• Title/Summary/Keyword: prescribing

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Influence for Pharmacy Management by Health Functional Food after the Separation of Prescribing and Dispensing Practice (의약분업후 건강기능성식품이 약국경영에 미치는 영향)

  • Choi, Byung-Chul;Kang, Hyo-Sook;Kwak, Hyun-Soo;Sohn, Uy-Dong
    • YAKHAK HOEJI
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    • v.53 no.2
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    • pp.45-50
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    • 2009
  • The purpose of this study is to investigate the best way that health functional food contributes the diversification of pharmacy management at the new point after the separation of prescribing and dispensing practice. In the question of the number of prescription paper, it was more than 200 papers (18.9%), next 100 papers (11.3%). In case of daily total sales volume except prescription fee, it was more than 1,000,000won (28.3%). About the motivation using health functional food, the reason for activation of pharmacy management was 66%. The selling method was mainly by pharmacist recommendation and consumer's need. In comparison with after and before the separation of prescribing and dispensing, more than 60% of subjects answered that sales volume was decreased and no changed. Concerning the ratio of total sales volume to health functional food within 5 years, 66% of subjects expected that it will be increased positively. The type of best pharmacy to handle health functional food was community pharmacy. These results suggest that the handling of health functional food by pharmacist will greatly increase in near futures and will be very important portion for pharmacy management.

Effects on the Antimicrobial Use of Clinical Decision Support System for Prescribing Antibiotics in a Hospital (항생제 처방 지원 프로그램이 항생제 처방과 사용량에 미치는 효과)

  • Kim, Hyun-Young;Cho, Jae-Hyun;Koh, Young Taeg
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.1
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    • pp.26-32
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    • 2013
  • Objective: This study was to define the clinical effect on the clinical decision support system (CDSS) for prescribing antibiotics integrated with the order communication system in a National Hospital. Method: We extracted data collected before integrating the CDSS of 4,406 adult patients in 2007 and data collected after integrating the CDSS of 4,278 adult patients in 2009. These patients were 50.4% and 45.2% of all patients admitted in 2007 and 2009, respectively. The clinical effect was defined as the proportion of prescribed antibiotics, the length of antibiotics use, and the DDDs (defined daily doses) of antibiotics per 1,000 patient-days using these retrospective data. Results: There were a significant change in the proportion of patient prescribed penicillins with extended spectrum (OR=0.55, p=001), penicillins included beta-lactamase inhibitors (OR=0.75, p<.001), 3rd cephalosporin (OR=1.47, p<.001). The mean of the length of antibiotics use was decreased statistically from $6.09{\pm}5.48$ to $5.85{\pm}5.51$ days (p=.003). The DDD of glycopeptides was decreased from 24.43 DDD to 19.55 DDD per 1000 patient-days. The DDD of 3rd cephalosporins was also decreased from 15.88 to 11.65. Conclusion: Therefore, the clinical decision support system for prescribing antibiotics was effective for the clinical outcomes.

A Study for Activation of Pharmacy Oriental Medicine after the Separation of Prescribing and Dispensing Practice (의약분업에 따른 약국 한약 활성화에 대한 조사 연구)

  • Choi, Byung-Chul;Kim, Ji-In;Sohn, Uy-Dong
    • YAKHAK HOEJI
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    • v.52 no.6
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    • pp.471-479
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    • 2008
  • The purpose of this study is to investigate the best way that Oriental medicine contributes for activation of pharmacy management after the separation of prescribing and dispensing practice since July 2000. In order to investigate current pharmacy conditions for handling of Oriental medicine and many problems for administering the Oriental medicine to patients, a questionnaire was written with a list of questions related to pharmacy management with Oriental medicine, and given to 58 subjects via fax or personal visit during the period of April 21 to 30, 2003. The research results was as follows; In th 58 subjects, 45 subjects (77.6%) were pharmacists with a licence for dispensing Oriental medicine. 70.7% of subjects most likely preferred to extract granule as administering type of oriental medicine. About the motivation using Oriental medicine, the reason for activation of pharmacy management was 39.7%, second, the reason for resolving the limitation of treatment over western medicine was 25.9%. Oriental medicine for patients was mainly administered by recommendation with pharmacist (65.5%). In comparison with after and before the separation of prescribing and dispensing, 51.7% of subjects answered that sale volume was decreased after the separation. Concerning the ratio of total sales volume to Oriental medicine within 5 years, 50% of subjects expected that sales volume will increase positively. About treating Oriental medcine, 34.5% of subjects thought the problem is the regulation by limiting 100 kinds of formulary. The most important factor for increasing Oriental medicine selling amount was continueous education for various information of oriental medicine in case of 44.8% of sujects. The best pharmacy to handle oriental medicine was community pharmacy (36.2%). It was expressed the reason why many pharmacists have not been treated oriental medicine because lots of time needs for dispensing prescription from clinics in these 4 years after the separation of prescribing and dispensing. These results lead to the conclusion that the Oriental medicine at pharmacy will greatly increase within 5 years and will be very important portion for pharmacy management.

