• Korean Journal of Clinical Pharmacy
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• v.20 no.3
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• pp.262-267
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• 2010

Therapeutic duplication of prescriptions is the most frequently reported inappropriate drug use in Korea. To prevent significant problems during drug prescribing and dispensing, prospectively, development of standard including drug lists considered as therapeutic duplications for the prioritized drug classes first would be necessary. This study was aimed to analyze frequent drug classes of therapeutic duplications by healthcare providers in clinical practice settings. National health claims data for drug review and reimbursement (1,426,065 prescriptions dated March 19, 2008) were analyzed. Therapeutic duplication was defined as the prescription including more than 2 ingredients belonging to the same KFDA drug classification numbers that considered to have therapeutic similarities. The following 3 drug classes were mostly frequent therapeutic duplication classes: 114 anti-pyretics, analgesics and anti-inflammatory drugs; 117 drugs for psycho-nervous system; 141 Antihistamines. About 3.5% of overall prescriptions analyzed showed therapeutic duplications. This result might be starting step to develop DUR therapeutic duplication standard.

• Korean Journal of Clinical Pharmacy
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• v.22 no.1
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• pp.73-80
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• 2012

This study was to determine the inappropriate drug use in pediatric outpatients who received 2 or more prescriptions on the same day. Retrospective drug utilization reviews (DURs) were implemented to samples obtained from national health insurance claims data during December 2008 to February 2009, using 5 DUR criteria (duplication, drug-drug interaction, drug-disease interaction, drug-age contraindication, incorrect dosage) established in the Drug Information Framework (DIF)-$Korea^{TM}$, DUR program. Among 38,451 claims analyzed in the study, 74.7% had more than one conflicts in the 5 DUR modules. Among 16,472 patients analyzed, 49.6% had conflicts with duplication criteria composing of ingredient duplication (23.3%) and therapeutic class duplication (39.6%). Incorrect dosages were found in 73.6% of patients and under-dosage conflicts accounted for 59.9%, which was higher than over-dosage conflicts (38.3%). In this study, inappropriate drug prescriptions such as under-dose, pediatric contraindication and therapeutic duplication were prevalent in pediatric outpatient settings, suggesting much more awareness to the society, to prevent drug related problems in a vulnerable pediatric group.

• YAKHAK HOEJI
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• v.56 no.2
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• pp.126-135
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• 2012

Purpose: To develop therapeutic duplication criteria for the drugs used for respiratory diseases. Method: Therapeutic duplication was defined as "more than 2 drug ingredient-usage in which each has the same therapeutic effect and combination therapy does not confer additional therapeutic benefit". Respiratory system drugs approved in Korea were examined for the study. The WHO's Anatomical Therapeutic Chemical Classification System was used for grouping of the corresponding drug ingredients. The principles and recommendations on combination usage or multiple drug regimens were reviewed by using the clinical practice guidelines, textbooks, product labelings, and clinical articles. Clinical expert group consultation was performed and expert opinions were incorporated into the final criteria. Results: Nine hundred sixty two drug products with Korean Food and Drug Administration classification codes of 141, 149, 222, and 229 were evaluated, of which 87 active ingredients were composed. The drug ingredients were classified into 12 groups (antihistamines, oral nasal decongestants, leukotriene receptor antagonists, inhaled anticholinergics, inhaled corticosteroids, oral ${\beta}2$-agonists, long-acting ${\beta}2$-agonists, short-acting ${\beta}2$-agonists, xanthines, antiallergics, mucolytics and cough suppressants). The use of more than 2 drug ingredients including the same group was therapeutic duplication, and thus combination should be recommended not to be used. Conclusion: Twelve drug groups were identified as therapeutic duplication criteria. Combination therapy within each group should not be used otherwise therapeutic benefits outweigh potential risks.

• Korean Journal of Clinical Pharmacy
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• v.28 no.2
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• pp.107-116
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• 2018

Objective: This study analyzed the national claims data of veterans to generate scientific evidence of the trends and appropriateness of their drug utilization in an outpatient setting. Methods: The claims data were provided by the Health Insurance Review & Assessment (HIRA). Through sampling and matching data, we selected two comparable groups; Veterans vs. National Health Insurance (NHI) patients and Veterans vs. Medical Aid (MAID) patients. Drug use and costs were compared between groups by using multivariate gamma regression models to account for the skewed distribution, and therapeutic duplication was analyzed by using multivariate logistic regression models. Results: In equivalent conditions, veteran patients made fewer visits to medical institutions (0.88 vs. 1), had 1.86 times more drug use, and paid 1.4 times more drug costs than NHI patients (p<0.05); similarly, veteran patients made fewer visits to medical institutions (0.96 vs. 1), had 1.11 times more drug use, and paid 0.95 times less drug costs than MAID patients (p<0.05). The risk of therapeutic duplication was 1.7 times higher (OR=1.657) in veteran patients than in NHI patients and 1.3 times higher (OR=1.311) than in MAID patients (p<0.0001). Conclusion: Similar patterns of drug use were found in veteran patients and MAID patients. There were greater concerns about the drug use behavior in veteran patients, with longer prescribing days and a higher rate of therapeutic duplication, than in MAID patients. Efforts should be made to measure if any inefficiency exists in veterans' drug use behavior.

