• 보건행정학회지
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• 제22권4호
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• pp.561-578
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• 2012

This study was performed in order to compare a change in pharmaceutical expenditures per outpatient of clinic and to analyze factors relevant to a systems as part of evaluating policies for the incentive scheme to reduce total prescribed drug expenditure and for the drug utilization review system("DUR system" hereafter). For this, it had finally analytical subjects as 21,320 clinics nationwide without a change in location, clinics symbol and signed subject during both terms of the first half of 2010 and the first half of 2011. As a result, the odds ratio with reduction in pharmaceutical expenditures of clinic was statistically higher significantly in the shorter year number of opening clinic, in the larger number of doctors, when the classification of establishment is other, not individual, and when the signed subject is surgical division. Also, the odds ratio was significantly higher in the less patient number of clinic and in the lower ratio of patients aged over 65. Finally, the odds ratio was significantly high when a clinic had been located in DUR system demonstrative project area. Through this, a case of policy for improvement in doctor's autonomous prescription behavior like DUR system can be known to be effective for reduction in pharmaceutical expenditures. A future research on evaluation of policy for pharmaceutical expenditure management system will need to be performed in-depth analysis in consideration of diverse characteristics on the participatory entities.

• 보건행정학회지
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• 제26권3호
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• pp.207-218
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• 2016

Background: This study was performed to identify factors associated with the utilization of tests for diabetes complication and hemoglobin A1c (HbA1c) among diabetes patients in Jeollanam-do, Korea. Methods: The study subjects were 2,310 diabetes patients participated in 2014 community health survey in Jeollanam-do, Korea. Dependent variables were the utilizations of fundus examination, microalbuminuria test, and HbA1c test. The used statistical analysis methods were chi-square test and hierarchical regression analysis with weight in consideration of complex sample design. Results: The utilization rates of fundus examination, microalbuminuria test, and HbA1c test were 25.8%, 27.4%, and 12.3%, respectively. In the results of hierarchical regression, fundus examination was significantly related to age, education level in predisposing factors, residential area in enabling factors and recognition of blood sugar, drug therapy, and subjective health status in need factors. Microalbuminuria examination was significantly related to monthly income, residential area in predisposing and health screening, recognition of blood sugar, drug therapy, diabetic education, number of chronic disease, and subjective health status in need factors. HbA1c examination was significantly related to age, education level, marital status in predisposing factors, residential area in enabling factors and drinking, recognition of blood sugar, drug therapy, and diabetic education in need factors. Conclusion: The results of this study were shown that perception of their disease seriousness, education about diabetes management, and accessibility of tests were important to utilization of test for diabetes complication and HbA1c. It might be necessary to the develop and strength strategies for enhancing the utilization of tests for diabetes complication and management in diabetes patients.

• 대한임상약리학회:학술대회논문집
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• 대한임상약리학회 2003년도 춘계 Symposioum
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• pp.3-4
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• 2003

• 한국임상약학회지
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• 제26권3호
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• pp.220-229
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• 2016

Background: The treatment goal for patients with chronic hepatitis B infection is to prevent progression of the disease to cirrhosis and hepatocellular carcinoma. Current therapies include standard and pegylated interferon-alfa and nucleoside/nucleotide analogues: lamivudine, adefovir, entecavir, telbivudine, clevudine, and tenofovir. This study aims to analyze changes in the prescribing patterns of chronic hepatitis B (CHB) medications in South Korea between 2013 and 2014. Methods: A cross-sectional study was conducted using National Patients Sample data compiled by the Health Insurance Review and Assessment Service from 2013 and 2014. Patients with CHB were identified with Korean Standard Classification of Diseases code-6 (B18.0 and B18.1) and those who were maintaining active prescriptions with CHB medications covering the index date (December $1^{st}$, each year) were included. The utilization of antiviral therapy was investigated during 2013 and 2014. Results: A total of 4,204 and 4,552 patients in 2013 and 2014 respectively, were included in the analysis. The proportion of male patients was two of third and the patients 41-60 years old accounted for 60% of all analyzed patients. The most utilized drug was entecavir (55.1% in 2013 and 44.8% in 2014) and the second most utilized drug was tenofovir in both years (18.8% in 2013 and 29.0% in 2014). The percentage of combination therapy was 13.6% and 13.1% in 2013 and 2014, respectively. The proportion of tenofovir prescriptions was increased in 2014 compared with 2013. Conclusion: With the development of new drugs and the changes in clinical practice guidelines, the prescription pattern of the antiviral agents for patients with CHB has changed. The rate of utilization of tenofovir has increased.

• 한국임상약학회지
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• 제27권3호
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• pp.127-135
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• 2017

Background: Kawasaki disease (KD) is an acute febrile, systemic vasculitis as a leading cause of acquired heart disease in children. Intravenous immunoglobulin G (IVIG) and aspirin are the standard initial therapy in the treatment of acute KD. The purpose of this study was to investigate drug utilization in children with KD, and to compare "IVIG + high-dose aspirin" and "IVIG + moderate-dose aspirin" in preventing cardiac complications. Methods: We analyzed pediatric patient sample data compiled by the Health Insurance Review & Assessment Service from 2010 to 2015. We identified patients with KD using the KCD-6 code of M30.3. We excluded patients in chronic phase or ${\geq}1$0 years. We also excluded patients who were diagnosed KD in November or December. Drug utilization pattern were assessed in acute KD patients and 30-day and 60-day cardiac complications were investigated between "IVIG + high-dose aspirin" group and "IVIG + moderate-dose aspirin" group. Results: In acute phase, IVIG was administered to 95.8% patients, and 57.1% patients were prescribed moderate-dose aspirin and 25% patients were with high-dose aspirin. Steroid use was rapidly increased from 4.0% in 2010 to 11.3% in 2015. Both 30-day and 60-day cardiac complications occurred less in "IVIG + high-dose aspirin" group compared to "IVIG + moderate-dose aspirin" group, but not statistically significant (0.9% vs 1.8%, p=0.252 for 30-day complication rate; 1.5% vs 2.7%. p=0.073 for 60-day complication rate). Conclusion: We were not able to demonstrate which aspirin therapy is superior for preventing cardiac complications in acute KD patients and further research is warranted.

