• 제목/요약/키워드: Drug utilization

검색결과 219건 처리시간 0.03초

DUR 제도 및 DUR 고도화 시범사업에 대한 인식 탐구: 포커스 그룹 인터뷰 기법 중심의 질적 연구 (Exploring the Perception on Drug Utilization Review System and DUR Modernization Pilot Project: A Qualitative Study Using Focus Group Interviews)

  • 배성호;전하림;윤동원;최아형;이혜성;신주영
    • 한국임상약학회지
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    • 제31권2호
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    • pp.104-114
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    • 2021
  • Objective: To explore the perception of drug utilization review (DUR) system and DUR modernization pilot project among healthcare professionals and patients. Methods: We conducted 8 times of focus group interviews (FGI) between August 1, 2019 to December 31, 2019. The healthcare professionals and patients who participated in the DUR modernization pilot project were included in the present study. Based on the type of project participation or medical institution, the participants were divided into the following four groups: group 1, hospital; group 2, clinic; group 3, pharmacy; and group 4, patient. Within each group, interviews were conducted under a pre-defined agenda to identify the implicit perceptions of the participants; the contents of the interviews were, then, categorized. Results: Healthcare professionals established a consensus on the positive aspects of the DUR system and DUR modernization pilot project. However, substantial concerns remain, such as additional workload associated with monitoring adverse events or acquiring consents from patients. Furthermore, a difference of opinion over the DUR convenience system was observed. Among 3 DUR convenience system, the personal medication history review service was highly utilized, but pop-up hold function and communication system was rarely used. Conclusion: We observed that systematic intervention using the DUR system is effective for both healthcare providers and consumers. Adverse events caused by inappropriate drug use can be prevented by continuous patient monitoring. Therefore, the role of DUR system needs to be expanded to establish a safe drug management system.

의약품의 적정 사용을 위한 전략 (Strategies to Improve Use of Medicines)

  • 박실비아
    • 한국의료질향상학회지
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    • 제12권2호
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    • pp.93-112
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    • 2006
  • This study reviewed published studies on interventions used by hospitals, health insurance programs, or governments to improve use of medicines in foreign countries. Interventions to improve use of medicines are classified into two categories: 1) information strategies-dissemination of educational materials, group education, one-to-one educational outreach, drug utilization review, and feedback; 2) managerial strategies- formularies, prior authorization, and financial incentives. Dissemination of educational materials, which is a common intervention, was unsuccessful in changing physicians' prescribing behaviors. Problem-based small group education was more likely to change behaviors than didactic large group education. One-to-one educational outreach(academic detailing) was among the most effective strategies used to change prescribing behaviors. Prospective drug utilization review (DUR) program was more successful in improving use of medicines than retrospective DUR program. Feedback intervention has been reported to be ineffective to change behaviors. Formularies are frequently used to control medication use by most health insurance programs. Financial incentives provide physicians economic incentives according to appropriateness of prescribing. However, few published studies have assessed the efficacy of formularies or financial incentives. Prior authorization requires physicians to get authorization from health insurers before prescribing a certain group of drugs which is usually of high costs or risk. There is no magic bullet for quality use of medicines. Multifaceted interventions that help to predispose, enable, and reinforce desired behaviors are more likely to be successful.

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Synthesis and hypoglycemic Activity of the Substituted Pyrrolidine Thiazolidinedione Derivatives

  • Kim, Bok-Young;Ahn, Joong-Bok;Lee, Hong-Woo;Shin, Jae-Soo;Moon, Kyoung-Sik;Kim, Joon-Kyum;Lee, Do-Young;Ahn, Soon-Kil;Hong, Chung-Il
    • 대한약학회:학술대회논문집
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    • 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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    • pp.342.3-343
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    • 2002
  • Non-insulin dependent diabetes mellitus (NIDDM) is characterized by hyperglycemia, hyperinsulinemia. and impaired insulin action. Insulin resistance is considered to be the underlying mechanism in the pathogenesis of type 2 diabetes. which also leads to dyslipidemia, hypertension. and obesity. Thazolidinediones are a class of oral insulin-sensitizing agents that improve glucose utilization without increasing insulin release. They significantly reduce glucose, lipid and insulin levels in rodent models of NIDDM and obesity, and recent clinical data support theri efficacy in obese diabetic patients. (omitted)

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Induction of Apoptosis and Autophagy by Resveratrol via Activation of AMPK Pathway in 5-Fluorouracil-Resistant Colon Cancer Cells

