• Title/Summary/Keyword: Clinical Prescription

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Analysis of the Prescription Patterns of Medications that List Suicide in Use Cautions using the HIRA Claims Data (건강보험청구데이터를 이용하여 사용상의 주의사항에 자살이 기재된 약물의 처방 양상 분석)

  • Oh, Suin;Park, Hyekyung
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.3
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    • pp.202-208
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    • 2019
  • Objective: Suicide has recently become an important social problem. Thus, we analyzed prescription drugs that cause suicidal ideation. Methods: Of 156 drugs on the the Minister of Food and Drug Safty (MFDS) EZ-Drug site that had "suicide" listed as a side effect, 78 had "suicide" listed as a warning or contraindication; those 78 drugs were analyzed using data from the 2016 Health Insurance and Review and Assessment Services National Patient Sample (HIRA-NPS). Results: 51 "suicide risk" drugs was identified. Of all patients, 5.2% had received such drugs. The prescription rate was 0.8% of all prescriptions, accounting for 1.6% of all prescription days. From logistic regression analysis, the prescription rate for the drugs was approximately 1.1 times higher for women than for men. With regard to age, the prescription rate for patients 66 years and older was 15.5 times higher than those for patients 25-years and lower. With regard to medical departments, the prescription rates in psychiatry and dermatology departments were 8.1 times higher and 0.6 times lower than those in internal medicine departments, respectively. With regard to region, the prescription rates in Daegu and Jeju were 1.3 times higher and 0.79 times lower than those in Seoul, respectively. Conclusion: Drug-induced suicidal behavior is possible, and therefore efforts are needed to prevent it.

Community Pharmacists' Perception of Barriers to Pharmacy Work (약국업무시 고충에 관한 개국약국 약사의 인식에 관한 연구)

  • Kim, Hyun-Ah
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.1
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    • pp.37-42
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    • 2009
  • The purpose of this study was to evaluate barriers to pharmacists' routine work in community setting. A survey was given to 281 pharmacists who enrolled in 16-week clinical pharmacy educating program in continuous education center for advanced pharmacy at Seoul National University. Three main questions that pharmacists were asked to answer were: (1) difficulties on dispensing prescription, (2) difficulties on communicating with doctors, (3) most difficult disease on patients counseling. The response rates for the survey were more than 60 % for each three questions (62.63 %, 63.7 %, and 64.41 %, respectively). The top three barriers to dispensing prescription were lack of professional knowledge about medications, prescription error and its solving ability and patient counseling. The top three barriers to communicating with doctors were lacking of opportunity to discuss about patients' medication due to unavailability of doctors, doctors' attitude using authoritative manner, and a pharmacist's lack of knowledge. The top 4 most difficult diseases on patients counseling were cardiovascular disorders, dermatologic disorders, endocrinologic disorders, and psychiatric disorders.

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A Report on the Collecting Status of the Prospective Clinical Data Included the Constitutional Prescription (전향적 체질치료 임상증례 수집현황에 대한 보고)

  • Kim, Sang-Hyuk;Kim, Ho-Seok;Park, Ki-Hyun;Lee, Siwoo
    • Journal of Sasang Constitutional Medicine
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    • v.28 no.1
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    • pp.57-66
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    • 2016
  • Objectives The purpose of this study is to report on the collecting status of the prospective clinical data, that is designed to find clinical factors for determining the constitutional prescription.Methods We collected the prospective clinical data of 1208 subjects in the 10 oriental hospitals and 2 oriental clinic, from September 2012 to July 2015. Subjects were diagnosed and prescribed by the Sasang Constitution specialist. We counted the usage frequency of each constitutional herbal formula. Besides we check the main chief complaints on each constitutional herbal formula.Results & Conclusions In TE type, Yeoldahanso-tang, Cheongsimnyeonja-tang were used in high frequency. In SE type, Palmulgunja-tang, Gwakhyangjunggi-san were used in high frequency. In SY type, Hyeongbangjihwang-tang, Yanggyeoksanhwa-tang were used in high frequency. The both of high frequency-prescriptions in TE types were for the Interiorheat disease, expecially liver-heat lung-dry symptomatology. The main chief complaint of high frequency-prescriptions was fatigue in every constitution. We hope that the process of constitutional prescription would be standardized through the subsequent researches.

