Kim, Jong-Min;Jeon, Hyung-Joon;Cho, Chong-Kwan;Lee, Yeon-Weol;Yoo, Hwa-Seung
The Journal of Internal Korean Medicine
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v.34
no.4
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pp.478-483
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2013
Objectives : To observe the therapeutic effects of an oriental herbal prescription in a hepatocellular carcinoma patient with splenomegaly and pancytopenia. Methods : Modified Sipjeondaebo-tang was prescribed three times a day to a hepatocellular carcinoma patient with splenomegaly and pancytopenia. Laboratory tests were carried out regularly to observe the therapeutic effects of the oriental herbal prescription for pancytopenia. Results : When treated with modified Sipjeondaebo-tang including Cinnamomi Cortex, the levels of white blood cells, red blood cells, hemoglobin, and hematocrit increased. However, aspartate transaminase, alanine transaminase, alkaline phosphatase, gamma-glutamic transpeptidase, total bilirubin, direct bilirubin levels also increased. Conclusions : Administering modified Sipjeondaebo-tang with Cinnamomi Cortex showed effect in improving pancytopenia but an increase in liver enzyme levels was also observed.
Background: Drug-related problems have the potential to threaten patient health, and pharmacists are in a position to prevent such problems through prescription reviews and patient counseling, actively engaging in pharmaceutical care activities. This study aims to categorize and analyze the intervention activities of pharmacists in community pharmacies concerning drug-related problems, following international criteria. Methods: Over a six-month period, prescription interventions completed in a community pharmacy in Seoul were selected as the research subjects. The causes of interventions were classified according to the Pharmaceutical Care Network Europe (PCNE) drug-related problems (DRPs) classification system and the types and frequencies of DRPs were identified. Results: Among a total of 49,334 prescriptions, 527 interventions were completed, constituting approximately 1.07% of the daily average filled prescriptions. Individuals over 60 years of age represented more than 50%. The primary cause of DRPs was prescribing and drug selection issues, comprising 256 cases (48.58%), with specific subcategories including 109 cases of drug selection, 79 cases of treatment duration errors, 47 cases of dose selection, and 21 cases of inappropriate dosage form selection. Patient-related issues accounted for 204 cases (38.71%). Conclusion: The study demonstrated that the pharmacists' intervention in community pharmacies contributes to the safe use of medication by patients.
Major purposes of this study were to investigate the administration patterns of analgesics and sedatives in SICU and to identify the factors influencing the use of prn analgesics and sedatives by ICU nurses. The sample of this descriptive study was 50 adult patients in SICU and 53 ICU nurses. Patient's medical records were reviewed to investigate names, doses, the routes of administration, the interval of administration, and the type of prescription of sedatives and analgesics administered. Study medications were narcotics, hypnotics, and antipsychotics. To identify the factors influencing the use of prn analgesics and sedatives, 53 ICU nurses checked 9 items, and rank them from first to fifth. The selection of items was based on the previous studies and the experience of the investigator. The results of the study are as follows: 1. The mean age of the subjects was 53 years, 24 patients out of 50 subjects had received mechanical ventilation therapy. Most of the patients received neurosurgeries and abdominal surgeries. 2. For 4 days, 13 total study medications and combination of these were administered to the patients. Commonly prescribed drugs were Ketoprofen and Midazolam. Twenty six to fourty two percent of the patients did not receive any drugs for at least one day during the four days. 3. On the average, the study drugs were administerd 1.4 to 2.6 times per day during 4 days. 4. More than 50 percent of the prescription was as-needed (prn) except those of the POD 3. Fourteen percent of the patients did not have any prescription for sedation and pain control after surgery. 5. Examination of the frequency of sedatives and analgesics bolus administration revealed that a greater number of doses were given during daytime (from 7 am. to 7 pm.) than nighttime (from 7 pm. to 7 am.). The difference was significant at Alpha, .05. 6. First factor that most influenced nurses to administer sedatives and analgesics for intubated patients was the evaluation of patient's vital signs (51%). For non- intubated patients, the factors that nurses considered important were the patients' complaints of pain (64%) and evaluations of patients' vital signs (23%). In conclusion, the results of this study indicate that patients in SICU might not receive enough analgesics and sedatives to feel completely free from pain during the post operational period. Future study should be focused on the evaluation of the adequacy of current practice for pain and anxiety control in terms of the SICU patient's response.
