• Title/Summary/Keyword: Concurrent Medication

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Concurrent Use of Korean Herbal Medicines and Western Chemical Medicines: Evidence from HIRA-NPS (건강보험 급여 한약제제와 양방 처방의약품의 병용투여 현황)

  • Lee, Hye-Jae;Yoon, Nan-He;Park, So Hyun;Shin, Seungwon;Park, Minjung
    • Journal of Society of Preventive Korean Medicine
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    • v.25 no.2
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    • pp.1-11
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    • 2021
  • Objective : The purpose of this study is to analyze Korean patients' characteristics, who were concurrently treated with both Korean herbal medicines and Western chemical medicines using nation-wide database. Method : Using the patients sample data (HIRA-NPS 2018) provided by Health Insurance Review and Assessment Service, a group of patients who co-administered Korean herbal and Western medicines was selected, and their basic characteristics, diagnosis, and prescribed chemical medicines were analyzed. Results : Out of the 1,481,921 sample population, 17,629 patients (1.2%) were selected as a concurrent medication group. Compared to the whole sample, the concurrent medication group was composed of more women (65.8% vs. 51.1%), the more elderly people (65 or older years old) (44.5% vs. 14.6%), and the higher prevalence of chronic diseases (49.1% vs. 22.2%). The most frequent diagnosis treated with Western medicines was mental and behavioral disorders, musculoskeletal and circulatory disorders. Frequently used drugs among concurrent medication group were anti-anxiety drugs, gastric ulcer treatment drugs, and senile diseases treatment drugs. Conclusion : The evidence reported in this study is expected to provide herb-drug interaction researchers with important reference to set the priorities of research topics in the future.

Risk Factors Associated with Medication Adherence in HIV/AIDS Patients (한국인 HIV/AIDS 환자의 복약순응도에 미치는 위험 인자 연구)

  • Kyung Sun Oh;Jin-soo Lee;Euna Han
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.4
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    • pp.254-260
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    • 2023
  • Background: Adherence to antiretroviral treatment (ART) is crucial for maintaining the HIV-RNA suppression in patients living with HIV/AIDS. This study aims to analyze the risk factors contributing to low medication adherence among individuals with HIV/AIDS by analyzing data from the Korean HIV/AIDS cohort study. Methods: The dependent variable is ART medication adherence. The depressive symptom and anxiety scores were collected as main independence variables. Covariates included gender, age, transmission route, alcohol and smoking information, and antiviral treatment regimen details. To predict the relationship between ordinal dependent variables and independent variables, an ordered logistic regression analysis was conducted, and odds ratios (OR) were calculated. Results: The results of the ordered logistic regression analysis showed that female was associated with a higher risk of low medication adherence (OR=2.91, 95% CI=1.08, 7.83). Among the subjects who were non-smokers and non-drinkers, the risk of low medication adherence was lower (OR=0.36, 95% CI=0.18, 0.70). Depending on the ART treatment group, individuals taking integrase inhibitor had a lower risk of medication adherence (OR=0.31, 95% CI=0.13, 0.76), and those experiencing depressive symptoms were related with a higher risk of low medication adherence (OR=1.97, 95% CI=1.12, 3.46). Conclusions: The encouragement and emotional support of healthcare professionals are essential for patients living with HIV/AIDS who experience depressive symptoms to maintain ART adherence. Additionally, further research is needed to ensure that HIV/AIDS infected female with concurrent depressive symptoms can achieve appropriate ART therapeutic effect.

Potential Drug Interactions in Cancer Patients on Oral Kinase Inhibitors (경구용 활성효소 억제제 복용 암환자의 잠재적 약물상호작용 연구)

  • Jung, Eun-Hee;Bang, Joon Seok;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.2
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    • pp.129-136
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    • 2013
  • Objectives: Among many new drugs that are under investigation with intent to treat cancer, oral kinase inhibitors are proven to be effective in numerous clinical trials and easy to administer. Due to these advantages the use of oral kinase inhibitors is increasing. Oral kinase inhibitors are metabolized by CYP450 which can result either increase of adverse effect or decrease of drug effect by drug interaction when used concurrently with other agents. In this research, the medication records of patients on oral kinase inhibitors from Oct. 2010 to Nov. 2011 were reviewed to investigate potential drug interactions. Methods: From Oct. 2010 to Nov. 2011, cancer patients in Inha University Hospital who took oral kinase inhibitors more than once were included. The patients' medication records were reviewed to list out concurrent medications that have interaction potential with oral kinase inhibitors, the frequency of concurrent use, and the severity of interaction result using Micromedex$^{(R)}$ and Lexicomp-online$^{(R)}$ as references. Results: As a result, 90 cases of drug with interaction potential were prescribed by Micromedex$^{(R)}$ and 179 cases by Lexicomp-online$^{(R)}$ data. In case of severity, 33.3% by Micromedex$^{(R)}$ and 26.3% by Lexicomp-online$^{(R)}$ were categorized as Major and 65.6% by Micromedex$^{(R)}$ and 72.6% by Lexicomp-online$^{(R)}$ as Moderate. The number of adverse events was 92 cases which 58.7% were on skin and 19.6% on Gastro-intestinal tract. Conclusions: Considerable number of drug with interaction potential was used though each oral kinase inhibitors showed differences in extent. Hence there exists the risk of drug interaction in patients taking oral kinase inhibitors with other drugs.

