• Quality Improvement in Health Care
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• v.20 no.1
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• pp.28-40
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• 2014

Objectives: Prescriptions for Parkinson's can be dispensed at the outpatient pharmacy. In general, the treatment of Parkinson's disease requires a multitude of drugs, sometimes taken 4 to 6 times a day at specific times as prescribed by the medical practitioner. Said "time-specific therapy" is one of the major reasons of dispensing delay observed at the outpatient pharmacy. Because our establishment lacked a computerized system to support time-specific prescriptions, they were not recognized electronically. They had to be issued and dispensed manually, which required a greater amount of time than the automated process. To solve the problem, a new sig code was developed to handle time-specific prescriptions with a comprehensive automated dispensing system to support it. This study aims to create electronic programs and streamline the process to increase dispensing performance. And thus, ensure greater patient safety and dispensing accuracy within a shorter dispensing time and also increase employee satisfaction through a decreased workload. Methods: After identifying the problems caused by non-electronic prescriptions an automated system that allowed the issuance of time-specific prescriptions was developed. A new sig code was created that could be recognized by the Pharmacy electronic medical program, the label printer to group medications by administration times and the Automatic Tablet Counter(ATC) to count the grouped drugs accordingly. Result: With the new sig code, the practitioner became able to electronically select the times of drug administration while issuing the prescription. This 'time-specific prescription' can now be recognized by the pharmacy electronic medical program, the label printer and the ATC like any other prescription. Conclusion: The developed program started operating on September 2013. Although not all Parkinson's patients have been issued with the new electronic 'time-specific prescription', the overall dispensing process has become more streamlined and accurate. As the medical team continues to integrate the new system in their practice an additional decrease of the dispensing time is predicted. Future program upgrades and other new time-saving approaches are scheduled, which are expected to further increase the service quality of our outpatient pharmacy.

• Korean Journal of Clinical Pharmacy
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• v.25 no.1
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• pp.18-26
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• 2015

Background: The recent change in pharmaceutical education system following the paradigm shift to patient-oriented pharmacy service requires an in-depth discussion to reorganize a future direction and establish a basis for maximizing social values of community pharmacy service. Objective: This study was conducted to review the current status of community pharmacy service provision in Korea based on published literatures. Methods: The electronic databases of National Digital Science Library and Electronic National Assembly Library were used to search the journal articles and dissertation papers. A search term "community pharmacy" was used and the published period was limited to papers published after year 2001, when the legal separation of prescribing and dispensing was implemented. Relevant study reports were also searched manually. Information about pharmacy service provision and study outcomes were retrieved from the selected papers, and classified by predefined individual service scope. Results: A total 33 papers reporting services provided by community pharmacies were selected (journal article 11, dissertation paper 17, and study report 5). Pharmacy services identified in these papers could be classified into prescription dispensing service, pharmaceutical care service, self medication service, other products service, and health promotion service. Twenty papers reported prescription dispensing services, three papers reported pharmaceutical care service, and only two papers reported health promotion service. Current community pharmacy services are highly dependent on prescription drugs while expanded services such as pharmaceutical care and health promotion are peripheral. Most prevalent research topic was medication counseling service (18 papers), reflecting that community pharmacists generally consider it to be the most important and fundamental service. Overall, current pharmacy services are very limited and focus on prescription dispensing service. Conclusion: At this point of time requiring expansion and quality improvement of community pharmacy services, we suggest further lively discussion to strengthen pharmacist's functional identity and set conditions for providing socially expected services.

• Journal of Korean Neurosurgical Society
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• v.67 no.5
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• pp.560-567
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• 2024