Potentially Inappropriate Prescriptions of Antibiotics in Patients with Acute Rhinosinusitis in Ambulatory Settings in South Korea (외래 급성 비부비동염 환자의 잠재적으로 부적절한 항생제 사용)

  • Daei Jung;Nam Kyung Je
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.4
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    • pp.261-269
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    • 2023
  • Background: Acute rhinosinusitis (ARS) is a common condition encountered in ambulatory practice and is one of the most common reasons for antibiotic prescriptions. This study aimed to evaluate the potentially inappropriate antibiotic prescribing for ARS in South Korea and identify influencing factors. Methods: We analyzed Health Insurance Review and Assessment Service-National Patient Samples data. We selected outpatients aged 20 to 64 with ARS, prescribed antibiotics between February and November 2020. Potentially inappropriate antibiotic prescribing was categorized as: 1) inappropriate antibiotic selection and 2) inappropriate antibiotic dosage or duration. Multiple logistic regression was conducted to estimate the impact of various factors on inappropriate antibiotic prescribing. Results: Of 1,210 patients, 80.83% received potentially inappropriate ARS antibiotic prescriptions. Inappropriate antibiotic selection accounted for 43.55%, and inappropriate antibiotic dosage and duration contributed to 37.28%. Otolaryngologists had higher odds ratio (OR) of potentially inappropriate antibiotic prescribing compared to internal medicine practitioners, while dentists had lower OR. Patients aged 20 to 29 years had a higher OR than other age groups, and those who visited primary care clinics had a higher OR than those who visited hospitals. Conclusion: Potentially inappropriate antibiotic prescribing for ARS is prevalent in South Korea. This study identified physician specialty, patient age group, and the level of healthcare facility as factors influencing potentially inappropriate antibiotic prescriptions. Addressing this issue through targeted interventions, such as improved guidelines adherence and patient education, is imperative to mitigate the risks associated with antibiotic misuse and antibiotic resistance.

A Reflection on the Struggles 2000 around the Separation of Prescribing and Dispensing (2000년 의료사태의 경험과 교훈)

  • 김한중
    • Health Policy and Management
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    • v.11 no.1
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    • pp.87-106
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    • 2001
  • There has been a series of struggles around the governmental enforcing separation of prescribing and dispensing since the consensus for the policy at May 10, 1995, and the strike among the physicians nationwide at June 19, 2000. This thesis is to review the process of the affair as a whole and find out some achievements and lessons from it. Most visible achievement is that physicians have obtained governmental apology for the enforcing the unprepared policy, and promise to revise the Law on the Pharmaceutical Affairs, to enlarge governmental support for the medical insurance program, to construct a presidential committee for the reformation of medical affairs, and so on. Besides these achievements, physicians have learned much on the relations among them and with society in general. However this is only the first scene on the road to an extensive transformation in the medical area following more critical Issues on the medical reformation.

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Review of the Retrospective Drug Utilization Review Program from Foreign Countries' Experience (외국의 후향적 DUR 제도 현황과 정책적 함의)

  • Kim, Dong-Sook;Kim, Su-Kyeong;Jang, Sun-Mee
    • YAKHAK HOEJI
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    • v.55 no.3
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    • pp.173-184
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    • 2011
  • The purpose of this study was to review foreign retrospective Drug Utilization Review(DUR), and so to suggest a development plan suitable for use with domestic situation. Literature review of foreign retrospective DUR program and domestic project such as DUR and prescribing analysis project were reviewed. To improve prescribing quality, developed countries such as US, Canada, UK, France, and Australia have implemented various forms of policy. Based on the review of foreign retrospective DUR program, we suggested to apply practical implementation of retrospective DUR program.

