• Title/Summary/Keyword: Patient Prescription

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Physicians and Pharmacists' Perceptions about the Goal Achievement of the Separation Policy of Drug Prescribing and Dispensing, and Benefit and Loss Caused by the Policy in Busan (부산시 개원 의사와 개국 약사의 의약분업 정책목적 달성도와 손익에 대한 인식도)

  • 박재성;남은우;권영철
    • Health Policy and Management
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    • v.11 no.4
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    • pp.70-87
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    • 2001
  • The purpose of this study was to identify health care providers' perceptions about the goal achievement and benefit/loss caused by the separation policy of drug prescribing and dispensing after the policy implemented on July 1, 2001. Uslng stratified sampling method based on the administration area, Ku, 315 physicians and pharmacists were sampled from the rosters of physician and pharmacist association in the city of Busan on 2001. There were 122 and 115 responses from physician and pharmacist sample, respectively. 78.3% of physicians and 50.4% of pharmacists evaluated that the goal of the policy was not achieved. Moreover, 75.3% of physicians and 40.7% of pharmacists did not support the policy. Most physicians and pharmacists considered preventing the citizens with drug abuse and misuses as the most important benefit derived from the policy. However, physicians and pharmacists concerned over raising health care cost that could be patients' burden. The most important physicians' benefit derived from the policy was free choice of all possible medicine that might result in effectiveness of medication. In physicians' the most important loss, most physicians worried about that breaking traditional patient and physician relationship might cause physicians' authority in treating diseases to be damaged. Pharmacists considered the most important policy benefit as hiked social status resulted from enforcement of profession due to the policy whereas they considered the most significant loss as expected financial problems of small pharmacies compared to that of large pharmacies or pharmacies adjacent to hospitals. In the current problems of the policy, physician and pharmacists blamed the government for inadequate preparations of the policy implementation. Physicians and pharmacists also considered citizens' mature attitudes toward the policy as a crucial success factor.

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A Case of Self-prescribed Licorice-induced Hypokalemic Paralysis (자가 처방 감초 다량 복용 후 발생한 저칼륨성 하지마비 1례)

  • Kwon, Seung-Won;Jeong, Hwan-Yong;Yoon, Seung-Kyou;Seo, Yu-Ri;Park, Joon-Young;Im, Jin-Wook;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk
    • The Journal of Korean Medicine
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    • v.32 no.5
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    • pp.134-138
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    • 2011
  • Glycyrrhetinic acid, which is a component of licorice, can cause hypermineralocorticoidism through the inhibition of $11{\beta}$-hydroxysteroid dehydrogenase. So, a high dose intake of licorice can lead to hypermineralocorticoidism with potassium loss and depression of the renin-angiotensin-aldosterone system. We report a 73-year-old man with muscle weakness of proximal lower limbs with hypokalemia (Serum $K^+$: 1.4 mEq/L) due to taking self-prescribed licorice without OMD's diagnosis. He boiled 60~100g licorice / day in water and drank it intermittently for 1 month due to arthralgia and swelling of both his knees. Patient's serum renin activity and aldosterone level were far beyond the normal range. He also had metabolic alkalosis with pH 7.552. After quitting the licorice, hypokalemia and muscle weakness of proximal lower limbs gradually improved within 1week.

A Case Report on Pressure Ulcer Patient Treated with Fractional Laser Therapy and Korean Medicine (프락셔널 레이저 치료와 한의치료를 병행한 욕창치료 1례)

  • Kang, Ja-Yeon;Lee, Gi-Hyang;Jang, In-Soo;Kim, Hong-Jun;Jeong, Min-Jeong;Seo, Hyung-Sik
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.31 no.4
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    • pp.126-135
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    • 2018
  • Objectives : The purpose of this report to represent the efficacy of pressure ulcer treatment with fractional laser therapy and Korean medicine. Methods : We treated Parkinsonism patients with pressure ulcer using herbal medicine, fractional mode laser therapy, acupuncture and simple dressing for 3 weeks. Laser was set on fractional mode (on time $100{\mu}s$, dot pitch 0.6 mm, shape RECT) and irradiated around pressure ulcer site and center of pressure ulcer site once a day. The treatment effect was evaluated by The National Pressure Ulcer Advisory Panel(NPUAP) stage and the The Pressure Ulcer Scale for Healing(PUSH) tool(3.0). Results & Conclusions : Pressure ulcer site have improved markedly. NPUAP stage was improved from 2 to 1 and total score of the PUSH tool decreased from 12 to 8. Even though the wound was not cured completely, this shows that fractional laser therapy and Korean medicine could be effective treatment for improving pressure ulcers.