A Study on Role Conflict and Job Satisfaction of Neurosurgery Clinical Nurse Specialist (신경외과 임상전문간호사의 역할갈등과 직무만족에 관한 연구)

  • Lee, Hae Jin;Kang, Young Sil;Choi, Eun Sook
    • Korean Journal of Adult Nursing
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    • v.18 no.2
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    • pp.304-313
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    • 2006
  • Purpose: The purpose of this study was to describe role conflict and job satisfaction of Neurosurgery Clinical Nurse Specialist(NCNS) and to identify associated factors. Method: The target populations was 77 NCNSs from 30 general hospitals. Data were collected with self-administered questionnaires and analyzed using t-test and ANOVA. Results: The overall mean scores of role conflict and job satisfaction were $3.60({\pm}0.54)$ and $3.04({\pm}0.46)$ respectively. Significant variables affecting role conflict were the working period as NCNS, the number of colleague NCNSs in working hospital, and assignment of prescription rights. The significant variable affecting job satisfaction was assignment of prescription rights. There was no statistically significant correlation between job and role conflict. Conclusion: The variable effecting both role conflict and job satisfaction was the extent of prescription rights. In order to improve the quality of patient care and to protect Neurosurgery Nurse Clinical Specialist, the enactment of law on prescription practice is needed.

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Developing History of Theory on Ten Kinds of Prescriptions ('십제'설('十劑'說)의 변화·발전 과정)

  • Jo, Hak-Jun
    • Journal of Korean Medical classics
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    • v.26 no.4
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    • pp.223-235
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    • 2013
  • Objective : This study is about how the theory on ten kinds of prescriptions has been developed and how it has been applied for in prescription books and clinical texts. Methods : I made a comparison of this theory in prescriptions books and clinical texts. After it, I investigated the developing history based on it. Results and Conclusion : This theory had been used for classification of not prescription but herb, until Cho Gil(趙佶) and Seong Mugi(成無已) enlarged its meanings. The first mention about it was made by Jin Janggi(陳藏器). Yu Wanso(劉完素) gave it more definite meanings by showing prescription examples than before. Jang Jahwa(張子和) corrected what Yu Wanso explained. Besides, someone for example, Gu Jongseok(寇宗奭), Mok Huiong(繆希雍), Seo Chunbo(徐春甫), and so on added some kinds of prescription.

An Analysis on Prescribing Patterns of Antidepressants and Their Associated Factors in Lung Cancer Patients (폐암 환자의 항우울제 처방현황과 관련 요인 분석)

  • Sung, Kyeong Eun;Jeong, Kyeong Hye;Kim, Ae Ri;Kim, Eun Young
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.2
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    • pp.107-114
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    • 2016
  • Background: Depression is the leading cause of lowering the quality of life of cancer patients and lung cancer is the most likely to cause depression. It is necessary to find out depression-related factors in lung cancer patients. Methods: The study was a retrospective cohort study using medical records, and was a non-equivalent comparison group design. It involved patients diagnosed of lung cancer at the Konkuk University Medical Center from January to December 2012. Between antidepressants prescription group and non prescription group, socio-demographic factors, clinical factors, treatment-related factors and other factors were analyzed statistically. Results: Antidepressant prescription group consisted of 23 people and non-prescription group of 206 people. Prescription rate of quetiapine was the highest 47.8% (11/23), followed by escitalopram (43.5%, 10/23), amitryptyline and trazodone (30.4%, 7/23). The prescription group was prescribed with an average of 1.9 antidepressants. Antidepressants were prescribed after average of 248 days from lung cancer diagnosis and prescription period per patient was average 177.5 days. According to the result of univariate logistic regression analysis between 2 groups, factors such as number of outpatient visit, number of admission, days of hospitalization, sleep disorder, and comorbidity were found to be statistically significant (p < 0.05). However, According multivariate logistic regression analysis showed that number of admission, days of hospitalization and sleep disorder were statistically significant (p < 0.05) excluding comorbidity. Conclusion: About 10% of lung cancer patients had received a prescription for antidepressants after lung cancer diagnosis. A sleep disorder, number of hospitalization and length of stay were identified as factors influencing the prescribing antidepressants.