Background: Medication counseling is important to improve qualify of pharmaceutical care, but there are lack of studies to investigate satisfied counseling practice in community pharmacies. Purpose: This study was to investigate current medication counseling provided by community pharmacists. Method: Questionnaires to assess medication counseling practices were mailed to nationwide 1,269 community pharmacists who were Sookmyung Women's University alumni. Result: One hundred sixty five pharmacists were responded to the questionnaires (response rate 13.63%). 16.8% of them all respondents had counseling room in their pharmacies. 75% and 29.9% of respondents provided patient counseling always for new and refilled prescriptions, respectively. Counseling was provided primarily by verbal, but especially for drug name, usage and storage, it was provided in written concurrently. 31.1% of respondents was satisfied with counseling practices by themselves, and a major barrier of unsatisfied counseling was lack of time in 64.6% of respondents. Majorities of respondents (66.3% and 76.3%) spent 1-3 minutes and <1 minute, for new prescription and refilled prescription, respectively. Approximate 99% of respondents presented necessity of standardized patient counseling information for drugs and 97.6% responded that quality of patient counseling would be improved by using software containing counseling information. Old respondent group had higher accumulative patient counseling practice scores and pharmacy owner group took much time for counseling, resulting in higher scores too. Conclusion: This study showed that qualified patient counseling practice has not been reached in community pharmacies. Much more discussion to seek ways to improve the quality would be necessary.
Objectives : 28 prescriptions with the name 'Dossi' can be found in Yixuerumen, and all these prescriptions are highly useful due to their clinical effectiveness. Among them, Dossisosihotang has an important role as the essential prescription utilizing harmonizing and releasing formula. Therefore, this paper aims to ponder upon this prescription. Methods : Dossisosihotang's origin and effectiveness were studied, and the findings served as the basis for analyzing the varied forms of this prescription which came about in the later generations in order to consider more detailed usage of this prescription. Results & Conclusions : Dossisosihotang directs its patient to consume sosihotang added with chenpi, shaoyao, chuanxiong, then simmered, and added with three spoons worth of raw wormwood juice. Its origin can be traced back to shachechuifa's 'Sihossanghaeeum,' and it is mainly effective for treating the blood aspect syndrome of lesser yang disease such as women's cold damage and heat entering the blood chamber. In treating the symptom of half-exterior and half-interior, taohua developed prescriptions depending on the syndrome, such as Sihijigyungtang, Sihohamhyoungtang, Samhosambacktang, Siryungtang, Sihosamultang, Sigalhaegitang, and Samhoseoggotang. These prescriptions became widely known for their clinical efficacy, leading to many later generations of clinical doctors to use them.
Purpose: The purpose of this study was to describe role conflict and job satisfaction of Neurosurgery Clinical Nurse Specialist(NCNS) and to identify associated factors. Method: The target populations was 77 NCNSs from 30 general hospitals. Data were collected with self-administered questionnaires and analyzed using t-test and ANOVA. Results: The overall mean scores of role conflict and job satisfaction were $3.60({\pm}0.54)$ and $3.04({\pm}0.46)$ respectively. Significant variables affecting role conflict were the working period as NCNS, the number of colleague NCNSs in working hospital, and assignment of prescription rights. The significant variable affecting job satisfaction was assignment of prescription rights. There was no statistically significant correlation between job and role conflict. Conclusion: The variable effecting both role conflict and job satisfaction was the extent of prescription rights. In order to improve the quality of patient care and to protect Neurosurgery Nurse Clinical Specialist, the enactment of law on prescription practice is needed.