Smart Phone based Personalized Menu Management System for Diabetes Patient (스마트 폰 기반의 당뇨병 환자를 위한 개인 맞춤형 식단 관리 시스템)

  • Lee, Young-Ho;Kim, Jong-Hun;Kim, Jae-Kwon;Min, Kyong-Pil;Jung, Eun-Young;Park, Dong-Kyun
    • The Journal of the Korea Contents Association
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    • v.10 no.12
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    • pp.1-9
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    • 2010
  • Diabetes is a type of metabolic disease presented by high blood sugar and that leads to significantly decrease the quality of life causing various symptoms. It is essential to manage a systematic menu for preventing such diabetes even though there are some ways for it including diet, physical exercise, medicinal prescription, and so on. This study proposes a smart phone based personalized menu management system for achieving the systematic diabetes management. At the present time almost menu systems for diabetes patients are subjectively prescribed by dietitians or doctors and that does not reflect current situations and personal preferences. The system proposed in this study provides the menu for diabetes patients according to season, weather, time, and personal preferences. In particular, the recipe and personalized menu for patients can be provided without limiting any time and location based on smart phone services, and its menu can easily be changed or selected by the phone.

Influence of the Concomitant Use of Clopidogrel and Proton Pump Inhibitors on Adverse Cardiovascular Events in Korean Patients with Acute Coronary Syndrome (Clopidogrel에 Proton Pump Inhibitors 병용 시 급성 관동맥 증후군 환자의 심장관련 부작용에 미치는 영향)

  • Kim, Su Hyun;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.2
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    • pp.106-114
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    • 2014
  • Purpose: Recent investigations suggest that the antiplatelet effect of clopidogrel may be decreased when this medication is taken together with certain proton pump inhibitors (PPIs). However, there has been no study conducted in Korea regarding the clinical effect of clopidogrel-PPI interaction. This study targeted patients who received stents to investigate the effect of the concomitant use of clopidogrel and PPIs on the occurrence of adverse cardiovascular events in Korean patients. Methods: The patients who received a stent insertion at the Yeouido St. Mary's Hospital between January 2010 and April 2011 were included. The patients were divided into two groups, clopidogrel and clopidogrel + PPI, and followed for 12 months after the date of stent insertion using prescription history and medical records. The recurrence rates of the cardiovascular events among the two patient groups were statistically analyzed. Results: There was no difference between the two groups in the basic characteristics of the 157 patients in the clopidogrel group and the 62 patients in the clopidogrel+PPI group. Simple logistic regression showed a significantly higher rate of re-hospitalization in the clopidogrel+PPI group (OR=1.893, 95% CI 1.040-3.445, p=0.037). However, the results of the multivariate logistic regression of the variables found to have statistical significance by crosstabulation showed no significant difference in the rate of adverse cardiovascular events or re-hospitalization between the two groups. Conclusions: There was no significant difference between the clopidogrel and clopidogrel+PPI group among new patients with cardiovascular stents with respect to the occurrence of revascularization procedures, stent thrombosis, or chest pain, or with respect to the re-hospitalization rate for all cardiovascular events.

The Analysis of Item Management on Foreign Pharmacists Examination (외국 약사 국가시험 문항관리 분석연구)

  • Kwon, Kyenghee;Lim, Sung Cil;Sohn, Uy Dong
    • YAKHAK HOEJI
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    • v.59 no.5
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    • pp.235-244
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    • 2015
  • The goal of this study is to help for the utilization the national pharmacists test through the analysis of item development management to the foreign pharmacists examination. The United States is going to NABP (National Association of Boards of Pharmacy) initiative under the curriculum in question on the basis of this assessment and develop standards and unified, systematic system to conduct tests pharmacist. Practice oriented (patient scenario, the participation of a pharmacist or perform work, clinical practice) examination is doing in Canada, The UK is asking the for more than 70 percent and the prescription needed for actual calculation in practice prior to testing program, and by the including that allows references use. Our country may introduce the job as a clinical pharmacist, positively. Item management system is integrated into four regions based on the six-year curriculum should be done in harmony proportion of each region. Integration of fusion of each region in accordance with the duties should be come out. It has gradually been able to item management system developed by the United States or Canada. This item notice pharmacist judging the results of the work must be carried out for management upgrading to a form of management with an emphasis on clinical practice in developed countries. Foundation design, development, production and management and test after actively reviewing ways to improve management system for to management systems, a pharmacist to improve the quality of the national examination could be contributing are involved.