Prescribing Patterns of Antidepressants and Their Associated Factors in Breast Cancer Patients (유방암 환자의 항우울제 처방 현황 및 영향요인 연구)

  • Lee, Hye Min;Kang, Rae Young;Kim, Su Yeon;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.3
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    • pp.213-222
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    • 2013
  • Purpose: The aim of this study was to investigate the current state of antidepressant prescriptions in breast cancer patients and factors affecting the prescription of antidepressants. Methods: This study targeted female breast cancer patients who were prescribed antidepressants by a psychiatrist at least once between August 2010 and July 2011 at the Asan Medical Center in Seoul. The prescription history of each study subject was investigated to analyze the current state of antidepressant prescriptions in breast cancer patients. Results: The analysis of the prescription histories of 136 subjects in the antidepressant group determined that escitalopram, mirtazapine, and trazodone were the three most commonly prescribed medications with an average of 1.54 antidepressants prescribed per patient. A logistic regression analysis showed a statistically significant increase in antidepressant prescriptions in patients who were divorced or widowed, had sleep disturbances, or had undergone oncologic surgery for the breast cancer (p<0.050). In contrast, the prescription rate was lower for patients with tumour sizes greater than 50 mm (p<0.050). Conclusion: The sociodemographic factor of marital status, clinical factors of sleep disorders and tumour size, and a treatment-specific factor of the use of surgical therapy were identified as affecting the prescription of antidepressants in female breast cancer patients.

Retrospective Drug Utilization Review of Drug-Drug Interaction Criteria Based on Real World Data: Analysis in Terms of Dispensing Types (건강보험심사청구 자료에 근거한 병용금기 약물의 후향적 약물사용평가 : 처방전 조제 형태별 분석)

  • Lee, Young-Sook;Shin, Hyun-Taek
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.3
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    • pp.249-255
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    • 2011
  • Objective: To examine the drug use (prescribing) pattern of serious drug-drug interactions (DDIs, contraindicated drug interactions) using real world data. Prescription patterns were examined in terms of dispensing types. Method: Retrospective drug utilization review (DUR) study was performed. One hundred and six datasets of serious DDIs (DDI pairs) were determined among DDI datasets that Ministry of Health & Welfare announced for the DUR system from 2004 to 2005. Electronically transacted ambulatory patients' prescription database to Health Insurance Assessment and Review Services (HIRA) from July, 2005 to June, 2006 was collected with personal information deidentified and analyzed in terms of types of dispensing as a contributing factor. Results: After prescription data analysis per each patient, total number of DDI cases using 95 DDI pairs was 5,511, which accounted for 2.6 cases per patients. DDI cases between two drugs from each of community pharmacy dispensing- type prescription were considerable (63% vs. 24% in those from each of in-institutional dispensing-type prescription and vs. 13% in those from a community pharmacy dispensing-type prescription and an in-institutional dispensingtype prescription). Conclusions: DDI cases from different prescribers were found to be significant. Thus, the concurrent DUR process between prescriptions from different physicians and institutions should be implemented for the safe drug use.

The Impacts of Guideline for Digestives on Physicians' Prescription of GI medication (소화기관용약제 처방지침이 의사의 소화기관용약 처방률에 미치는 효과분석)

  • Kim, Dong-Sook;Park, Choon-Seon;Jang, Sun-Mee
    • 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.

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Clinical Analysis of Symptoms and Oriental Medical Prescriptions According to Elapsed Time of Stroke in Oriental Medical Hospital Inpatients

  • Yun, Hen-Ja;Sung, Kang-Keyng
    • Herbal Formula Science
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    • v.20 no.1
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    • pp.133-147
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    • 2012
  • Objectives : This study was intended to understand characteristics of symptoms, oriental medicine prescription and laboratory test results according to elapsed time of stroke. Methods : Through the medical records of 205 stroke inpatients in the oriental medical hospital in the year 2010, we investigated manifested symptoms, administered oriental medicine prescription and clinical pathological examination results. Collected items were classified to depend on stroke types, cerebral infarction and hemorrhage. We analyzed association between manifested symptoms, the oriental medicine prescription, and laboratory test results of stroke patients and elapsed time. Chi-square tests were performed to determine the significance level of association. Results : All symptoms, prescriptions and laboratory test results in cerebral infarction patients were associated with elapsed time. Especially, symptoms, prescriptions and pathological examination results showed very high statistical significance with elapsed time (a symptom; chi-square(df)=164.3(22), p<0.001, prescription; chi-square(df)=93.5(22), p<0.001, and pathological examination results; chi-square(df)=164.3(22), p<0.0004). But in the case of cerebral hemorrhage, there was not statistical significance. Conclusions : The elapsed time of stroke may be an essential requisite in catching symptoms and prescribing for stroke patients in oriental medical treatment.