weekly dose (TWD) adjustment), Guideline II (percentage-based TWD adjustment). The effectiveness of Guideline 1 was superior to Guideline II overall in patients with both AVR and MVR/DVR. Conclusion: The guideline suggested in this study could be useful when the dosage adjustment of wafarin is necessary in outpatients with mechanical heart valves.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.565-570
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• 2010

Purpose : To verify the efficacy and safety of lamotrigine (LTG) monotherapy in newly diagnosed children with epilepsy. Methods : We prospectively enrolled 148 children who had undergone LTG monotherapy at our institution between September 2002 and June 2009. Twenty-nine patients were excluded: 19 due to incomplete data and 10 were lost to follow up. The data of the remaining 119 patients was analyzed. Results : We enrolled 119 pediatric epilepsy patients (aged 2.8-19.3 years; 66 males and 53 females) in this study. Out of 119 patients, 29 (25.2%) had generalized epilepsy and 90 (74.8%) had partial epilepsy. The responses of seizure reduction were as follows: Seizure freedom (no seizure attack for at least 6 months) in 87/111 (78.4%, n=111) patients; partial response (reduced seizure frequency compared to baseline) in 13 (11.7%) patients; and persistent seizure in 11 (9.9%) patients. The seizure freedom rate was in 81.6% in patients with partial seizure (75.9% for complex partial seizure and 90.9% for benign rolandic epilepsy) and 44.8% in patients with generalized epilepsy (30.0% for absence seizure, 35.7% for juvenile myoclonic epilepsy patients, and 100.0% for idiopathic generalized epilepsy patients). Adverse reactions were reported in 17 (14.3%) patients, and 8 patients (6.7%) discontinued LTG because of rash and tic. No patient experienced severe adverse reaction such as Stevens-Johnson syndrome. Conclusion : LTG showed excellent therapeutic response and had few significant adverse effects. Our findings report may contribute in promoting the use of LTG monotherapy in epileptic children.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.55-84
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• 2015

The tuberculosis is the infectious disease. Generally, the active tuberculosis patient can infect the 10 persons for one year within the daily activities like casual conversation and singing together. The infectivity of tuberculosis can continue for a life time, and infected persons can remain at risk for developing active tuberculosis. To control this contagious disease, along with the active tuberculosis patients, non-infectious but non-compliant patients who can be infectious if their immune systems become impaired have to be managed. To control the non-complaint patients, medical treatment order should be combined with the public order. Because tuberculosis is the risk of community health, the human rights like liberty and freedom of movement can be restricted for public welfare under the article 37(2) of constitution. Even when such restriction is imposed, no essential aspect of the freedom or right shall be violated. The degree of restriction on the rights of citizens is different what methods are chosen to non-complaint patients. For example, under the directly observed therapy program, the patients and medical staffs make an appointment and meet to confirm the drug intakes according to the schedule, which is the medical treatment combined with the mildest public order. If the patients break the appointments or have the history of disobedient, the involuntary detention can obtain the legitimate cause. The Tuberculosis Prevention Act has the two step programs on this involuntary detention, The admission order (Article 15) is issued when the patients are infectious. The quarantine order (Artle 15-2) is issued when the patients are infectious and non-complaint. The legal criteria for involuntary detention are discussed and published through the international conventions and covenants. For example, World Health Organization had made guidance on human rights and involuntary detention for tuberculosis control. The restrictions should be carried out in accordance with the our law and in the legitimate objective of public interest. And the restriction should be based on scientific evidence and not imposed in an unreasonable or discriminatory manner. We define and adopt these international criteria under our constitution and legal system. Least restrictive alternative principle, proportionality principle and the individual evaluation methods are explained through the reviews of United States court decisions. Habeas Corpus Act is reviewed and adopted as the procedural due process to protect the patient rights as a citizen. Along with that, what conditions and facilities which are needed to performed quarantine order are discussed.

• Tuberculosis and Respiratory Diseases
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• v.44 no.2
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• pp.241-250
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• 1997

Objective : Although the prevalence of pulmonary tuberculosis has decreased progressively after the national control program for tuberculosis began, nowadays the number of MDRTB is increasing seriously. MDRTB tends to be poor responsive to current antituberculosis regimens. It is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. The purpose of present study is to evaluate the clinical features of pulmonary tuberculosis patients admitted in one national tuberculosis hospital and to expose the problems pertaining to current remedies, to increase the treatment efficacy for pulmonary tuberculosis including MDRTB in the end. Method : Retrospective analysis of 336 pulmonary tuberculosis patients admitted in National Masan Tuberculosis Hospital was done. Contents of analysis were patients profile, the first diagnosed time and medical institutes, family history, residence, previous treatment history, chief complaints at the time of admission, lesion site on chest X -ray film, combined deseases, side reaction to antibuberculosis drugs, used drugs before admission and the results of drug sensitivity test. Results : The ratio between male and female was 4 : 1. Age showed relatively even distribution from 3rd to 6 th decades. 64.6% of the patients was diagnosed at public health center. Weight loss was the most common complaint at admission. Bilateral lesions on chest X-ray films were 59.8%. 130patients had combined desease, of which DM was the most common(37.7%). 95patients had family history, of which parents were the most common(41.7%). According to the time of first diagnosis, 31 patients were diagnosed before 1980, and after then the number of patients was increased by degrees. Residence overwhelmed in pusan and gyung-nam province. 258 patients got previous treatment history, of which 112 patients(43.4%) had more than 3 times and only 133 patients(51.6%)got regular medication. 97 patients used more than other 3 drugs in addition to INH, EMB, RFP and PZA before admission. 154 patients were informed with the results of drug sensitivity test. of which 77 patients had resistance to more than 5 drugs. Gastrointestinal problem was the most common in side reaction to drugs. Conclusion : In the case of weight loss of unknown cause, tuberculosis should be suspected. In first treatment, sufficient and satisfactory explanation for tuberculosis is necessary and treatment period should not be stict to 6 month-short term therapy. In retreatment, new drugs should not be added to used drugs even though drug sensitivity results show sensitivity to some of them. Proper time for surgical intervention should not be delayed.