Clinical Analysis of Facial Nerve Paralysis Patients Improved by Sasang Constitutional Medical Treat : A Retrospective Cross-Sectional Study (한방병원을 내원한 말초성 안면신경마비 환자의 사상의학적 임상 치료 : 후향적 단면연구)

  • Kang, Seok-Hwan;Jeon, Soo-Hyung;Jeong, Jong-Hun;Na, Young-Ju;Seo, Yeon-Ju;Kim, Jong-Won
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.1
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    • pp.138-148
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    • 2015
  • Objectives This study was conducted in order to analyze the distribution of Sasang constitution, herbmed, exterior-interior disease and concomitant symptoms of 36 facial nerve paralysis patients. Methods A clinical study was done on 36 patients, treated as facial nerve paralysis. Sasang constitution specialist diagnosed their constitution and gave prescription. Degree of improvement was evaluated by assessment scale or change of patient's complaint. Results 1) Distribution of sasang constituion : Taeeumin 21 patients, Soyangin 8 patients, Soeumin 7 patients. 2) Distribution of exterior-interior disease : Taeeumin and Soeumin were diagnosed as interior disease more than exterior disease, Soyangin was reverse. 3) Hyeongbangdojeok-san and Hyeongbangjihwang-tang (Soyangin), Galgeunhaegi-tang(Taeeumin) and Gwakhyangjeonggi-san(Soeumin) were used the most in each sasang constitution. 4) Seventeen patients had concomitant symptoms : digestive disorder, sleep disorder, tinnitus, hypertension, diplopia, itching, gout, neck-shoulder pain, constipation and dizziness. Conclusions Patients had different Sasang constitution and in the same Sasang constitution, they had different symptomatology.

Drug Use Evaluation of the Elderly Patient with Major Depressive Disorder (Major Depressive Disorder 질환성 노인 환자들의 치료제 평가)

  • Lim, Ok-Jeong;Lee, Ok Sang;Yun, Hye-Sul;Choe, Kevin Kyungsik;Lim, Sung Cil
    • YAKHAK HOEJI
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    • v.57 no.2
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    • pp.101-109
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    • 2013
  • Depressive disorders are the most common psychiatric problem in the elderly. Most depression treatment guidelines emphasize treatment with antidepressant medication and recommend that benzodiazepine use be minimized for limited period, particularly to elderly patients. In order to evaluate appropriate use of antidepressants and benzodiazepine, retrospective review of prescriptions was performed. The study population are older than 65 years who had been newly diagnosed with major depressive disorder in specialty mental health at a community general hospital from January $1^{st}$, 2007 to October $31^{th}$, 2012 (N=373). Initial antidepressant accounted for 89.5% with SSRI, and escitalopram accounted for 60.9% of SSRI group. 79% or more of the patients were prescribed the recommended dosage. The maintenance rate for 4 weeks of initial antidepressant was 48% and 6 weeks was 39%. Treatment-discontinuation rate was 68% at 3 month. Alprazolam (short acting benzodiazepine) was prescribed the most, followed by clonazepam (long acting benzodiazepine) and then diazepam. 55% of patients received a duplicated prescription for short acting plus long acting benzodiazepine. 61% of patients used long acting benzodiazepines. Prescribed dosages of benzodiazepines were commonly within a recommended range, while no one was prescribed a appropriate period (up to 2 weeks) except for the early discontinued patients. Appropriate use of zolpidem was only 16.2%. The depressed elderly treated in specialty mental health mostly received long-term treatment with benzodiazepines in combination with antidepressants, guideline recommendations was not followed. Multidisciplinary interventions like audit and feedback of benzodiazepine use are needed and education for the elderly is needed to properly maintain antidepressant treatment.

