• 한국임상약학회지
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• 제25권1호
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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.

• 한국의사학회지
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• 제26권2호
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• pp.175-185
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• 2013

Purpose : The current Medical Law and the Pharmaceutical Affairs Act, which are incapable of utilizing the research results and the advanced academic, clinical, and pharmaceutical system of the present-day Korean (Oriental) medicine, have limitations and create a paradox by provoking social conflict among the professionals in the field. The aim of this study was to find out the legal and systematic problems that contributed to a complicated conflict amongst Korean (Oriental) medicine doctors, doctors, pharmacists, and Korean (Oriental) pharmacists regarding the classification of their functions. Methods : We reviewed the history and characteristics of the legislation regarding the duties of Korean (Oriental) medicine doctors and Korean (Oriental) pharmacists as well as the relevant and important public health policies since the enactment of the National Medical Services Law in 1951. We focused on the laws and regulations that are made in the process of the separating functions of physicians and pharmacists and the dispute between the Korean (Oriental) medicine doctors and the Korean (Oriental) pharmacists in the 1990s and 2000s. Results : The legislations and amendments of the medical and pharmaceutical laws and regulations that reflect the modern academic, clinical, and pharmaceutical system of the Korean (Oriental) medicine and the research results could be summarized as follows: 1) A partial amendment of the Medical Law in 1987, which added the provision of "Oriental health guidance" as one of the duties of Korean (Oriental) medicine doctors, assured a place for Korean (Oriental) medicine doctors in the field of public health. 2) A partial revision of Pharmaceutical Affairs Act in 1994 established a new system for Korean (Oriental) pharmacists, bringing about the creation of dualistic pharmaceutical system that complements the dualistic medical system. 3) The Promotion of the Research and Development of Wonder Drugs by Using Natural Substances Act was legislated in 2000 in order to stimulate research and development of Korean (Oriental) medicine and its industrialization. 4) Oriental Medicine Promotion Act in 2003 was enacted to lay foundation to specify and promote technology and industry that are related to Korean (Oriental) medicine. Discussions and conclusions : Although the dualistic medical and pharmaceutical system is set up by the Medical Law and Pharmaceutical Affairs Act, it is shown that the relevant regulations have been developed from a perspective of the western medicine.

• 한국의사학회지
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• 제29권2호
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• pp.35-47
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• 2016

"JeSeBoGam (濟世寶鑑)" was a medical document authored by Moon Gi-hong during the Japanese colonial rule in 1933, and the author acted as a Korean medicine doctor, an acupuncturist, a medicine practitioner and an apothecary. Since its first publication in 1933, it has been published three times in 1966 and 1975, from the Japanese colonial period to the liberation period. "JeSeBoGam" is largely divided into Preface part, "List of drugs according to symptoms [隨症用藥目錄]", "JeSeBoGam-Gap (濟世寶鑑甲)", and the Appendix includes "Key points for diagnosing the disease [察病要訣]" "Key points of acupuncture and pulse [脈訣]" "Key points of acupuncture and moxibustion treatment [針灸訣]" in the back of the book. In 1933, there are attached exam books and license application forms related to Korean medicine doctor and pharmacist, so strict regulations on them during the Japanese occupation period can be confirmed. "JeSeBoGam-Gap" contains 208 prescriptions from 143 prescriptions taken from "BangYakHapPyeon" and 65 prescriptions from other books. It divided into Gap (甲) Eul (乙) Byung (丙) Jung (丁). These prescriptions were placed in "List of drugs according to symptoms [隨症用藥目錄]" according to a symptom 1,286 times. Considerable parts of organization and prescription drug composition of "JeSeBoGam" are closely related with "BangYakHapPyeon", but there were adjustments in all medicinal ingredients and capacity for the rest of them except 23 prescription drugs. Compared to "BangYakHapPyeon", there was a tendency to substitute the basic prescription in "JeSeBoGam" for prescriptions used for the same disease. Though only 65 prescriptions were taken from books other than "BangYakHapPyeon", 575 times were reflected in "List of drugs according to symptoms [隨症用藥目錄]", and the rate of utilization is high compared with the number of prescriptions of "BangYakHapPyeon". It is thought that the circumstances of the Japanese occupation period, limits in medicinal ingredients composition due to regional characteristics, and changes in a patient's condition and the treatment method might have an influence on the author's drug use tendency. "JeSeBoGam" is similar to "BangYakHapPyeon" in composition, but it is a new practical medical book in which the author's clinical records are concentrated.

