• Korean Journal of Clinical Pharmacy
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• v.32 no.4
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• pp.321-327
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• 2022

Background: To implement medication management service in Korean nursing home (NH), medication review tool for residents in Korean long-term care facilities was developed. This prospective pilot study aimed to verify the applicability of this newly developed tool and to evaluate the drug related problems (DRPs) identified by pharmacists' medication review in NH setting. Methods: This study was carried out in two NHs in Korea. The elderly residents (65 or older) using 5 or more medications were eligible. Pharmacists conducted medication review and identified the DRPs and potentially inappropriate medications (PIMs) based on the newly developed tool. Results: Among 43 NH residents, 27 residents agreed to participate. The median age was 87 and about 55.6% of them were taking 10 or more medications. Pharmacists identified a total of 37 PIMs in 18 NH residents (66.7%) and 54 DRPs in 22 residents (81.5%). The most frequent PIM was general-PIM (26 cases) followed by PIM under specific diseases or conditions (7 cases). Out of 77 items contained in the tool, 15 items were detected in study participants. 'Continued use or regular daily use of hypnotics' was the most highly detected item (9 cases) followed by 'multiple prescriptions within each class of hypnotics/sedatives' (5 cases). Among 54 DRPs identified, pharmacist intervened 39 cases (72.2%) and interventions were accepted in 18 cases (46.1%). Conclusion: This pilot study demonstrated that newly developed tool is feasible for the nursing home residents. However, further studies with larger population are warranted.

• International Journal of Advanced Culture Technology
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• v.10 no.4
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• pp.23-244
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• 2022

The Pulpose of this systematic review is aimed to establish the procedure of the injection with saftey and efficiency in the pre-hospital cardiac arrest patient performing the cardiopulmonary resuscitation (CPR), compared with traditional medication administration using Ampoule and medication administration with Prefilled Syringe. Databases were searched for CPR, heart arrest, resuscitation, Pre-filled Syringe, and Ampoule by the electronic data research including Pubmed, EMBASE and Cochran Library of Konyang University Library: 4 articles were selected by three co-authors using EndNote X20 and Covidence (Covidence.org) and were systematically reviewed. The Result of this study, the medication administration using Pre-fillled Syringe improves the safety of patients and Emergency medical workers by reducing the error in administration dose and administering the drug in safe than the medication adminisrtaion using Ampoule, also, contributes to the increment of survival rate of cardiac arrest and severe patients by decreasing the administration time that prevents the delay of medication administration.

• The Journal of Health Technology Assessment
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• v.5 no.1
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• pp.31-41
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• 2017

Objectives: To explore prevalently used types of medication error and the types of medication error which would be appropriate to be used in Korea. Methods: In depth literature review was performed to explore the mostly used types of medication error in the United States, Canada, Europe, Australia, and Japan. We intended to examine experts' view on the suitability of the types of medication error to be used in Korea. The types of medicati0on error were classified by activity criteria, severity criteria, process criteria, and responsible person criteria based on literature reviews. Results: According to the result of literature review, activity criteria was the most commonly used type of medication error. Ten experts in the area of patient-safety and medication error responded and the top two types of medication error which were appropriate and suitable to be used in Korea were severity criteria and activity criteria. Conclusion: Severity criteria and activity criteria could be recommended to be used as the standard types of medication error in Korea although there are other types of criteria such as process criteria and responsible person criteria.