Objective : We investigated how treating large brain metastasis (LBM) using 2-day fraction Gamma Knife radiosurgery (GKRS) affects tumor control and patient survival. A prescription dose of 10.3 Gy was applied for 2 consecutive days, with a biologically effective dose equivalent to a tumor single-fraction dose of 16.05 Gy and a brain single-fraction dose of 15.12 Gy. Methods : Between November 2017 and December 2021, 42 patients (mean age, 68.3 years; range, 50-84 years; male, 29 [69.1%]; female, 13 [30.9%]) with 44 tumors underwent 2-day fraction GKRS to treat large volume brain metastasis. The main cancer types were non-small cell lung cancer (n=16), small cell lung cancer (n=7), colorectal cancer (n=7), breast cancer (n=3), gastric cancer (n=2), and other cancers (n=7). Twenty-one patients (50.0%) had a single LBM, 19 (46.3%) had a single LBM and other metastases, and two had two (4.7%) large brain metastases. At the time of the 2-day fraction GKRS, the tumors had a mean volume of 23.1 mL (range, 12.5-67.4). On each day, radiation was administered at a dose of 10.3 Gy, mainly using a 50% isodose-line. Results : We obtained clinical and magnetic resonance imaging follow-up data for 34 patients (81%) with 35 tumors, who had undergone 2-day fraction GKRS. These patients did not experience acute or late radiation-induced complications during follow-up. The median and mean progression-free survival (PFS) periods were 188 and 194 days, respectively. The local control rates at 6, 9, and 12 months were 77%, 40%, and 34%, respectively. The prognostic factors related to PFS were prior radiotherapy (p=0.019) and lung cancer origin (p=0.041). Other factors such as tumor volumes, each isodose volumes, and peri-GKRS systemic treatment were not significantly related to PFS. The overall survival period of the 44 patients following repeat stereotactic radiosurgery (SRS) ranged from 15-878 days (median, 263±38 days; mean, 174±43 days) after the 2-day fraction GKRS. Eight patients (18.2%) were still alive. Conclusion : Considering the unsatisfactory tumor control, a higher prescription dose should be needed in this procedure as a salvage management. Moreover, in the treatment for LBM with fractionated SRS, using different isodoses and prescription doses at the treatment planning for LBMs should be important. However, this report might be a basic reference with the same fraction number and prescription dose in the treatment for LBMs with frame-based SRS.

• Journal of Society of Preventive Korean Medicine
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• v.10 no.1
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• pp.109-121
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• 2006

The purpose of this study was to determine factors influencing patient satisfaction with medical services in hospital, which is classified into environmental aspect, human services and procedural services. Based on the results of literature review, the study focused on effects of social-demographical factors on patient satisfaction. The environmental aspect of medical care services included medical equipment and facilities, hygiene, ventilation, heating and air-conditioning, waiting and resting space, ward space and parking facilities. Procedural service included registration process, bill payment, waiting time after registration, examination and prescription as well as appointment process. Human services consisted of physicians listening to stories of patients, examination duration, physicians' explanation and physicians' service. As for nurses, explanation about disease, examination procedure and results, kindness and nursing care were evaluated. Services provided by other staff members were also evaluated. Patient satisfaction, defined as individual attitude toward medical service as a whole, was measured using a questionnaire. A total of 700 in-or out-patients were surveyed in 6 hospitals with more than 300 beds in North Gyeongbuk Province. 1. The level of patient satisfaction varied with characteristics of patients. Male patients and those in their 30s had a low level of satisfaction. Dissatisfaction level was positively related to education level but negatively related to economic condition. 2. As for patient satisfaction with medical service providers and other employees in hospital, satisfaction level with physician's explanation about treatment was higher. But dissatisfaction levels with treatment duration and the lack of explanation about examination procedures were high, calling for improvement. Dissatisfaction level with nursing care was high, calling for training of nurses for better service. Given the low level of satisfaction with human services, hospital employees need to be trained to improve their service. 3. It Was found that administrative service was also a significant factor influencing patient satisfaction in addition to medical service. It is therefore important for hospitals to provide patients with prompt and convenient procedural service. 4. Environmental factors such as medical equipment and amenity facilities also affected patient satisfaction. Thus environmental condition, procedural service and human service are all important to improve medical service in hospital. In summary, procedural service was the most significant factor for patient satisfaction. The level of satisfaction in patients was also affected by human service and environmental condition. It is therefore necessary to take patient-oriented approach in providing medical service in an effort to improve patient satisfaction. The finding of a lower level of satisfaction with human service signifies the need for training of healthcare providers and other hospital employees for better services. The introduction of advanced management programs is also needed to improve procedures that patients go through in hospitals.

• Journal of Sasang Constitutional Medicine
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• v.22 no.2
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• pp.115-122
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• 2010

1. Objectives: This case study reports clinical improvement of a Soyangin benign arrhythmia patient who showed improvement of palpitation symptoms after treatment with Hyeongbangjihwang-tang. 2. Methods: The patient's subjective and objective symptoms were observed daily, and the VAS scores and duration times of palpitation were recorded daily throughout the hospitalization period. 3. Results: The general condition of the patient improved by the end of hospitalization. The VAS score dropped from 4-10 to 0-1, and the duration of palpitation dropped from 50-160 min to 0-5 min. Other symptoms such as diarrhea and lower back pain also showed improvement. 4. Conclusion: This case study shows the effectiveness of Hyeongbangjihwang-tang in the treatment of palpitation. Although the literature on Hyeongbangjihwang-tang does not report its usage on palpitation, the prescription was shown to be effective in the case where the palpitation symptom is concomitant to the general symptomatology of the Mangeum disease, a pathology indicative of Hyeongbangjihwang-tang.