  • Lee, Seung Young;Jung, Ji Young;Choi, Hee Won;Choi, Kyung Min;Jeong, Jin-Woo
    • 한국자원식물학회:학술대회논문집
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    • 한국자원식물학회 2018년도 추계학술대회
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    • pp.101-101
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    • 2018
  • Resveratrol is a polyphenolic compound, which is a naturally occurring phytochemical and is found in a variety of plants, including food such as grapes, berries and peanuts. Although several studies have demonstrated that resveratrol possesses anti-cancer activity against various types of human cancer, the molecular mechanisms of resveratrol-mediated overcome drug resistance potential are unclear. In this study, we determined whether resveratrol attenuates drug resistance responses in 5-fluorouracil-resistant colon cancer (SNUC5/5-FUR) cells. Treatment with resveratrol significantly enhanced apoptosis in a concentration-dependent manner, which was associated with the modulation of anti- and/or pro-apoptotic protein expression, activation of caspases and activation of AMP-activated protein kinase. Resveratrol treatment also increased the induction of autophagy through up-regulation of autophagy-related genes such as Microtubule-associated protein 1A/1B-light chain 3, P62 and beclin-1. However, blocking of autophagy by bafilomycin A1 reduced apoptotic cell death, suggesting that resveratrol-induced autophagy functions as a cell death mechanism in SNUC5/5-FU cells. Although the further studies are needed, these findings suggest that resveratrol may have therapeutic potential to overcome drug resistance in colon cancer patients.

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병용금기, 연령금기 경고 등급화 방안과 DUR 처방변경률 분석 (Tiering 'Drug Combinations to Avoid' and 'Drug-age Precaution' DUR Alerts by Severity Level and its Application)

  • 이수옥;제남경;김동숙;천방옥;황인옥
    • 약학회지
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    • 제59권6호
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    • pp.278-283
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    • 2015
  • The computerized prospective Drug Utilization Review (DUR) program supported by the Korean government has provided alerts to physicians and pharmacists since December 2010. This study aims to propose and apply the tiering system in "drug combinations to avoid (DCA)" and "age-precaution" alerts based on severity to improve the compliance of users. To propose the severity and clinical importance of 647 DCA alerts and 140 age precautions, a Delphi evaluation survey was conducted. An expert panel comprising 5 clinical pharmacists and 5 physicians were participated in mail surveys. Based on the results of Delphi survey, DCA pairs were classified into 3 groups; group 1 (70.6%), 2 (26.9%), and 3 (2.8%). Drug-age precaution ingredients were also classified into three groups; group 1 (53.6%), group 2 (40.7%), and group 3 (5.7%). When this grouping was applied to claim data from 2011 to 2013, the majority of alerts had occurred in the groups of high severity. Presenting DUR alerts with severity level is expected to improve the compliance of clinicians. The implementation of tiering system in DUR criteria should be considered.

한국과 미국의 약사 연수 교육 분석을 통한 자기 주도적 약사 연수 교육 도입 방안 (A Study on the Introduction of Self-directed Pharmaceutical Training Education through the Analysis of Pharmaceutical Education in Korea and the U.S.)

  • 정수철
    • 한국콘텐츠학회논문지
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    • 제19권1호
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    • pp.598-607
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    • 2019
  • 현재 한국의 약사 연수 교육은 연간 8시간으로 대한약사회와 그 산하 지부 및 분회에서 주로 실시하고 있다. 정해진 시간에 다수의 약사들을 대상으로 진행되는 교육은 학습효과가 제한적이며 적극적인 학습 참여를 유도하기 어렵다. 본 연구에서는 약사 제도의 역사가 긴 미국의 약사 연수 교육을 문헌 연구 하여 한국의 약사 연수 교육의 발전 방안을 찾아보았다. 연구의 대상은 한국과 미국의 약사 연수 교육 운용 방식, 평가제도, 교과목 등이었다. 연구 결과 미국의 약사연수 교육은 다양한 방식이었으며 이수 시간이 길며 약사 면허 갱신 제도와 연계되어 있었다. 한국의 약사 연수 교육이 교육 시간의 연장, 교육 내용의 다양화, 자기 주도적 학습 및 현장 실습 교육을 도입 한다면 현재보다 더 발전할 것이다.

일부(一部) 농어촌주민(農漁村住民)의 상병(傷病) 및 의료이용도(醫療利用度)에 관(關)한 조사연구(調査硏究) (A Study on Sickness and Utilization of Medical Care in a Rural Area of Kyunggido)