Reliability and Validity Tests of Patient Classification System Based on Nursing Intensity (간호강도에 의한 환자분류도구의 신뢰도 및 타당도 검증)

  • Park, Jung-Ho;Kim, Eun-Hye
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.1
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    • pp.5-16
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    • 2007
  • Purpose: This study is to verify the validity and reliability of classified items and criteria of the patient classification system(PCS) based on Park's definition of nursing intensity. Methods: An expert group of 8 persons verified the content validity of the tools. The 1817 inpatients at a tertiary hospital in Seoul, Korea were classified into 4 groups according to two tools for verifying concurrent validity and interraters' reliability. These verifications were performed from September to October, 2004. Results: Nursing domains of the tools have been divided into 12 items: hygiene, nutrition, elimination, exercise & activity, education & counseling, emotional support, communication & consciousness, treatment & examination, medication, measurement & observation, coordination of multidisciplinary team, admission & discharge & transfer management. Content validity was verified by the content validity index(above 0.75 in all 12 areas). Interraters' reliability was no significant difference in the results of the patient classification between the two raters(A group 93.75%. B group 88.24%). Concurrent validity was also verified by the agreement of two tools(73.7%). Conclusion: These results showed that the reliability and validity of the PCS based on the nursing intensity were verified. These will use an data for nursing productivity in the future.

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Development of Patient Classification System based on Nursing Intensity in Stroke Unit (뇌졸중 전문치료실의 간호강도에 근거한 환자분류도구 개발)

  • Kim, Eunjung;Kim, Heejung;Kim, Miyoung
    • Journal of Korean Academy of Nursing Administration
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    • v.20 no.5
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    • pp.545-557
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    • 2014
  • Purpose: The purpose of this study was to develop a patient classification system based on nursing care intensity for patients with acute stroke-related symptoms and verify its validity and reliability. Methods: Data were collected between November, 2013 and February, 2014. The verification for content validity of the patient classification system was conducted by a group of seven professionals. Both interrater reliability and concurrent validity were verified at stroke units in tertiary hospitals. Results: The intensive nursing care for acute stroke patients consisted of 14 classified domains and 56 classified contents by adding 'neurological assessment and observation' and 'respiratory care': 'hygiene', 'nutrition', 'elimination', 'mobility and exercise', 'education or counselling', 'emotional support', 'communication', 'treatment and examination', 'medication', 'assessment and observation', 'neurological assessment and observation', 'respiratory care', 'coordination between departments', and 'discharge or transfer care'. Each domain was classified into four levels such as Class I, Class II, Class III, and Class IV. Conclusion: The results show that this patient classification system has satisfactory validity for content and concurrent and verified reliability and can be used to accurately estimate the demand for nursing care for patients in stroke units.

A Case Study of Implementation of Concurrent Drug Utilization Review System at a General Hospital (동시적 의약품 사용평가(cDUR) 시스템 구축 및 적용 사례 연구 : 국내 한 대학병원을 중심으로)

  • Choi, Jong Soo;Kim, Dongsoo
    • Journal of Korean Institute of Industrial Engineers
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    • v.39 no.1
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    • pp.20-29
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    • 2013
  • Medical errors such as adverse drug event, improper transfusion, wrong-site surgery, mistaken patient identity and so on commonly occur at health care practice. Information technology, like Drug Utilization Review(DUR) system which reviews, analyzes, and interprets medication data when prescribing, can play a key role in reducing such medical errors and improving patient safety. Korean Government has guided all hospitals to implement concurrent DUR(cDUR) system, which is the first case worldwide in that all healthcare providers have to use cDUR system when prescribing. This paper introduced a case study that a tertiary hospital has integrated the cDUR system into its comprehensive Hospital Information System(HIS) and analyzed the whole prescription data during a week right after adoption of cDUR system. Considering technical strength and weakness, the cDUR system was integrated into the HIS, using Broker Servers for minimizing doctors' anxiety. As the quantitative analysis of the whole prescription data, DUR conflict events, which mainly included duplicate medications and contra-indicated drug interactions for outpatients, were 2.77%. Although only 0.7% is for the contra-indicated drug interactions, it will be greatly devoted to achieve the purpose of DUR such as improving patient safety.