• The Journal of Korean Obstetrics and Gynecology
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• v.21 no.2
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• pp.252-262
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• 2008

Purpose: This paper is aim to report that menopausal disorder can be effectively diagnosed and treated by referring to the life event stress of patient. Methods: Researchers got a grip on the life event stress of patient by using medical examinations by interview and compared the conditions of patient before and after treatment by using Kupperman's Index. The prescription of the Gamidangguisu-san hap samhap-tang( Jiaweidangguixu-san he sanhetang) and the Gamisoyo-san (Jiaweixiaoyao-san) and the acupuncture therapy and the moxibustion therapy were used for the treatment. Results: The serious musculoskeletal systemic pains, which includes back pain, lumbago, and myalgia, and other menopausal troubles were improved remarkably. Conclusion: The menopausal disorder could be caused by not only the change of hormone but also complex factors of environmental matters which includes social cultural surroundings, mentality etc. Therefore the life event stress could be one of critical factors of menopausal disorder. The diagnosis and treatment considering the life event stress could be effective method to relieve patient's menopausal disorder.

• Korean Journal of Clinical Pharmacy
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• v.29 no.3
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• pp.193-201
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• 2019

Background and Objective: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. Methods: A literature search of the following databases was performed: Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were "hospital pharmacist", "clinical pharmacist", and "Korea". Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. Results: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians' prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). Conclusion: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists' professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.

• The Journal of Korean Medicine
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• v.35 no.4
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• pp.116-122
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• 2014

Objectives: Rectal cancer bleeding occurs approximately 20% of overall rectal cancer patients. The current standard treatments cannot cover minor bleeding enough. Failures of the local or systemic approaches to stop bleeding are frequently reported. Methods: we reported a case of male rectal cancer patient who was treated with herbal decoction and significantly improved on symptoms, such as, loose stools and rectal bleeding. Previous to first visiting to our clinic, he was prescribed to use oral tranexamic acids, which failed to relieve his symptoms. He was administered with an herbal decoction, Inhyungtang, clinically known to have hemostastic effect in hematochezia. Results & Conclusion: The prescription showed significant improvement on his symptom, in particular, his bleeding. Thus, we report his case and we expect further experiences and experimental studies to support efficacy of Inhyungtang.

• Journal of the Korea Computer Industry Society
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• v.3 no.9
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• pp.1245-1250
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• 2002

This paper is an intelligence type of remote medical examination system for both on-line and off-line mode to transcend time and space on web where anyone can participate ;on-line consultation among patient, doctor, Korean medical doctor, medical examination in off-line mode, transmission of prescription to the pharmacist designated by patient and preparation of medicine, and semi-eternal storage of medical examination data by storage and check of medical examination data ; and database is composed by using intelligence type of object control which enables effect of treatment for heredity including check and mutual holding of medical examination data among family, fast treatment effect pursuant to situation of past medical examination through control of private disease history, cooperated medical examination among doctors, and so on.

• 대한상한금궤의학회지
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• v.5 no.1
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• pp.101-111
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• 2013

Objective : The purpose of this study is to find out the proper dosage of Ma-huang for clinical use of Shanghanlun(傷寒論) Methods : To achive the purpose of this study, web-databases(pubmed, naver, google) were searched with the keywords including 'dose of Ma-huang Ephedra Ephedrine','dosage of Ma-huang Ephedra Ephedrine', and 'water extract of Ma-huang Ephedra'. The searched 30 papers and articles were reviewed. Results & Conclusions : 1. Proper dosage of Ma-huang 1) Adult: up to 9-12g/day 2) Adolescent: up to 6g/day 3) Hypertension disorder patient: up to 6g/day 4) lactating women: up to 6g/day 5) child: <2 years 0.7-2.5g/day, $${\geq_-}2$$ years 2.6-6g/day (Different from body weight) Although administration of Ma-huang to hypertension disorder patient, lactating women, child is safe on the paper, It is not recommended to these people because Ma-huang is one of toxic herbs. 2. Dosage form of Ma-huang There's no safety paper about pill or powdered Ma-huang(麻黃). There's not pill or powdered prescription of Ma-hunag in Shanghanlun(傷寒論), either. So it is recommended to administrate water exetract of Ma-huang.