• 한국임상약학회지
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• 제30권2호
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• pp.73-80
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• 2020

Objective: The Australian Pharmaceutical Benefits Scheme (PBS) is a national drug subsidy program. Given the similarity and comprehensiveness of the Australian PBS and the Korean National Health Insurance (NHI) data, these data are increasingly used for pharmacoepidemiological investigations, as well as international comparative studies. This study aims to introduce the various sources of publicly available PBS data and provide a practical guide to researchers conducting drug utilization studies. Methods: We searched literature and websites to detail and compare the collection, structure, components, and characteristics of each PBS data format. We identified different characteristics of the PBS data from the Korean NHI claims data which are mainly owing to their unique co-payment policies and data collection processes. In addition, the utilization and expenditure of atorvastatin, a widely used treatment for hyperlipidemia, were analyzed using two different sources of PBS data and the different results were interpreted. Results: There exist differences in when data were collected or non-subsidized uses of medicine were included among sources of PBS data. Additionally, two countries have different cost sharing methods inmedicine subsidy scheme; co-payment in Australia and co-insurance in Korea. Therefore, it should be noted that prescriptions under co-payment are not included in some data sources in Australia. Conclusion: Despite several analytical challenges, open access and easy data management are the strengths of the PBS data sources. A detailed knowledge of the PBS data can ensure robust methodology and interpretation of pharmacoepidemiological investigations or international comparative studies.

• 한국콘텐츠학회논문지
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• 제20권2호
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• pp.462-471
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• 2020

일반적으로 수면제로 사용되는 졸피뎀은 신경 억제 물질을 증가시키기 위해 GABA 수용체에 결합한다. 실제 졸피뎀을 4주 이상 연속으로 복용하는 경우는 많이 있다. 현재 한국에서 시행되고 있는 의약품 사용평가(DUR)은 졸피뎀의 사용 패턴을 확인할 수 있다. 수면제인 졸피뎀의 과다 사용을 예방 할 필요가 있다. 본 연구는 2019년 5월 10일부터 2019년 5월 15일까지 진행되었다. 검색된 총 125,197건의 문서 중 1차 및 2차 선별을 실시하여 진행하였다. 졸피뎀 과다 사용과 직접적인 관련이 있는 최종 254개의 문헌 사례를 선정하였다. 체계적인 문헌 연구를 통해 졸피뎀의 과다 사용을 예방 할 수 있는 방안을 모색하고자 하였다. 연구대상 선별과정에서 연구의 비뚤림 효과를 최소화 하였다. 졸피뎀의 과다 사용은 심각했으며 사용량이 계속 증가하는 추세였다. 졸피뎀을 이용한 범죄도 증가하고 있었다. 졸피뎀은 마약류 통합 관리 시스템과 의약품 사용평가를 통해 관리 될 수 있다고 연구되었다. 졸피뎀의 사용을 줄이기 위해서는 마약류 통합관리 시스템과 과다 사용자 교육을 통한 수요와 공급을 동시에 억제할 필요가 있다.

• 한국임상약학회지
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• 제20권3호
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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.

• Biomolecules & Therapeutics
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• 제23권6호
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• pp.510-516
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• 2015

In this review, lipid A, from its discovery to recent findings, is presented as a drug target and therapeutic molecule. First, the biosynthetic pathway for lipid A, the Raetz pathway, serves as a good drug target for antibiotic development. Several assay methods used to screen for inhibitors of lipid A synthesis will be presented, and some of the promising lead compounds will be described. Second, utilization of lipid A biosynthetic pathways by various bacterial species can generate modified lipid A molecules with therapeutic value.

• 보건교육건강증진학회지
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• 제29권2호
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• pp.1-12
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• 2012

Objectives: Several practice guidelines recommended both medication and behavior modification to control hypertension. The objective of this study was to analyze ambulatory care utilization pattern and related factors. Methods: A retrospective cohort study was conducted among 45,267 new users who initiated treatment with hypertensive drugs in 2003. Korean National Health Insurance Claims Data was used to study the medical care utilization behavior and related factors after treatment initiation for up to four years. Taking prescription was considered as medical care utilization. Results: More than 20% of patients discontinued visiting physicians for prescription after initiating antihypertensive drug therapy. The average number of institutions visited by patients was about 1.3 annually. Clinic was the most frequently visited institution by patients. In GEE analysis, probability of continuous visit one institution after initiating antihypertensive drug treatment increased in patients who were women, old, have comorbidity, visited clinic or hospital mainly in previous year. Conclusions: Young hypertensive male patients who have no major comorbidity showed high possibility to discontinue medical service utilization. It is necessary to educate these targeted patients about importance of hypertension management in early stage after treatment initiation.