• Journal of Chest Surgery
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• 제38권11호
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• pp.746-760
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• 2005

배경: 인공심장판막 시술 후에 환자들은 혈전색전증의 위험성을 감소시키기 위해서 평생 warfarin투여를 받게 된다 한국인 환자에서 목표 INR 2.0-3.0을 유지하는 것은 여러 가지 이유로 어려움이 따른다. 이 연구의 목적은 약사에 의해서 운영되는 anticoagulation service (ACS)을 받는 한국 인공심장판막 외래환자에서 치료 범위를 벗어난 INR의 원인을 분석하고 warfarin치료에의 복약불이행과 관련된 요인들을 확인하고자 하였다. 대상 및 방법: 1997년 3월에서 2000년 9월까지 서울대학교병원에서 ACS를 방문한 모든 환자의 의무기록을 후향적으로 검토하였다. 수술 후 6개월이 경과된 화자로 INR 2.0 미만과 INR 3.0초과가 한 번 이상 있는 환자 866명(5,304회 방문)을 대상으로 치료 범위를 벗어난 INR의 가능한 모든 원인들을 환자 방문 때마다 분석하였다 성별, 연령, ACS 상담을 받은 기간 및 warfarin 치료 기간과 복약불이행과의 상관성은 단변수 분석으로 확인하였다. 걸과· 비치료범위의 INR의 원인은 다음과 같았다: 부적절한 용량 조절$(21\%)$, 복약불이행$(13\%)$, 약물-약물/한약 상호작용$(12\%)$, 식이의 변화$(7\%)$, 확인불가$(42\%)$. 낮은 연령, 짧은 ACS 상담 기간, 장기간의 warfarin 치료가 복약불이행과 관련이 있었다 결론: 이 연구에서 복약불이행, 약물과 식이의 상호작용이 비치료범위의 INR의 중요한 요인임이 확인되었다. 낮은 연령과 장기간의 warfarin치료 기간이 복약불이행과 상관이 있었던 반면 ACS 등록된 기간이 길수록 warf arin에 대한 치료 순응도가 높아졌다.

• 동아시아식생활학회지
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• 제15권5
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• pp.516-523
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• 2005

This study was performed to investigate dietary behaviors and consumption of health food in cancer patients. The subjects were 163 cancer patients recruited from the general hospital in Seoul, Korea. The data were obtained by the structured self administered questionnaire. The mean age of subjects was 51 years. Most of subjects didn't eat the visual fat of meat and chicken skin. The mealtime of the subjects was generally regular and most of subjects had breakfast. The subjects of this survey liked to eat foods with sweet taste but disliked to eat hot, salty and sour taste ones. The preference for fish, marine products and vegetables was high but that for instant foods and frying foods was very low. Most of subjects consumed the foods that is generally known as anticancer foods such as vegetables and fruits. On the other hand, most of subjects didn't intake butter, margarine, and frying foods that is known as risk factors of cancer. The majority of subjects$(84.7\%)$ consumed the health food The main reasons for taking health foods by subjects were to cure disease$(58.0\%)$, to prevent disease$(45.3\%)$, to supply nutrients$(39.3\%)$, to maintain the mental state$(12.7\%)$ and to recover fatigue$(10.7\%)$. Majority of subjects$(66.0\%)$ spent money more than 200,000 won/month to buy health foods. The purchasing channels of health foods by subjects were recommendation by family or friend$(64.0\%)$, by physician/pharmacist$(18.0\%)$ and by nutritionist or dietician(6.0), and advertisement through TV or radio$(12.0\%)$. The types of taking health foods of the subjects were vegetable extracted food$(60.0\%)$, mushrooms$(51.3\%)$, Lactobacillus food$(25.3\%)$, enzyme food$(22.6\%)$ calcium containing food$(20.0\%)$ and so on. The results of the current study show that although many cancer patients already practice healthy dietary behaviors, there is a substantial proportion who do not and most of cancer patients consume health foods.' Further intervention is needed to explore the effect of health foods in cancer patients

• Journal of Preventive Medicine and Public Health
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• 제33권4호
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• pp.436-448
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• 2000