A Study on Knowledge and Attitude of Housewives toward Health Care and Antibiotics in a Rural Area (농촌주부(農村主婦)들의 의료(醫療)와 항생제(抗生劑)에 대(對)한 지식(知識)과 태도(態度)에 관(關)한 조사(調査))

  • Kim, Soon-Ki
    • Journal of Preventive Medicine and Public Health
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    • v.9 no.1
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    • pp.147-151
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    • 1976
  • A study was conducted during the period of August 13 to August 18, 1974 to obtain information on knowledge and attitude of the rural area housewife toward health care and antibiotics using. Interviewed 242 housewives dwelling in Soodong and Hwado Myun, Yangju Gun, Kyunggi Do, a typical rural area in Korea and the following results are obtained: 1. Of 242 housewives interviewed, 20.2% were illiteracy, 68.2% was graduated from primary school, 9.1% from middle school and 2.5% from high school. 2. Of those interviewed, 8.7% were Christian, 5.0% Bueldist, 2.9% Confucianism, and 83.4% of those were no religious preference. 3. Utility rate according with the kind of mass media in home was 85.1% of respondants possessed radio, 16.1% of magazine, 12.8% of newspaper, and 4.1% of television. 4. In the case of patients occure in a family, 13.0% out of 242 respondants had chosen physician's clinics for inicial medical care place, 58.4% drug stores, 0.9% herb medicine and 27.7% of those had chosen folk medicine at home. 5. Antibiotics effective complaints listed by the respondants were skin diseases with 43.8%, suppurated wound 30.0%, URI like symptoms 18.2%, diarrhea 14.5%, low back pain 12.9%, fever 6.2%, loss of appetite 3.3%, all kind of diseases 2.5%, urethral discharge 2.1% and tuberculosis 0.8% respectively. 6. Only 14.7% of respondants had obtained antibiotics for medical care from physician's clinics and 85.3% of the respondants had obtained antibioties from drug store (70.7%), village shop (10.4%), and salesmen in street market without any physician's prescription. 7. Eighty-nine percent of the respondants were understanding on patient care activity as the local health subcenter but only 11.0% of those on M.C.H., 29.0% of those on family planning, 21% on vaccination, and only 6.6% on tuberculosis control activity. 8. Utility rate of the local health subcenter was 71.9% out of the patients indicated medical care of medical facilities.

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Study of the Drugs Prescribed on Alzheimer's Disease: from the Insurance Claims Data of Korea National Health Insurance Service (우리나라 건강보험 청구자료를 이용한 알츠하이머성 치매 치료제의 사용현황 분석)

  • Kim, Jungeun;Lee, Jonghyuk;Jeong, Ji Hoon;Kang, Minku;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.4
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    • pp.255-264
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    • 2014
  • Objective: The aims of this study are to investigate the total volume of prescribed medicines against Alzheimer's disease (AD) and the trends of usage by analyzing the claims-data from the Korea National Health Insurance Service. Method: The demographic and claims-data were included the major AD treating medicines such as donepezil, galantamine, rivastigmine and memantine, and analyzed during the period of 2010~2012. The assessing criteria were gender, age, habitation, types of medical institution, code of ingredients, outcomes of treatment, volume and amount of claims, and the numbers of patients with dementias. After trimming the data, it were analyzed by the market size, demographic traits, characteristics of medical service, characteristics of each anti-AD medicine, etc. Results: Among the chosen 4 medicines, donepezil had the top prescription volumes. Most prevalent prescribing preparations of donepezil were conventional types. However, among the non-conventional types, oro-dispersible formulation is the fast increasing one in both volume and growth rate. This specialized preparations to improve both toleration and adherence, tend to being prescribed generally at the tertiary medical institutions. While the younger patients with mild-to-moderate AD mostly treated by expensive medicines in resident at the tertiary hospitals, the rest older patients with severe AD have been treated non-expensive one at long-term care facilities. Conclusion: AD is a chronic illness therefore, long-term use of therapeutic medications are highly important. If an anti-AD treatment was applied steadily in the earlier stages, it would be achieved not only improving the quality of life of patient but also reducing the expenses in the medical and nursing cares. As the socioeconomical impacts of AD is expanding, healthcare professionals need to aware the importance of pharmacotherapy and to improve sociopolitical fundamentals.