• 한국임상약학회지
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• 제30권2호
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• pp.113-119
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• 2020

Background: Reducing the total anticholinergic burden (AB) in older adults is recommended owing to the several peripheral and central adverse effects. This study aimed to identify the AB status of patients admitted to geriatric centers for assessing the influence of the pharmacist-involved multidisciplinary geriatric team care on reducing the AB. Methods: We retrospectively reviewed the medical records of 328 older patients hospitalized in geriatric centers from July 1, 2018 to June 30, 2019, who received comprehensive geriatric assessment and pharmaceutical interventions from a multidisciplinary geriatric team. We measured the total AB scores for the medications at the time of admission and upon hospital discharge using the Korean Anticholinergic Burden Scale (KABS). The pre-admission factors associated with high AB (KABS score ≥3) at the time of admission were identified. Results: The proportion of patients with high AB significantly decreased from 41.8% (136/328) at the time of admission to 25.0% (82/328) on discharge (p<0.001). The pre-admission AB of patients transferred from skilled nursing facilities (odds ratio[OR]: 2.85, 95% CI: 1.26-3.75), taking more than 10 medications (OR: 3.70, 95% CI: 1.55-8.82), suffering from delirium (OR: 2.80, 95% CI: 1.04-7.50), or depression (OR: 2.78, 95% CI: 1.04-7.41) were significantly high. Antipsychotics were the most frequent classes of drugs that contributed to the total KABS score at the time of admission, followed by antihistamines. Conclusions: This study demonstrated that the multidisciplinary teams for geriatric care are effective at reducing AB in older adults. The factors associated with high AB should be considered when targeting pharmaceutical care in geriatric individuals.

• 치위생과학회지
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• 제11권5호
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• pp.417-422
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• 2011

본 연구는 우리나라 일부 약사들이 어린이대상 구강투여용 약을 판매하는 과정에서 무설탕 약을 우선시하는지 의 실천도를 조사하고, 각각의 실천도와 약사의 구강보건지식과 태도 및 인식과의 연관성을 파악할 목적으로, 약사 151명을 대상으로 조사하여 다음과 같은 결과를 확인하였다. 1. 약사의 어린이대상 구강투여용 무설탕약 추천을 고려하는 비율과 무설탕약을 선택하도록 설득을 시도하는 비율은 각각 33.8%와 55.6%로 연령계층과 경력별 유의성을 확인할 수 없었으나(p>0.05), 무설탕약에 대한 구강건강관련 조언을 제공하는 비율은 45.7%로 연령계층과 경력별로 유의한 차이가 있었다 (p<0.05). 2. 약사의 구강보건태도와 인식이 높은 집단에서 구강 투여용 무설탕약 추천을 고려하는 비율과 무설탕약을 선택하도록 설득을 시도하는 비율, 무설탕약에 대한 구강건강관련 조언을 제공하는 비율이 높은 것으로 확인되었으며, 연령계층과 경력별로 유의한 차이가 있었다(p<0.05). 3. 무설탕약 추천고려 여부와 구강보건태도 간에, 무설탕약 선택 설득시도 여부와 구강보건인식 간에, 무설탕약에 대한 구강건강관련 조언제공 여부와 구강보건태도 및 인식 간에 연관성이 확인되었다. 4. 30-60%수준인 약사의 어린이대상 구강투여용 무설탕약 관련 실천도를 향상시키기 위해, 약사의 구강보건지식, 태도, 인식을 향상시킬 수 있는 방안의 개발필요성을 확인하였다.

• 의료법학
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• 제15권1호
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• pp.123-164
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• 2014

Under the new system of 'Separation of pharmaceutical prescription and dispensing' in Korea, which was implemented in 2000, physician could not dispense a medicine, and outpatient should have a physician's prescription filled at a drugstore. After pharmacist makes up outpatient's prescription, National Health Insurance Service(NHIS) pay for outpatient's medicine to pharmacist, except an outpatient's own medicine charge. And NHIS only pay for outpatient's prescription fee to physician and, physician doesn't derive profit from dispensing medicine in itself. Nevertheless, if physician writes out a prescription with violation of 'Criteria for the Medical Care Benefits', NHIS clawed back the payment of outpatient's prescription and medicine from the physician or the medical institution which the physician belongs to. In the past, NHIS's confiscation was in accordance with 'the National Health Care Insurance Act, Article 52, Clause 1'. But, since 2006 when the Supreme Court declared that there was no legal basis on the NHIS's confiscation of outpatient's medicine payment, NHIS had put in a claim for illegal prescriptions on the basis 'the Korean Civil law, Article 750(tort)'. So, Many medical institutions filed civil actions against NHIS. The key point of this actions was whether the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits constitute of the law of tort. On this point, the first trial and the second trial took different position. Finally the Supreme Court acknowledged the constitution of the law of tort in 2013. In this paper, the author will review critically the decision of the Supreme Court, and consider the relativeness between the legal effect of Criteria for the Medical Care Benefits and the constitution of the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits as the law of tort.