• Korean Journal of Clinical Pharmacy
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• v.31 no.1
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• pp.61-78
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• 2021

Background and Objective: The use of potentially inappropriate medications (PIMs) increases the risk of negative health outcomes, including drug-related admissions. Tools for structured medication review have been developed to ensure optimal medication use and safety. Here, we aimed to evaluate medication use review (MUR) tools for community-dwelling older patients. Methods: We performed a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). We searched PubMed, Embase, and the Cochrane Library from 1991 to 2020, excluding tools that are specifically applied to hospitalized patients or nursing home residents. We identified the most common inappropriate medications, drug-disease interactions, drug-drug interactions and prescribing omissions presented among tools. Results: From among 9,788 identified reports screened, 60 met our inclusion criteria; finally, 27 were eligible for data analysis considering originality and up-to-dateness. Most tools presented explicit criteria (93%), and only one was specific to community-dwelling elderly. The most common PIM was tricyclic antidepressants. Use of diltiazem and verapamil in patients with heart failure and the combination of nonsteroidal anti-inflammatory analgesics and warfarin were the most frequent disease-specific PIM and drug-interaction, respectively. Conclusions: Although several medication review tools have been developed for older adults, specific guidelines for community-dwelling populations remain limited. Furthermore, the list of PIMs differed among available tools. In future, specific but integrating MUR tools need to be developed for clinical practice considering this population.

• Korean Journal of Clinical Pharmacy
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• v.18 no.2
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• pp.124-131
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• 2008

The impacts of guideline for digestives on physicians' prescription of GI medication Clinical practice guidelines provide benefits to physicians, patients, and researchers. It also helps doctors to make decisions in medical services. In many countries, practice guidelines lead to activities of quality improvement and are developed using evidence based methods. This research was to assess the impacts of Korean Medical Association's guideline for digestives on the change of physicians' behavior. This study was progressed as one-group pre-test post-test quasi-experimental design using health insurance claims data. The unit of analysis was institution. Data was analyzed using paired t-test for change of prescription rate before and after the distribution of practice guidelines. And the multiple regression analysis was performed to examine the independent impact of the guideline on the prescribing rate of GI medication. Prescription rates of GI medication per claim by medical institution increased significantly, 1.98%point (from 50.27% to 52.25%) and multivariate regression analysis showed significant increase in the prescription rate of GI medication after the distribution of guideline (p<0.001). In conclusion, the distribution of guideline for digestive might not have the effects on the change in provider's behavior. Furthermore, to activate the use of practice guideline, it would be necessary to educate the contents to physicians as well as to develop practice guideline.

• Journal of Korean Biological Nursing Science
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• v.26 no.2
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• pp.83-98
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• 2024

Purpose: This study investigated how interprofessional education (IPE) related to medication for undergraduate healthcare students, including nursing students, has been designed and conducted. Furthermore, the outcomes of these IPE programs were evaluated. Methods: A scoping review was performed to understand the content and methods of IPE on medication for undergraduate healthcare students, including nursing students. A literature search was done using PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Research Information Sharing Service, and Korean Nursing Database in English between January 2000 and December 2022. In total, 14 papers were selected and reviewed. Results: Eleven research studies were conducted on the implementation of one-time IPE on medication safety or errors. Among them, six studies focused on providing IPE to nursing students alongside medical and pharmacy students, while three studies targeted nursing and medical students, and two studies focused on nursing and pharmacy students. The most commonly employed educational method was simulation, which was utilized in 12 studies. All studies consistently reported a positive impact on attitudes toward IPE and effective communication. Additionally, five studies evaluating medication knowledge reported improvements in participants' understanding of drugs. Conclusion: The effects of IPE related to medication for undergraduate nursing students have been confirmed. It is necessary to introduce IPE in the field of pharmacology.

• Imaging Science in Dentistry
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• v.50 no.4
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• pp.273-279
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• 2020

This review presents an overview of some diagnostic imaging-related issues regarding medication-related osteonecrosis of the jaws(MRONJ), including imaging signs that can predict MRONJ in patients taking antiresorptive drugs, the early imaging features of MRONJ, the relationship between the presence or absence of bone exposure and imaging features, and differences in imaging features by stage, between advanced MRONJ and conventional osteomyelitis, between oncologic and osteoporotic patients with MRONJ, and depending on the type of medication, method of administration, and duration of medication. The early diagnosis of MRONJ can be made by the presence of subtle imaging changes such as thickening of the lamina dura or cortical bone, not by the presence of bone exposure. Most of the imaging features are relatively non-specific, and each patient's clinical findings and history should be referenced. Oral and maxillofacial radiologists and dentists should closely monitor plain radiographs of patients taking antiresorptive/antiangiogenic drugs.