Objectives : To identify the factors affecting users' satisfaction with the Order Communicating System(OCS) and to highlight the factors important for the successful establishment of OCS. Methods : A Users Satisfaction survey was sent to 4,513 people, consisting of 1,503 doctors, 2,379 nurses, 255 pharmacists and 370 administrative workers in 16 hospitals which had introduced OCS. The response rate was 63.9%. Measurement of users' satisfaction was peformed with the instrument which was used in Doll's study. Some aspects of Doll's instrument were adjusted according to the aims of this study. The classifying sections of this survey included age, job and status classification, computer experience, OCS education, duration of daily OCS use, type of order entering, number of personnel in the Hospital Information System's department, cost of OCS, problem frequency, proportion of work managed by hand, OCS type, and Hospital establishment type. Results : There was a positive correlation between satisfaction level and managerial status throughout all job classifications. Irrespective of the importance of OCS education as a factor relating to users' satisfaction, the additional work load caused by OCS lowered users' satisfaction. Different factors affected users' satisfaction according to job and status classification. The composition of factors affecting the pharmacist and administrative worker satisfaction levels was simpler than that of the doctor and nurse levels. There were no statistically significant differences between the actual computer experience duration of daily OCS use and users' satisfaction with OCS. Conclusions : There was an understandable relationship between users' attitude to OCS and factors affecting users' satisfaction. The results of this study could be used as a basis for the successful expansion of the operation of OCS. But more detailed studies on users' satisfaction and further improvements of methodologies are required for the successful establishment of OCS.

• 한국학교ㆍ지역보건교육학회지
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• 제4권
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• pp.97-115
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• 2003

Middle and high school girl students' menstruation characteristics, appearance of menstruation dysmenorrhea, and coping with the menstruation dysmenorrhea were examined in order to give information in instructing girl students about menstruation dysmenorrhea, in delivering health education in the school, and establishing health policy. 970 girl students in middle and high schools in Cheju-do were selected and surveyed using the questionnaire the author developed based on the previous studies. The findings are as follows. First, the age of first menstruation was average $12.9{\pm}1.22$ years. The younger they were, the earlier their first menstruation came. The most common menstrual cycle was such one that continuously irregular from the beginning or that regular and irregular cycle run together. The first irregular menstrual cycle changed regular one within 1 or 2 years. Most of the respondents had normal menstrual cycle of $21{\sim}35$ days and menstruation period of $3{\sim}8$ days. Second, symptom of menstruation dysmenorrhea was orderly; hurt in the underbelly, tired, hurt in the waist, and headache. It was higher with high school students than middle school students. For the most part, time of heavy menstruation dysmenorrhea was the 2nd day after menstruation starts and period of menstruation dysmenorrhea was 2 days. More than the half of the respondents felt that the present menstruation dysmenorrhea was similar with the first one and they felt not comport in daily life due to menstruation dysmenorrhea, and 'hard to live a normal life' was higher with the high school girl students than with the middle school students. Third, how to cope with menstruation dysmenorrhea was enough sleep, relax and rest, taking a hot water shower, listening to music or watching a movie, taking medicine, and doing excercise. Few of the respondents have ever visited a doctor due to menstruation dysmenorrhea, and the reason was mostly irregular menstruation and heavy dysmenorrhea. Forth, when they took medicine due to menstruation dysmenorrhea, they gathered information on the medicine from family members and friends, while extremely low from a pharmacist or a doctor. The most of them have ever took medicine during menstruation once and took standard dose. While excess dosage was higher with high school students than with middle school students. From these findings, a good many girls are experiencing menstruation dysmenorrhea since their first menstruation. To discover early the severely abnormal findings and to treat, more interest from home and school, counseling and sexual education on time, and expert's diagnosis are necessary. Rather than unconditionally taking pain-relievers which can plainly solve the pain, continuous health education at home and in the school should be carried on for the girls to practice proper measures one think effective or an expert recommends.

