• Tuberculosis and Respiratory Diseases
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• v.76 no.6
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• pp.276-283
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• 2014

Background: We aimed to investigate the role of the physician in practice and the factors that influence the success rate of smoking cessation. Methods: This study retrospectively analyzed 126 adult smokers who had visited the outpatient department of pulmonology, and received motivational interviewing with or without supplement drugs. The findings include continuous smoking abstinence rate, which was evaluated at 6, 12 and 24 weeks, and the factors associated with continuous abstinence for 6 months or longer. Results: The patients with only motivational interviewing accounted for 57.9%, while the nicotine patch therapy was applied to 30.2%; and varenicline was prescribed to 11.9%. The smoking cessation success rates of at 6, 12, and 24 weeks were 55.6%, 47.6%, and 33.3%, respectively. However, even in the failure group at six months, tobacco consumption was decreased under 10 cigarettes per day in 42.1% (53/126). In multivariate logistic regression analysis, degree of Fagerst$\ddot{o}$m Test for Nicotine Dependence (p=0.034; odds ratio, 3.607; 95% confidence interval [CI], 1.102-1.807), the absence of smoking-related lung disease (p=0.008; odds ratio, 4.693; 95% CI, 1.497-14.707), and education level (p=0.001; odds ratio, 181.420; 95% CI, 8.414-3,911.502) were the predictors of successful smoking cessation. Conclusion: An improved continuous smoking abstinence rate can be obtained by motivational interviewing, regardless of the association with pharmacotherapy.

• Korean Journal of Clinical Pharmacy
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• v.28 no.1
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• pp.30-39
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• 2018

Background: Clinical Pharmacy Practice Experience (CPPE) is an important curriculum that offers students patient-centered disease prevention and treatment with evidence-based optimal pharmacotherapy for better clinical outcomes. However, few studies have evaluated the perception of pharmacy students regarding CPPE in tertiary and secondary hospitals. This study aimed to evaluate the perception of pharmacy students regarding the learning program of CPPE. Methods: The survey questionnaire consisted of 15 self-administered questions regarding pharmacy practices, barriers, and improvement of practical training. Fourteen institutional pharmacies located in seven regions responded to a survey questionnaire from March 1 to June 30, 2017. The participants were pharmacy students doing clerkship in a hospital setting. Results: The response rate was 73.6%. Thirty-five participants (22.4%) had used a hospital library, but 121 (77.6%) had never used the library for drug information resources. Eighty-one (50.0%) responded that clinical knowledge and drug information was the most beneficial practice. Thirty-seven (31.1%) respondents in the tertiary hospitals and 19 (46.3%) in the secondary hospitals answered that they were filling prescriptions during the daily break. On the other hand, 72 respondents (60.5%) in the tertiary hospitals and 17 (41.5%) in the secondary hospitals did literature research to prepare for presentation. Conclusion: More students in secondary hospitals continue to fill prescriptions during the daily break, as compared to those in tertiary hospitals. Therefore, the authors suggest self-directed learning to improve clinical performance and each institution considers offering onsite or online library service to improve evidence-based CPPE for pharmacy school students.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2383-2391
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• 2014

Tobacco use is described as the single most preventable cause of morbidity and mortality globally, with the World Bank predicting over 450 million tobacco-related deaths in the next fifty years. In India, the proportion of all deaths that can be attributed to tobacco use is expected to rise from 1.4% in 1990 to 13.3% in 2020 of which smoking alone will cause about 930,000 adult deaths by 2010. Many studies have shown that counseling from a health professional is an effective method of helping patients quit the tobacco habit. Tobacco cessation needs to be urgently expanded by training health professionals in providing routine clinical interventions, increasing availability and subsidies of pharmacotherapy, developing wide-reaching strategies such as quitlines, and costeffective strategies, including group interventions. The WHO Framework Convention on Tobacco Control (FCTC) emphasizes the vital contribution of participation of health professional bodies, as well as training and healthcare institutions in tobacco control efforts. Dentists can play an important role in helping patients quit using tobacco. One of the key strategies to reduce tobacco-related morbidity and mortality is to encourage the involvement of health professionals in tobacco-use prevention and cessation counselling. The dental office is an ideal setting for tobacco cessation services since preventive treatment services, oral screening, and patient education have always been a large part of the dental practice.