Objective: South Korea made a list of potentially inappropriate medications (PIMs) for elderly patients in 2015 and has prompted medical professionals to prescribe proper medication by using the drug utilization review (DUR) system. It has been three years since the system was introduced, but related studies have rarely been conducted. This study aimed to evaluate the effect of the DUR system on the prescription of PIMs for elderly patients. Methods: The data on the prescription of PIMs for elderly patients (${\geq}65$ years) who received medical treatment between March 1st and May 31st in 2015 (before introduction of the DUR system) and who received medical treatment between March 1st and May 31st in 2018 (after introduction of the DUR system) were retrospectively collected from electronic medical records. Results: The prescriptions of PIMs decreased from 3,716 (7.7%) to 3,857 (6.9%) (p < 0.001). The prescription of escitalopram and paroxetine, among selective serotonin reuptake inhibitors, increased significantly, and that of short-acting benzodiazepines also increased significantly from 454 (0.93%) to 624 (1.2%). Conclusion: Prescription of PIMs for elderly patients significantly decreased (p < 0.001) after the DUR system was introduced. Further expanded studies of PIMs need to be conducted for the safety of elderly patients.
International journal of advanced smart convergence
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v.10
no.3
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pp.66-71
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2021
Recent healthcare environments have characteristics of expanding the scope of healthcare-impacting healthcare, complexity resulting from diversification of components, and accelerating the pace of change. Drugs are used for the prevention, mitigation, and treatment of diseases, so they can inevitably cause harm, while they have efficacy and effectiveness, which are key elements of health recovery. Therefore, many countries regulate permits for safe and effective medicines, and also designate essential drugs directly related to life as pay targets and guarantee health insurance. Especially Pharmacist relying on manpower for composition medicine is liable for mal-manufacture due to combination of toxic medical substances or other chemical usage. In this paper, we focus on using Kiosk and Optical Character Recognition (OCR) for automated pharmacy to level up medical service and create labor friendly environment for pharmacist themselves through maintenance of prescription data and automated manufacturing solution. Presentation of drug substances and precautions will lead to efficient drug prescription and prevent misuse of information while auto manufacturing system efficiently maintain labor force and raise patient satisfaction level by reduction of waiting time.
Drug Utilization Review (DUR) is known to play an important role to improve appropriateness of drug prescriptions. This retrospective, observational study was conducted to compare prescription patterns after installation of Computerized DUR Program (Drug Information Framework-$Korea^{TM}$) (Jan-Mar 2008; After) to before DUR program (Jan-Mar 2007: Before). 8 physicians affiliated in the S University Hospital were enrolled in the study and their 3 months' prescription data were analysed for drug prescription trends and DUR conflict events per 7 DUR screening modules (drugdrug interaction, therapeutic duplication, allergy, dosing, disease contra-indication, geriatric contra-indication, pediatric contra-indication). Average rate of DUR modules usage in 2008 (After) were 0.72. Average number of prescription drug per patient were reduced from 5.6 (Before) to 3.8 (After), and DUR program seemed to effect positively on physician's prescription related decision process. Overall DUR conflict events occurred by 8 physicians for 3 months were 17,923 Before and 20,057 After DUR program, and DUR conflict events per prescription were 2.8 Before and 2.9 After, respectively. Therapeutic duplication (37%), geriatric contra-indication (34%) and dosing (18%) were high ranked DUR conflicts. As the study was not sufficient to show a consistent trend to reduce DUR conflicts After, another study to confirm it's effectiveness would be recommended. This study would be of help to develop awareness of DUR program to healthcare providers.
Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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2018.05a
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pp.690-692
/
2018
Recently, university hospitals have problems as patient datas grows. And it is difficult that medical staffs check patients living on their prescription. Patients don't often remember their prescription, and don't know how to apply the prescription to their life. To solve these problems, To solve these problems, it is customized healthcare service platform using MQTT push notification. It is provided in form of a web application having good accessibility that. Based on doctor's prescription, the patients take notifications that is the timing of medication, medical appointments, and other prescription informations. The results can be entered into the web application. The healthcare professionals can check that the patients are following their prescription well. In this paper, we provide the above functions via the web application and a RESTful API server platform, and notification function can be efficiently performed by MQTT Broker. So we checked the customized healthcare service can be effectively provide.
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