• Korean Journal of Clinical Pharmacy
• /
• v.24 no.3
• /
• pp.193-198
• /
• 2014

Objective: This study was conducted to compare the adherence, clinical and economical utility of fixed-dose combination tablets of sitagliptin/metformin with concomitant administration of sitagliptin and metformin in patients with type 2 diabetes mellitus. Methods: Adherence was measured as the medication possession ratio (MPR) of ${\geq}80%$, and MPR was calculated as the number of total prescription days divided by the total treatment period. Hemoglobin $A_{1C}$ ($HbA_{1c}$) differences between baseline and predetermined periods were analyzed. Proportions of patients who achieved $HbA_{1c}$ less than 6.5% for three or more consecutive times were compared. To evaluate cost-effectiveness, prices of sitagliptin, metformin and sitagliptin/metformin tablets were investigated. Results: More than 90% of patients showed adherence in both groups (92.0% in fixed-dose combination group vs 95.9% in concomitant administration group), and there was no statistically significant difference (P = 0.113). Proportion of patients with HbA1c less than 6.5% for three or more consecutive times tended to be somewhat higher in fixed dose combination group than in concomitant administration group without a statistically significant difference (32.6% vs. 28.0%, P = 0.344). Total price of metformin and sitagliptin was cheaper up to 222 KRW in the case of fixed-dose combination tablets compared to the case of concomitant administration. Conclusion: The sitagliptin/metformin fixed-dose combination tablet had a similar patient adherence and was not significantly different in efficacy to the concomitant administration of each component. In terms of drug prices, fixed-dose combination tablets were cheaper than concomitant administration of each tablet.

• Korean Journal of Clinical Pharmacy
• /
• v.23 no.3
• /
• pp.197-205
• /
• 2013

Background: Many factors including drugs, dietary supplements, and food intake can affect the development and organ formation of fetuses. Because of this, subject tends to avoid consuming things like coffee, alcohol, or cigarettes due to the risks they pose during pregnancy. Therefore, analysis of drugs and favorite food consumption is needed and important to ensure safe health management for subject. Purpose: This study was conducted domestically to analyze these factors in South Korea. Method: The survey was conducted from pregnancy-related online communities for six days and the survey results were received via email for analysis. Result: A total of 127 subjects answered the questionnaire via email; the characteristics of subjects are widely varied in their ages, education levels, job statuses, and residences. The questionnaire included the intake of dietary supplements during pregnancy including vitamins and the result showed that the subjects took 2.23 different kinds of supplements on average. In order of highest frequency, 101 subjects took multivitamins; 79 subjects took an iron supplement; 30 subjects took analgesics; 20 subjects took prescribed antipyretic and medication for upper respiratory diseases; 12 subjects took antibiotics; 7 subjects took antiemetics. Their compliances were different in each medication categories. Only 8% of subjects answered that they had asked a pharmacist for medication information during pregnancy. In addition, 78% of subjects answered that they never counseled with anyone about pregnancy related medication use. Conclusion: In conclusion, many subjects took medication including dietary supplements. The role of pharmacists should be actively developed to improve subject care such as education about subject's medication uses and their food consumption behavior.

• Journal of Korean Medicine for Obesity Research
• /
• v.19 no.1
• /
• pp.31-41
• /
• 2019

Objectives: The purpose of this study was to investigate the effects of gender, age, body weight, muscle mass, fat mass, body mass index (BMI), metabolism, and compliance with medication on weight loss in obese adults. Methods: We reviewed the medical records of 178 patients who were visited to the Korean Oriental Clinic for 3~6 month and had obesity treatment using Gamitaeumjowee-tang from April 2017 to May 2017. We conducted a paired T-test, correlation coefficient and decision tree to analyze factors influencing obesity treatment. Results: The results of correlation analysis showed that initial weight (kg), initial fat mass (kg), BMI ($kg/m^2$), compliance with medication (%), Original Harris-Benedict Equation, Revised Harris-Benedict Equation and The Mifflin St Jeor Equation was significantly correlated to weight loss (kg) (P<0.001). As a result of constructing the decision tree model, it showed that over 5% weight loss of their initial weight (n=154) was related with initial BMI ($kg/m^2$), compliance with medication (%) and initial muscle mass (kg). In case of over 5 kg weight loss of their initial weight (n=131), it was related with initial BMI ($kg/m^2$), compliance with medication (%) and final BMI ($kg/m^2$). Conclusions: This study suggests that weight loss may be affected by initial factors and that initial factors can be used for obesity treatment.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.22 no.3
• /
• pp.223-235
• /
• 2009