• Korean Journal of Biological Psychiatry
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• v.21 no.2
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• pp.49-56
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• 2014

Objectives Previous literature on the prescription change among patients with schizophrenia mainly focused on antipsychotics. This study investigated chronological change in the patterns of discharge medication among inpatients with schizophrenia at a psychiatric inpatient unit of a university-affiliated hospital. Methods All admission records at a psychiatric unit of Hanyang University Guri Hospital with discharge diagnosis of schizophrenia during two different five-year time frames (1996-2000 and 2006-2010) were reviewed including the demographic and clinical data and discharge medications. The data were gathered from a total of 207 patients (95 in 1990s and 112 in 2000s). Results The frequency in use of atypical antipsychotics (p < 0.01), antidepressants (p < 0.05), beta-blockers (p < 0.01), and benzodiazepine (p < 0.01) was significantly higher in 2000s. Anticholinergic drugs were less likely used in 2000s (p < 0.01). We did not find significant differences in the equivalent dose of antipsychotic drugs, the use of mood stabilizers and cholinergic drugs between two time frames. Conclusions Increased proportion of atypical antipsychotics and decreased use of anti-parkinsonian drugs are in line with literature. Our results show that more diverse classes of psychotic medications are used for schizophrenia in recent years. It is likely that psychiatrists are becoming more conscious of negative symptoms, anxiety, and depression in the pharmacotherapy of schizophrenia as well as positive symptoms of the illness.

• The Korean Journal of Physiology and Pharmacology
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• v.15 no.2
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• pp.67-81
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• 2011

Epilepsy is a chronic disease occurring in approximately 1.0% of the world's population. About 30% of the epileptic patients treated with availably antiepileptic drugs (AEDs) continue to have seizures and are considered therapy-resistant or refractory patients. The ultimate goal for the use of AEDs is complete cessation of seizures without side effects. Because of a narrow therapeutic index of AEDs, a complete understanding of its clinical pharmacokinetics is essential for understanding of the pharmacodynamics of these drugs. These drug concentrations in biological fluids serve as surrogate markers and can be used to guide or target drug dosing. Because early studies demonstrated clinical and/or electroencephalographic correlations with serum concentrations of several AEDs, It has been almost 50 years since clinicians started using plasma concentrations of AEDs to optimize pharmacotherapy in patients with epilepsy. Therefore, validated analytical method for concentrations of AEDs in biological fluids is a necessity in order to explore pharmacokinetics, bioequivalence and TDM in various clinical situations. There are hundreds of published articles on the analysis of specific AEDs by a wide variety of analytical methods in biological samples have appears over the past decade. This review intends to provide an updated, concise overview on the modern method development for monitoring AEDs for pharmacokinetic studies, bioequivalence and therapeutic drug monitoring.

• Anxiety and mood
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• v.12 no.1
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• pp.47-55
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• 2016

30% of patients with panic disorder (PD) show treatment-resistant and chronic waxing and waning course. Therefore, adequate treatment strategies for PD by evidence based pharmacotherapy and combined cognitive behavioral therapy (CBT) are recommended. Regarding how and why CBT for PD works, three hypotheses include the cognitive theory, anxiety control theory, and behavioral theory were discussed. The recent findings that the altered activation in frontal lobe is normalized after CBT, suggest a reduction of an altered top-down fear processing in the neural correlates of CBT in PD. In order to improve accessibility to CBT, brief CBT and internet based CBT for PD were suggested. Despite limitations of sample sizes and study design, most of studies suggest that brief CBT is more effective than control conditions, and even as equally effective as standard CBT. The evidences suggest that internet based CBT may not be significantly different from face-to-face CBT in reducing anxiety. Several advances within the field of third-wave CBT for PD have led to the development of new techniques based on mindfulness, such as mindfulness-based cognitive therapy and acceptance and commitment therapy. Based on Korean algorithm project for panic disorder, especially the psychological education and cognitive reconstruction components were recommended in CBT with PD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.53-63
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• 2003