• 한국임상약학회지
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• 제26권3호
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• pp.201-206
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• 2016

Objective: Direct current cardioversion for atrial fibrillation could be associated with the risk of thromboembolic events. Anticoagulation therapy with warfarin (INR 2.0-3.0) is recommended 3 weeks before and 4 weeks after cardioversion to reduce the risk of thromboembolism. This study evaluated warfarin therapy in pharmacist-managed anticoagulant services (ACS). Methods: This retrospective study was performed in 106 patients with atrial fibrillation from 2012 to 2013. The primary efficacy endpoint was the composite of stroke, transient ischemic attack, myocardial infarction, and cardiovascular death. The primary safety measure was major bleeding. To evaluate the peri-procedural effects of warfarin treatment, we studied whether target INR was maintained, as well as the maintenance period of the therapeutic range. Quality of treatment was measured by time in therapeutic range (TTR) by using the Rosendaal method. Results: There were no thromboembolic events, but TEE examination at time of cardioversion showed a left atrial thrombus in three patients (2.8%). Bleeding complications after cardioversion occurred in 2 patients (1.9%). The average INR value at the time of cardioversion was $2.59{\pm}0.8$, and was within the therapeutic range in 83 patients (78%). Analysis of the patients in whom the value was within the therapeutic range twice consecutively showed that the ratio of TTR was 80% and the therapeutic range was maintained in 67 patients (63%) for an average of 4.90 weeks prior to cardioversion. Similarly, 76 patients (72%) had a stable INR within the therapeutic range for an average of 5.70 weeks and a mean TTR of 83%. Conclusion: Pharmacists significantly contributed to appropriate warfarin treatment with close monitoring during cardioversion. Likewise, active pharmacist monitoring and systemic management should be considered to reduce thromboembolism and bleeding complications in the peri-cardioversion period.

• 한국간호교육학회지
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• 제6권2호
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• pp.376-389
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• 2000

The Purpose of this study was to grasp the status of drug uses in college students, and to investigate the knowledge and attitude when they use it. We collected through questionnaires from Sep. 1 to Oct. 30 in 1999. The subjects were 490 college students in Seoul and northern of the Kyunggi-do. The data analysis was performed using SPSS (version 7.0) and ANOVA. The results of this study were as follows. 1. There was no correlation for all factors in the relationship between general characteristics of subjects and knowledge for drugs. On the contrary, in the relation of the general characteristics and attitude for drug of subjects, some factors are statistically significant e.g., department (F=3.049, p<.010), satisfaction for school life (F=6.167,p<.002), body shape(F=8.092, p<.000), and the relationship with ones parents (F=3.728, p<.005). 2. In the analysis of drug use status and knowledge, only in the factor of administration control was statistically significant(F=4.304, p<.014) and in the relation of attitude for drug uses, drug administration was statistically significant (F=4.521, p<.004). 3. In the mean scores for the drug knowledge analysis, the highest factor was 'A narcotic make deformed persons through poisoning of physical and mental' (M=4.14), the lowest factor was 'If catch the flu during the pregnancy, should be take drug as possible as quickly to reduce negative effect for fetal' (M=1.94). 4. In the analysis for drug attitude, the highest factor was 'A drug is alike a poison' (M=3.48), 'Should be keep the usage and dosage of drug' was the lowest (M=1.48). 5. From the investigation for status of drug use, it was revealed that the most subjects (73.6%) were purchase drugs after explain their symptoms to pharmacist. And they take drugs only when they felt painful in 43.1%. The most students (70.4%) were experienced control of drug administration. It was inquired that subjects were mainly obtained information about drugs from pharmacist and television (or radio) advertisement, 33.5% and 33.1%, respectively. In the examination for existence of long-term administrators in their family, 'none' and 'only parents' are 49.6% and 37.3%, respectively. When their parents have illness, the persons go to drugstore and hospital for heath-care, 47.8% and 44.3%, respectively. On the basis of results of this study, we suggest as follows. 1. This study was analyzed data from questionnaires for college students in a part of local areas, so we suggest that the next research should be perform for national-wide students as subjects to generalize the results. 2. It is need more intensive research methodologies such as interview and observation. 3. Additional research is required for knowledge and behaviors of drug uses that will how impact on ones health behavior.

• 한국의사학회지
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• 제36권2호
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• pp.27-48
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• 2023

This study identifies 164 Korean medicine practitioners among the independence activists and describes the types and characteristics of their independence movements. Their occupations included apothecary pharmacist, herbalist, and medicine dealer. They originated from Gyeongbuk, Hamnam, Pyeongnam, and Gyeongnam, with a higher proportion of Hamnams compared to independence fighters. Their ages are concentrated in the 30s and 40s. Their movements are similar to those of independence heroes, in the order of domestic resistance, the March 1 Movement, and Manchurian resistance. The crimes are Security Law, Exorcism No. 7 of the 8th Reign of Daejeong, Public Order Maintenance Law, and attempted murder. In terms of sentences, the proportion of those sentenced to five years or more in prison is higher, and the proportion of those sentenced to less is lower. The above independence movements in Korean medicine practitioners are characterized by (1) the use of direct force, (2) long-term and planned struggle, (3) the provision of contact points and funding sources, (4) a nationalist line, and (5) low socialist-communist share.