• 의료법학
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• 제21권3호
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• pp.77-116
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• 2020

현대 과학의 경험과 성과가 반영된 의약품의 사용으로 인류에게 질병의 치료와 건강 상태의 개선이라는 혜택이 주어지고 있다. 그러나 의약품은 질병의 치료라는 혜택 이외에도 본질적으로 피할 수 없는 부작용도 내포한다. 각국은 부작용으로 인한 피해의 최소화를 위해 시장진입 규제나 시판후조사 등의 조치를 취하고 있으나, 부작용의 발생은 피할 수 없다. 부작용으로 인한 손해의 발생이 불가항력이라도 그 점이 사전에 알려진 것이었다면, 의약품의 종류와 사용 형태에 따라서 처방한 의사나 복약지도를 담당하는 약사 등이 손해를 배상해야 한다. 의약품에 결함이 있어 손해가 발생하는 경우도 있는데, 손해 배상의 일반원칙을 그대로 적용해서는 결함으로 인한 부작용 피해자가 손해를 배상받기 쉽지 않다. 우리나라를 비롯한 여러 나라가 제조물 책임법을 통하여 피해자의 보호를 도모하고 있으며, 의약품도 제조물에 포섭되기 때문에 제조물 책임법을 통한 손해배상을 문의할 수 있는데, 이 때 주로 설계상의 결함이나 표시상의 결함이 문제될 수 있다. 제조물 책임법이 제정·시행되기 이전에도 의약품의 부작용으로 인한 손해는 발생하여왔다. 이러한 경우를 위해서 판례는 제조물 책임법과 유사한 법리를 발전시켜 왔고, 의약품 결함은 혈액제제와 관련하여 판례가 형성되어 왔다. 제조물 책임법 시행 이전에 제조된 의약품으로 인한 손해는 향후에도 발생할 수 있기에 판례 법리는 중요한 검토의 대상이다.

• 한국임상약학회지
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• 제29권2호
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• pp.125-132
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• 2019

Objective: To examine the perceptions and attitudes toward spontaneous adverse drug reaction (ADR) reporting system among community pharmacists and identify factors that influence reporting, by implementing a survey. Methods: A structured questionnaire was developed and distributed online. Request for the survey was posted on the website of pharmacy's billing program, and the survey was conducted for 8 days. We collected the participants' response on their work environment, experience of ADR reporting, and their perception and attitude on the reporting system. Multivariate logistic regression was used to evaluate factors influencing ADR reporting. Results: A total of 382 pharmacists participated in the survey. Significant contributing factors for reporting level were age (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.84-0.96), knowledge of reporting method (OR, 53.56; 95% CI, 9.10-315.41), installation of reporting program (OR, 31.92; 95% CI, 4.16-244.75), and encouragement from the Korean pharmaceutical association (OR, 4.13; 95% CI, 1.11-15.35). Regarding the attitude toward spontaneous ADR reporting system, 'lack of time for reporting' (OR, 0.29; 95% CI, 0.15-0.53) and 'complexity of reporting procedure' (OR, 0.51; 95% CI, 0.31-0.84), were associated with a low likelihood of reporting. Conclusion: Our results indicated that the knowledge of ADR reporting method, installation of the reporting program, and encouragement from the Korean Pharmaceutical Association contribute to active reporting. It is necessary to simplify the reporting method, make the ADR reporting program user-friendly, and provide educational interventions to increase participation in spontaneous reporting by the community pharmacists.

• 한국임상약학회지
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• 제32권2호
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• pp.116-124
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• 2022

Background: High-alert medications (HAMs) are medications that bear a heightened risk of causing significant patient harm if used in error. To facilitate safe use of HAMs, identifying specific HAM lists for clinical setting is necessary. We aimed to develop the national level HAM list for acute care setting. Methods: We used three-step process. First, we compiled the pre-existing lists referring HAMs. Second, we analyzed medication related incidents reported from national patient safety incident report data and adverse events indicating medication errors from the Korea Adverse Event Reporting System (KAERS). We also surveyed the assistant staffs to support patient safety tasks and pharmacist in charge of medication safety in acute care hospital. From findings from analysis and survey results we created additional candidate list of HAMs. Third, we derived the final list for HAMs in acute care settings through expert panel surveys. Results: From pre-existing HAM list, preliminary list consisting of 42 medication class/ingredients was derived. Eight assistant staff to support patient safety tasks and 39 pharmacists in charge of medication safety responded to the survey. Additional 44 medication were listed from national patient safety incident report data, KAERS data and common medications involved in prescribing errors and dispensing errors from survey data. A list of mandatory and optional HAMs consisting of 10 and 6 medication classes, respectively, was developed by consensus of the expert group. Conclusion: We developed national level HAM list for Korean acute care setting from pre-existing lists, analyzing medication error data, survey and expert panel consensus.