Purpose: To evaluate thermal effect and medication compliance of red ginseng extract. Methods: Randomized, double-blind, placebo-controlled, cross-over clinical study was performed. Twenty four healthy, married women aged 30-45 years with FSFI score below 25 were randomly divided into two groups; red ginseng group(N=12) and placebo group(N=12). During the first 6-week period (Study1), each group was dosed with red ginseng or placebo twice a day. Before starting the second 6-week period(Study2), a crossover design was chosen with a 2-week break(Washout period). Interchanging two groups after Washout period, red ginseng and placebo were dosed to each group. The efficacy of thermal effect was measured with subjective warm sensation scale and lower abdomen temperature by Digital Infrared Thermographic imaging(DITI) before and after each 6-week period. A medication compliance was assessed after each 6-week period and the correlation medication compliance between Sasang Constitution and subjective warm sensation was analyzed. Results: Overall 23 participants completed the study. In subjective warm sensation scale, after taking placebo, all participants exhibited an improving trend, but there was no significant difference. In lower abdomen temperature by DITI, statistically significant objective thermal effect of red ginseng was also not shown. A medication compliance was higher in Yin constitution(Taeumin, Soeumin), and showed an upward trend with decreasing subjective warm sensation. But no statistically significant difference was exhibited. Conclusion: Statistically significant thermal effect of red ginseng was not shown in this study. We anticipate if a long-term clinical trial is practiced, significant thermal effect of red ginseng will be shown.

• Korean Journal of Clinical Pharmacy
• /
• v.21 no.2
• /
• pp.81-89
• /
• 2011

Medication adherence is an important public health issue. This study is conducted to explore non-adherence of elderly with hypertension and/or diabetes mellitus and to better understand its' influencing factors. To explore non-adherence, 605 elderly patients in community were surveyed with Modified Morisky Scale (MMS), from Aug 18 to Sept 19, 2008. MMS is designed to predict medication-taking behavior and outcomes, and also to explain persistence of the patient's long-term continuation of therapy, which is a significant factor in the long-term management of chronic diseases. Also, MMS is designed to classify patients into a high/low continuum for knowledge and motivation. Patients self reported medication adherence were average 4.66 with MMS (range 0-6), only 78% of patients hold high motivation of medication adherence although 95.5% of patients hold high knowledge of medication adherence. This study explores which factors influence to high motivation of medication adherence and it proved that patients' participation in work, education level, participation in private health insurance, number of medication and medication frequency per day, pharmacists' explanation, experience of non adherence due to cost are important factors to explain high motivation of medication adherence of elderly with hypertension and/or diabetes mellitus.

• Korean Journal of Clinical Pharmacy
• /
• v.26 no.1
• /
• pp.13-23
• /
• 2016

Background: South Korea is rapidly being an aging-society and the demand of long-term care insurance services for elderly patients is rising. In addition, because the elderly taking multiple medicines, the adherence is lowered and the adverse events are easily occurred. Therefore, many are interested in introducing the geriatric pharmacy specialist to manage this situation. Purpose: By applying a similar program such as the geriatric pharmacy specialist working in nursing home, we conducted this study to evaluate the potential contribution to both the health insurance services and financial savings for the elderly patients. Methods: We conducted a trial in an elderly nursing home to collaborate between doctor and pharmacist making a checklist for improving medication adherence and establish a consultation system. Also we applied a smart phone application in the pharmaceutical care processes. Results: Thereby completing the drug therapy related checklist apply to nursing facilities in South Korea. And we got a performance that improves medication adherence when used in the clinical practice settings. Conclusion: By introducing a training program of pharmacy care managers and geriatric professionals such as the United States and Japan, we revealed the elderly nursing home residents and vulnerable elderly people living alone were improved the medication adherence and it will contributed to the health and quality of life of the patients.

• Quality Improvement in Health Care
• /
• v.9 no.2
• /
• pp.164-175
• /
• 2002

Background : The purpose of this study was to investigate the current status of medication compliance of outpatients and to analyze the factors contributing to medication non-compliance Methods : Telephone survey was conducted to the 1,000 outpatients who visited medical institutions during the period from January 2002 to April 2002. Subjects were randomly selected from the telephone directories of the nation, and the socio-demographic characteristics of the respondents such as age, gender and region were matched based on those of outpatients in 2001. Results : The results of survey revealed that those who complied with doctors' regimen in the right way accounted for 82.4%. The compliance increased with the strong belief in the medication, less unwanted side effects and inconvenience, more severity of disease, and lower perceived health status. Compliance rate was also higher in the patients group who experienced the drug education by the pharmacists than those who did not. Conclusion : In order to improve drug compliance, drug information on efficacy, adverse reaction, drug interactions, and basic disease information are to be provided to the patients. Drug education needs to be focused not only on providing knowledge of drugs and diseases but also changing attitude on drug use of the patients.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.6
• /
• pp.1234-1244
• /
• 1997