Post-exposure Treatment and Seroconversion to Blood-borne Viruses after Needlestick Injuries among Healthcare Personnel (의료종사자의 주사침 손상 사고 후 감염예방처치와 혈액매개바이러스 혈청양성전환)

  • Jeong, Jae Sim
    • Journal of Korean Biological Nursing Science
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    • v.16 no.1
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    • pp.26-32
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    • 2014
  • Purpose: Needlestick injuries (NSI) is the most frequent occupational hazard for healthcare personnel (HCP), and immediate report and adequate post-exposure prophylaxis (PEP) is essential in preventing occupational transmission of blood-borne pathogens. Methods: From June 2010 to October 2010, 544 NSI were reported through websites from 21 general hospitals in Korea. Among those, 499 cases of NSI were analyzed to identify the rate of follow-up treatment completion and for seroconversion. Results: 88.2% of the cases were completed with follow-up treatment, 8.8% of the NSI were not completed with follow-up treatment, and 5 cases were unavailable to trace. 4.2% cases of NSI required a hepatitis B vaccination concurrent with hepatitis B immunoglobulin. 41.1% of the cases and 31.1% of the cases needed to be tested for anti HCV and anti HIV, respectively. Prophylaxis medication for HIV was prescribed in 3 cases, and all cases completed required 1 month of medication. There was 1 case (0.2%) of seroconversion to HCV. Conclusion: The PEP completion rate was not satisfactory, and the importance of completion of PEP treatment should be emphasized through education and counseling. Also, a careful risk assessment is needed for HCP who are exposed to HCV or HIV.

A Case Report about Herbal Medicine Treatment's a Single Woman Patient with a Low Level of AMH in Progress of Oocyte Cryopreservation (난소기능저하 미혼여성의 난자동결보존 시 한약복용을 병행한 증례보고)

  • Koh, Ji-Eun;Lyou, Myung-Sook
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.2
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    • pp.119-128
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    • 2019
  • Objectives: The aim of this case is to report the effects of herbal medicine on a single woman patient with a low level of AMH (anti-$M{\ddot{u}}llerian$ Hormone) in progress of Oocyte Cryopreservation. Methods: A patient with a low level of AMH had symptom of secondary amenorrhea. For preparing oocyte cryopreservation after a long time of secondary amenorrhea, she was treated by twice a day herb medication for 10 months. And we observed the effects of treatments by improvement of symptoms and following up endometrium ultrasonography. After oocyte cryopreservation, for maintaining her menstruation, she was also treated by twice a day herb medication for two and a half months. Results: After treatments, symptom of amenorrhea was improved and the thickness of endometrium was increased as well as AMH in progress of oocyte cryopreservation. So 20 oocytes could be cryopreserved. Conclusions: This case shows that herbal medicine can be a concurrent method for a single woman patient with secondary amenorrhea in progress of oocyte cryopreservation.

Atrophic Gastritis Concurrent with Helicobacter Infection in Two Dogs

  • An, Su-Jin;Eom, Na-Young;Lee, Hee-Chun;Sur, Jung-Hyang;Park, Chul;So, Kyung-Min;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.33 no.5
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    • pp.286-289
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    • 2016
  • Two dogs (Case 1: Poodle, 4 years old, spayed female; Case 2: Bulldog, 3 years old, intact female) were referred to us for treatment of vomiting; Case 1 had a history of acute vomiting that started 1 day prior to presentation, and Case 2 had a history of chronic vomiting that started 2 years prior to presentation. The vomiting did not respond to medication in the local animal hospital. Results from abdominal ultrasound examinations showed that case 1 had gastric wall thickening, and case 2 had no remarkable findings. For both cases, we performed gastrointestinal endoscopic examinations, and several biopsy samples were obtained from different gastric areas. On the basis of the results of histopathological examinations, both dogs were diagnosed with atrophic gastritis concurrent with a Helicobacter infection. Clinical signs improved after antibiotic therapy. This case report describes the clinical, endoscopic, and histopathological findings of atrophic gastritis concurrent with a Helicobacter infection.