• 한국임상약학회지
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• 제25권1호
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• pp.27-33
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• 2015

Background: Since November 2012, some of over-the-counter (OTC) medications have been sold in convenience store without pharmacist' s supervision. We purposed to examine if the product labels of OTCs provide sufficient information that is appropriate for consumers who may have low health literacy. Methods: We compared the difficulty of words that are utilized in pharmaceutical product labels of interest (intervention) with those in the $6^{th}$ grade textbook (control). Pharmaceutical products of interest were comprised of 13 OTCs which have been sold currently in convenience stores. We grouped words into the 4 levels of difficulty based on the Korean Vocabulary Classification for Education, and statistically tested words frequency in each level between OTCs and control. Results: The 13 OTC labels included lay language (easier or equal to language used in primary school) about 10% less; professional language about 10% more (p < 0.001 in all). Labels for analgesics had the longest and most difficult information, followed by common cold preparations, muscle pain relievers as plaster or cataplasma and digestives. Conclusion: The 13 OTC labels might fail to provide appropriate information for safety use by consumers in terms of the difficulty level of words. The improvement of labels of OTC medications and consumer education strategies are called for safety use of OTC medications sold in convenience stores.

• 한국임상약학회지
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• 제16권2호
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• pp.96-100
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• 2006

Korea Food and Drug Administration (KFDA) has been expediting the Biological Equivalence Examination (BEE) project to encourage generic substitution without expense of inappropriate therapeutic outcome. However, little is known about which considerations are most important in making the decision to prescribe a drug among many generic drugs. The purpose of this survey was to identify how strongly the KFDA certification of BEE influenced doctors when they make a choice between brand and generics of glimepiride preparations. Telephone survey was performed towards doctors working at local clinics by using a questionnaire. Most influential factor to doctors' decision was drug cost followed by pharmaceutical representatives, therapeutic efficacy, and review guideline for reimbursement. Advertisement of the drug was the least influential followed by KFDA certification of BEE. The meaning of BEE was best understood by relatively young doctors with specialty in surgical parts. This survey result further indicated that the doctors considered the therapeutic equivalence examination a preferred measure to expedite generic substitution.

• 한국임상약학회지
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• 제20권2호
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• pp.120-127
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• 2010

Objective: The purpose of this study was to identify the type and frequency of chemotherapy-related prescribing errors and assess the pharmacist intervention in preventing potential harm. Methods: This study was performed in satellite pharmacy of oncology/hematology unit in tertiary teaching hospital from April to September, 2009. All chemotherapy prescribing errors detected by pharmacists were recorded. Frequency and characteristics of prescribing errors were analyzed. Pharmacists reviewed 28, 495 chemotherapy orders from 12,719 patients during 6-month periods. Results: A total of 835 prescription errors (2.93%) in 734 patients (5.77%) were detected by pharmacists. Alkylating agents (37.6%) followed by antimetabolite (23.35%), and mitotic inhibitors (21.44%) were the most prevalent classes in which errors occurs. The most common types of error detected were incorrect dose (34%), incorrect solution (33%), incorrect route (9%) and omission errors (8%). Changes in chemotherapy order due to pharmacists' intervention occurred in all error cases. Conclusion: Pharmacists' intervention in reviewing chemotherapy and drug orders intercepted potential harm due to prescribing errors. The current study provided strategies for reduction of medication errors.

• Journal of Pharmaceutical Investigation
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• 제37권2호
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• pp.119-126
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• 2007

Tablet splitting is used in pharmacy practice to adjust the dose to be administered. However, it also causes several problems such as undesirable effect for sustained release or enteric-coated dosage form, inaccuracy of dose, and pharmacist's safety by splitting hazardous drugs. This study investigated the current status of oral dosage form splitting for patients older than 19 years by analyzing Korea National Health Insurance Claims Database. Out of oral solid drugs prescribed (N=1,486,584) 9.8% of them included tablets (or capsules) split. There were some splitting cases even in sustained release (4.9%), enteric-coated forms (1.3%) and hazardous drugs (2.7%) that were selected by NIOSH (The National Institute for Occupational Safety and Health). The most frequently split drugs were antihistamines, neuropsychotics and steroids. In case of digoxin and warfarin, unit doses in a domestic market were not diverse compared to foreign markets. Guidelines for splitting oral solid dosage forms, approval of diverse doses and conducting dose-response studies for the commonly splitting ingredients on Korean people are needed for the saff and effective use of oral solid drugs.