• Korean Journal of Clinical Pharmacy
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• v.20 no.3
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• pp.213-220
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• 2010

Therapeutic duplication (TD) is a serious problem that frequently occurring primarily in the ambulatory setting in Korea. Implementation of concurrent drug utilization review (DUR) is a promising way to reduce inappropriate prescription and dispensing, and improve patient safety. This study was aimed to develop the process of DUR module of TD. Sixty-five drug ingredients classified into the drug category of the antipyretic, analgesic, and anti-inflammatory drug approved in Korea (The KFDA-dess nated classification codes of 114 or 264) were reviewed for this purpose. The drug ingredients (and products) were reclassified based on WHO's Anatomical, Therapeutic and Chemical (ATC) classification system. The clinical practice guidelines, textbooks and product labels on therapeutic uses of these drugs in Korea and several fores n countries were reviewed. If the drugs were categorized into the same therapeutically duplicable class, they were defined not to be used concurrently because the concurrent use was "therapeutically duplicated (unnecessary or even harmful)". Among the studied drug products, the following 5 drug classes were considto beas "therapeutic duplication": (1), on-t tooid DURnti-inflammatory drugs (NSAIDs, including s Dicylates), (2),Anilidts, (3),Opioids, (4) Ergot Dk Doids and (5) 5-$HT_1$ receptor agonot s. Therefore, concurrent prescribing or dispensing of more than 2 drug ingredients any in the above same classes should be considered as TD and needed to be warrant for careful review by pharmacists before dispensing.

• Molecules and Cells
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• v.42 no.12
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• pp.840-849
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• 2019

The spatiotemporal mitotic processes are controlled qualitatively by phosphorylation and qualitatively by ubiquitination. Although the SKP1-CUL1-F-box protein (SCF) complex and the anaphase-promoting complex/cyclosome (APC/C) mainly mediate ubiquitin-dependent proteolysis of mitotic regulators, the E3 ligase for a large portion of mitotic proteins has yet to be identified. Here, we report c-Cbl as an E3 ligase that degrades DDA3, a protein involved in spindle dynamics. Depletion of c-Cbl led to increased DDA3 protein levels, resulting in increased recruitment of Kif2a to the mitotic spindle, a concomitant reduction in spindle formation, and chromosome alignment defects. Furthermore, c-Cbl depletion induced centrosome over-duplication and centriole amplification. Therefore, we concluded that c-Cbl controls spindle dynamics and centriole duplication through its E3 ligase activity against DDA3.

• Biomolecules & Therapeutics
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• v.25 no.1
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• pp.57-68
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• 2017

Seven transmembrane receptors (7TMRs), also known as G protein-coupled receptors, are popular targets of drug development, particularly 7TMR systems that are activated by peptide ligands. Although many pharmaceutical drugs have been discovered via conventional bulk analysis techniques the increasing availability of structural and evolutionary data are facilitating change to rational, targeted drug design. This article discusses the appeal of neuropeptide-7TMR systems as drug targets and provides an overview of concepts in the evolution of vertebrate genomes and gene families. Subsequently, methods that use evolutionary concepts and comparative analysis techniques to aid in gene discovery, gene function identification, and novel drug design are provided along with case study examples.

• Proceedings of the Korean Society of Toxicology Conference
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• 2003.10b
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• pp.84-85
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• 2003

The process of drug development has seen major changes over the last two decades with the movement away from standard small molecule drug discovery programs, through computer-assisted drug design methodologies towards biotechnologically derived products. The aim of duplication of endogenously active materials to be administered exogenously has enormous impact on development practices and evaluation of safety.(omitted)

• Korean Journal of Clinical Pharmacy
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• v.21 no.2
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• pp.106-114
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• 2011

While multiple medication is an important global medication safety issue, ununified concomitant medication by multiple prescriptions may cause more severe problems by the fact that those are neither intended nor watched. This could cause therapy duplication and severe drug interaction and etc. Korean Government made region wide scale programs twice to detect such problems and give warnings to pharmacists and doctors through the internet system in 2009-2010, which are called Drug Use Review Services Pilot Project. This study is an analysis and comparison of the results of the two DUR pilot projects. There were 5.0 and 4.2 cases of severe drug interaction by the concomitant medication of multiple doctors' prescriptions per 10 thousand prescriptions, while only 0.37 and 0 cases by the medication of same doctor's prescription(s). There were 426 and 381 cases of drug duplication by the concomitant medication of multiple doctors' prescriptions per 10 thousand cases, while only 197 and 23 cases by medication of same doctors' prescription(s). Doctors' participation to those projects improved at Jejudo the later one compared to Goyangsi the former, which means the efforts of them to make less prescription problems succeeded to decrease the number of cases caused from same doctor's prescription. But they could not decrease the number of problem cases caused from concomitant medication by multiple doctors prescriptions enough. The findings support the issue of strengthening and widening the project nation wide and the issue of recommending the patients to designate their own pharmacy, which can provide them counseling for unified and safety controlled medication.

• Korean Journal of Clinical Pharmacy
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• v.21 no.1
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• pp.14-21
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• 2011

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.