  • 장용태
    • Journal of Preventive Medicine and Public Health
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    • 제9권1호
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    • pp.139-146
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    • 1976
  • This survey attempted to determine the overall health situation in Kyunggido in terms of sickness prevalence, sickness distribution, demand for medical care by type, and utilization of medical care. The survey was conducted on 766 households, or 4,065 people, from July 1-31, 1975. The findings from the survey are as follows: 1) In terms of age distribution, 28.7% of the sample was from 10-19, the 40-49 age group was the next largest group, and those over 60 made up 7% of the sample. 2. The education distribution is as follows, 30.4% completed primary school, 22.4% had no formal education, 20.6% attended but did not onplete primary school, and 1.8% attended unversities or higher. 3) In terms of occupation, 55.9% were unemployed or family employees, which represents a large dependent population, 30.4% of the workers were employed in farming or fisheries. 4. The marital status is as follows, 58.8% of the women were married, 32.3% unmarried, and 7.5% divorced. 5) The prevalence rate of mouthy illness was 19.7% of 100 infant, 42.8% became fatally ill within the first year of life. This is a very high percentage compared with more developed nations. 6) Of those reportion on illness, 54.6% sought treatment. The rate of treatment was highest in infants at 77.7%. Us age increased, demand for treatment decreased to 43.1% for those in the aldest age group. The oldest age group also had the highest rate of non treatment at 56.8%. 7) The demand for medical care showed that 65.6% utilized drug stores, 20.2% utilized hospitals and clinics, 5.4% used herbdrug-stores and herb clinices, and 3.9% relied upon folk medicine and withch craft. 8) The utilization of medical facilties by sex is as follows, 65.1% of the men and 66.0% of the women used drug stores, and 19.2% of the men and 20.2% of the women used hospitals and clinics. However, more men (3.5%) were hospitalized than women (1.8%) 9) In terms of out-patient care, the largest age group of males was 10-19 (28.2%), and the largest age group of females was 0-9 (30.8%). There was no sex difference in the use of western pharmacies. Menaged 30-39 and women aged 50-59 were the most frequent users of herb clinics. 10) The rate of receiving treatment at drugstore hospitals went towards declining level in the second case of what While increaing much more at herb clinics and folk medicines in the second case than the first one. 11) After primary utilization of hospitals, 32.7%. of the adults aged 20-59 used drug-stores as a secondary source of care, and 12.8% of children and youth under age 20 continued receiving care at hospitals. 12) After primary utilization of drug-stores, 32.5 % of the adults continued to seek care at drug stores and 1.8% used hospitals. 4.2% of those over age 60 utilized folk medcine and witch craft.

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마이크로니들을 이용한 경피약물전달의 피부 미용학적 접근 (A Study on Transdermal Drug Delivery System with Microneedle System in the Field of Skin Care)

  • 김성준
    • KSBB Journal
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    • 제26권4호
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    • pp.277-282
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    • 2011
  • The penetration of outside material into skin is not easy. It is since the skin, which is a very hard barrier, protects the body against outside chemical and physical stimulation. Microneedle system which can help improve drug penetration into skin is advancing variously in transdermal drug delivery system (TDDS) in the field of skin care. After inserting microneedle into skin by using electrical or artificial forces, it makes microhole and drug penetration easily and induces natural skin rejuvenation. Diffusion and penetration of drug by optical and electrical force of microneedle is better for fast and effective TDDS. This is more developed than the traditional method such as the manual stamp, roller, and meso gun. The drug absorbed into dermal layer by microneedle helps revive and repair damaged skin. In the future, utilization of microneedle for skin care will progress constantly because of its human-friendly biodegradable materials and the development of the no pain microneedle.

처방전 고려사항과 항생제 처방행위에 관한 연구 (A Study on the Factors to be Considered before Drug Utilization and the Prescribing Behavior of Antibiotics)

  • 문선순
    • 한국병원경영학회지
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    • 제4권2호
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    • pp.286-304
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    • 1999
  • The purpose of the study was to analysis physician's prescribing behavior. Data was collected from 320 medical doctors of 10 general hospitals from August to September in 1996. The major findings are as follows; 1) Prescribing dosage: 74% of total selected middle dosage. Resident doctors used maximum dosage. 2) The number of similar antibiotics: 72.4% of total used 1 antibiotic. Surgery depts. and resident doctors selected 2, 3 antibiotics. Physicians to consider of insurance benefit or non insurance benefit used the number of antibiotics less than not to consider. Physicians to think over patient's economic state used less the number of antibiotics than that not to consider. 3) Used term of antibiotics: Total mean was 7.39 days. medical parts had 9.11 days but surgery used 6.41 days. Specialists consumed 6.57 days and residents applied 7.80 days. Physician to reflect result of claim used short term of antibiotics than that don't reflected. 4) Optional order of antibiotics: First antibiotics were selected 68% of total respondents, by medical depts, but secondary, tertiary antibiotics was used surgery depts. Tertiary antibiotics was used residents doctors, universal hospitals, fill beds and over. 5) The number of the items of oral drug : 3-4 the items of oral drug were used 76% of respondent Surgery parts selected 1-2 the items of oral drug, medical depts. selected five and over. Physician to reflect result of claim used less the number of the items of oral drug than that don't reflected. Physician to prescribe different of class of insurance used less the number of the items of oral drug than that don't prescribe different.

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Biotransformation, a Promising Technology for Anti-cancer Drug Development

  • Gao, Fei;Zhang, Jin-Ming;Wang, Zhan-Guo;Peng, Wei;Hu, Hui-Ling;Fu, Chao-Mei
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권10호
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    • pp.5599-5608
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    • 2013
  • With the high morbidity and mortality caused by cancer, finding new and more effective anti-cancer drugs is very urgent. In current research, biotransformation plays a vital role in the research and development of cancer drugs and has obtained some achievements. In this review, we have summarized four applications as follows: to exploit novel anti-cancer drugs, to improve existing anti-cancer drugs, to broaden limited anti-cancer drug resources and to investigate correlative mechanisms. Three different groups of important anti-cancer compounds were assessed to clarify the current practical applications of biotransformation in the development of anti-cancer drugs.