Why the Prescribing-Dispensing Services Are Not Separated in Korea\ulcorner -An Economic Approach- (의.약분업 왜 안 되나\ulcorner -경제학적 일고-)

  • 변재환
    • Health Policy and Management
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    • v.2 no.2
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    • pp.179-193
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    • 1992
  • This paper attempts to explain why the prescribing-dispensing services are not seperated in Korea. The main reason why physicians and pharmacists do not compromise, even though the two parties support the seperation policy in public, is contended to be that both parties would lose their interests if the policy were implemented. Physicians' loss from giving up their vested rights to dispensing would be larger than their gain from an increase in the number of prescriptions. Pharmacists' loww from being forced not to to sell medicines without prescriptions would also be larger than their gain from prohibiting physicians from dispensing. The net ganier form the seperation policy would be the patients. Therefore, the seperation policy would not be implemented unless political pressure from general public surpasses that from physicians and pharmacists.

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Financing Mechanisms of Social Prescribing Projects: A Systematic Review

  • Dronina, Yuliya;Ndombi, Grace Ossak;Kim, Ji Eon;Nam, Eun Woo
    • Health Policy and Management
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    • v.30 no.4
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    • pp.513-521
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    • 2020
  • Aging populations and the increasing mental health issues among them have set a new challenge for the international community, governments, and people. Given this, society's role is very important, and involving the local community in resolving the problems can play a pivotal role. The current study presented the systematic review of the financing mechanism and cost-effectiveness of the "social prescribing" (SP) project in the United Kingdom and how SP can be adapted for other settings. The data showed comparatively low running costs and the overall effectiveness of SP projects. The running cost of SP projects varied between £54,525 and £1.1 million. The cost-effectiveness of the projects reported as 12% and the return of investment was about 50% depending on the type of analysis and the activities implemented. This type of intervention can be one of the options that support solving the issues of aging populations and their accompanying mental disorders.

Prescribing Patterns of Codeine among Children under Aged 12 in Korea (건강보험자료를 이용한 12세 미만 소아에서 코데인 처방양상평가)

  • Park, Hyo-Ju;Shin, Han-Na;Shin, Ju-Young
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.4
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    • pp.273-279
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    • 2015
  • Objective: Codeine may result in death or respiratory depression in children, particularly who are rapid metabolizer of CYP2D6, therefore it should be used cautiously among children under 12 years of age. This study was to investigate the prescribing pattern of codeine among children according to the age group, prescribed diagnosis, type of medical service and medical specialties. Method: We used Korea Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) database. Study subjects included inpatients or outpatients, who were prescribed codeine between January, 1, 2011 and December, 31, 2011. Contraindicated use of codeine was defined as the use of codeine at least one times under aged 12. Age groups were subclassified according to the <2 years, 2-4 years, 5-8 years, and 9-11 years. Frequently prescribed diagnosis (ICD-10), type of medical service, and medical specialties were also described among codeine users under aged 12. Results: Codeine users were 6,411 inpatients (9,958 prescriptions), and 3,397 outpatients (6,258 prescriptions), respectively. Codeine prescription under 12 years of age were 2.1% (210 prescriptions) among inpatients, and 12.3% (776 prescriptions) among outpatients (p-value<0.05). Outpatient prescriptions of codeine under 12 aged were issued mostly from primary care clinics and frequent diagnosis were unspecified bronchopneumonia (51.6%), and vasomotor rhinitis (23.7%). Conclusion: This study found prescribing of codeine under 12 aged is common in outpatient and primary clinics. Nationwide and community-based efforts should be needed to reduce inappropriate prescribing among children.

Impact of the Outpatient Prescription Incentive Program on Reduction of Pharmaceutical Costs of Clinics in South Korea

  • Kwon, Seong Hee;Han, Kyu-Tae;Park, Sohee;Moon, Ki Tae;Park, Eun-Cheol
    • Health Policy and Management
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    • v.27 no.3
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    • pp.247-255
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    • 2017
  • Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.