Background : Nowadays drug resistant tuberculosis is making problems in the treatment of pulmonary tuberculosis and its number is increasing. Several reasons for this are considered including irregular medication, poor drug compliance and wrong regimens. But there are treatment failure cases in spite of regular medication with short-term standard regimens. We reviewed clinical data of 50 patients to find out possible causes of this. Method : Subject of this study was 50 patients who failed in the primary treatment of pulmonary tuberculosis in spite of regular medication with short-term standard regimens. All of them were under treatment with secondary regimens in National Masan Tuberculosis Hospital on Oct 1996. The patient's records were analyzed retrospectively and direct interviews with patients were done. Results : There were relatively more patients in the age of 20th. Male overwhelmed in number. There were smoking in 22 patients and drinking in 24 patients during medication. 17(34%) patients had family history of tuberculosis. Public health center was the most common site for the initial diagnosis among medical institutes. 42 patients had subjective symptoms for pulmonary tuberculosis. 38 patients got sufficient explanation from medical institute about tuberculosis and medication courses. 24 patients had bilateral lesions on chest X-ray film and 43 patients had cavitary lesions. 29 patients had past history for pulmonary tuberculosis with regular medication. The results of drug sensitivity test showed resistance in 41 patients of whom we could get the results. Conclusion : Main cause of treatment failure of pulmonary tuberculosis in spite of regular medication with short-term standard regimens was drug resistance. Several factors were considered to be related to high prevalence of drug resistance, including age of 20th, male, family history for tuberculosis, bilateral lesions or remaining cavitary lesion on chest X-ray film.

• YAKHAK HOEJI
• /
• v.57 no.5
• /
• pp.369-375
• /
• 2013

Objective: Using the Korean Health Panel data (KHP) of 2008 and 2009, this paper analyzed the effect of antihypertension medication adherence on the changes in medical service utilization and medical expenditure in the next year. Method: Through a face-to-face interview survey, KHP has provided an extensive data on demographic characteristics, medical utilizations behavior, medical expenditure and health behaviors of the targeted households and their members since 2008. KHP is recognized as highly accurate regarding medical expenditure in that it makes the target households to record 'Health diary' whenever they use healthcare service, which could minimize their cognitive bias or memory distortion. The 2010 KHP data was based on the interview from 6,432 households and 19,697 household members. Two part model was used to explore the effects of medication adherence on medical use (logistic regression analysis) and medical expenditures (OLS). Result: Our study result demonstrated that the 74.7% of the patients who strictly adhere to their medication in both years, in 2008 and in 2009, were likely to use inpatient service in 2010. This shows the noncompliant patients were in fact use emergency service less than the compliant patients. Conclusion: Based on our analysis, this paper concludes that the high medication adherence of hypertensive patients could contribute to reduce the emergency service use. Therefore it is highly recommendable for the Korean government and the insurer, NHIS, to actively invest in developing education and promotion program to improve medication adherence among hypertensive patients.

• YAKHAK HOEJI
• /
• v.59 no.1
• /
• pp.23-28
• /
• 2015

Everyone has own color preference and the color preference can affect human psychology in various good or bad ways. Especially patients with chronic diseases often have depressed mood to take pills for their disease treatment. Therefore we evaluate the possibility of their color preference to pharmacotherapy in good way which increases the compliance of pharmacotherapy. We performed this study by a Questionnaire survey for total 150 agreed patients at K University hospital from Aug 7 to Sep 30, 2014. Questionnaire survey was performed to choose color of providing color kit (11 different color range kit) depend on each 16 questions which asked the patient characteristics, health condition, general color preference, color preference for medicine and expectation for drug compliance. In results, most preferred color was blue (20%), whereas disliked color was black (30%) in general life. However, most preferred color for pill was white (32%), for syrup was also white (31%) or orange (28%), and for vitamin was yellow (47%). When we asked the possibility of increasing compliance, if the current taking pill color will be changed for your preference color like a candy bar, 50.4% of respondents marked 4 or 5 of like-scale expressing positive opinion on it. In conclusion, compliance is very important to succeed the treating disease and may apply the psychologic application such as each patient color preference for drug compliance in the future.