• Health Policy and Management
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• v.20 no.2
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• pp.128-143
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• 2010

Objectives : This study aims to estimate the oral antihyperglycemic medications adherence among ambulatory care with adult type 2 diabetes patients and to identify factors affecting the medication adherence in Korea. Methods : This study used the Korean National Health Insurance Database. Study population was 40,082 patients who were 20 years of age or older and first diagnosed with type 2 diabetes (ICD-10: E11) in 2004. The patients were followed up for two years in order to measure adherence with oral antihyperglycemic medications. The level of medication adherence was measured by the medication possession ratio (MPR). Results : The average MPR in the study population was 49.5%. The appropriate adherence rate (MPR$\geq$80%) was 29.4% and showed variation according to the characteristics of individual patients. Multiple logistic regression analysis revealed that the odds of appropriate adherence increased with female (OR:1.21, CI:1.14-1.27), older age, increasing ambulatory care visits, health insurance (OR:1.53, CI:1.33-1.76), decreasing ambulatory care providers, using a specialized general hospital as their main attending medical institution (OR:10.08, CI:8.96-11.33), having co-morbidity, using polytherapy (OR:1.07, CI:1.01-1.13). Conclusions : The medications adherence for patient with type 2 diabetes is low in Korea, and shows variation according to the characteristics of patients. For proper management of diabetes, health care policy is expected to be enacted to improve medications adherence continuously. In particular, more intensive management is needed for patients with low medications adherence. Also, health care policy makers need to develop the program to induce health care utilization by a patient to be more concentrated with the same provider.

• Journal of Korean Public Health Nursing
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• v.29 no.2
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• pp.285-297
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• 2015

Purpose: The purpose of this study was to analyze published studies on medication adherence in Korea. Methods: The studies were identified and data were collected from Oct. to Nov. 2014 through the RISS, KISS, NDSL, and Nanet websites. Key words including medication adherence and medication compliance were used. A total of 37 published studies were reviewed using criteria developed by researchers. Results: Studies published and associated with adherence have increased since 2010. Several instruments have be enused to date however, there is no critical standard regarding medication adherence. In addition, various interventions are available and have positive effects but the main concept is also deferent with adherence and compliance. Conclusion: There sults show that research related to adherence has actively increased. How ever there are various concepts, method sand standard. Therefore more studies are required in the future for development of a unified concept, methods and standards for adherence for future.

• Korean Journal of Clinical Pharmacy
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• v.28 no.1
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• pp.1-9
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• 2018

Polypharmacy is increasing owing to an increase in the elderly population and multimorbidities associated with the increased risk of administration of potentially inappropriate medications (PIMs). The negative effects of polypharmacy on various health conditions and aspects, such as fall, fracture, mortality, cognitive function, and dementia, have been reported. The management of excess and inappropriate polypharmacy through proper interventions and local or national guidelines has been highlighted. The purpose of polypharmacy management is to appropriately prescribe medicines that are essential to treat diseases in patients and to avoid inappropriate polypharmacy, such as interactive or duplicate medicines under prescription and PIMs for specific diseases. Community pharmacists in Australia, the EU, USA, and Japan are collaborating with prescribers to review medications to ensure that the patients can be prescribed appropriate medications. The service cost is reimbursed by public or private insurers. A study in the United States has shown that even with medication review costs, the overall medication cost has reduced. In Korea, various projects such as Drug Utilization Review service and safe use of medicines have been conducted; however, no national guidelines or management measures have been established. It is necessary to implement a national long-term plan on polypharmacy management. Furthermore, a phased implementation plan is required. Shortly, active medication review services and education programs for healthcare professionals with the support of the government should be considered in Korea with reference to other countries in order to raise awareness of seriousness and risks of inappropriate polypharmacy.