The autistic disorder is identified as an independent clinical entity, since the first description of Leo Kanner. The etiologies of the autistic disorder are almost unclear and the autistic disorder has several abnormalities in aspect of morphology and function of brain. Self-mutilation is observed in the low functioning autistic patients, and early treatment for self mutilation are needed in order not to be chronic. This article reviewed the drugs for the several symptoms of the autistic disorder, especially for self-mutilation. The serotonin reuptake inhibitors does not have clear primary anti-aggressive effects. The dopamine blockers have considerable effects in order to decrease aggression and self injury, and the risperidone is most recommended because of side effects of conventional drugs. The naltrextone does not have consistent study results yet. The clonidine has aggression-decreasing effect. Also lithium is effective on the treatment for aggressive and self-injurious behaviors. And the anticonvulsants including carbamazepine are effective on aggressive explosive behaviors. In the future the pharmacotherapy for self-mutilation will be advanced through stalbe diagnosis and measurement of treatment response.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.27 no.1
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• pp.31-38
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• 2016

Pharmacotherapy is considered the first line therapy in attention-deficit hyperactivity disorder (ADHD). Many patients also choose complementary medicine such as dietary supplements. Omega-3 has shown some efficacy for improving ADHD symptoms in several studies. The goal of this review is to integrate the previous research findings on omega-3 and understand the issues worth considering in the treatment of ADHD. The terms "attention deficit disorder with hyperactivity", "omega-3", and "dietary supplements" were searched on PubMed, Cochrane, and Google scholar. The search was further limited to clinical trials, reviews, and meta-analyses. Trials that examined treatments for ADHD, used randomized design, and placebo-controlled trials were included. Eighteen clinical trials with a total of 1,141 participants were included in this review. Fifteen trials had parallel designs, comparing an omega-3/6 polyunsaturated fatty acid (PUFAs) or a combination of both to a placebo and three compared omega-3/6 PUFAs to a placebo and psycho-stimulants. Seven of the included trials showed significant improvements in groups receiving omega-3/6 PUFAs compared to placebo groups, however, 11 trials showed no significant differences. Evidence that PUFAs supplementation provides benefits for ADHD was yet limited. Mixed results were due to selection variability criteria, variability of supplementation, and short follow-up intervals.

• Korean Journal of Clinical Pharmacy
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• v.24 no.4
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• pp.304-310
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• 2014

Objective: The objective of this study was to evaluate the 6-year clinical pharmacy curriculum in Korea among 35 schools of pharmacy and to compare the pharmacy practice experience curriculum with the U.S. Methods: Data on the 6-year clinical pharmacy curriculum was collected and analyzed from 35 schools of pharmacy in Korea. Data were collected from each school's website, or through professors in clinical pharmacy or the administrative office, when not available online. Guidance for U.S. clinical pharmacy curriculum was referenced from the Accreditation Council for Pharmacy Education (ACPE) Accreditation Standards and Guidelines. Results: Pharmacotherapy was the only course that was offered in every school of pharmacy with average of $11.5{\pm}2.8$ credit hours offered. Only six subjects were offered in more than half of the schools. Average pharmacy practice experience credit hours in Korea were $1.8{\pm}0.6$, $7.8{\pm}1.5$, $4.9{\pm}1.2$, $3.5{\pm}1.1$, $11.8{\pm}1.2$ in introductory, hospital, community, pharmaceutical industry and administration, and intensified pharmacy practice experience, respectively. While the U.S. required introductory pharmacy practice experience (IPPE) to be conducted in the real pharmacy setting, the IPPE in Korea was conducted as an in-class simulation. The total required hours of IPPEs and APPEs were 1400 hours in Korea and 1740 (300+1440) hours in the U.S. Conclusion: Clinical pharmacy curriculum in Korea is offered through a variety of courses and the pharmacy practice experience curriculum has been adopted by every school of pharmacy. A guidance outlining the major required contents of clinical pharmacy curriculum could help standardize and advance the clinical pharmacy education in Korea.

• 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.