• Korean Journal of Clinical Pharmacy
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• v.26 no.1
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• pp.24-32
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• 2016

Objective: The visually impaired have limited access to health care services and related information, and thus, they can have serious hurdles against properly taking medications. Despite that it is important to improve self-care ability of the visually impaired for correct medication use, there have been few studies investigating their needs for health care services in Korea, particularly focusing on proper medication usage. This study is to explore safety-related issues regarding mediation usage among the visually impaired based on in-depth interview. We particularly focus on any obstacles for safe use of medicines including experience on medication-related adverse effects in order to provide preliminary evidence for policy measures to improve proper medication use among the visually impaired. Methods: Study sample was visually impaired individuals who resided in Seoul area and were registered in the National Association of Visually Impaired. The association helped the process of recruiting the study participants. In-depth interview for each study participants was conducted. Each interview was recorded and later converted into a written script to extract core contents for the analysis. Results: The study participants comprised of three women (42.9%) and four men (57.1%). One was in his 20's, and there were four participants in 30's and two in 40's. Fully impaired participants were majority (5 out of 7). Limitation to physical access to health care providers and health information were the key factors to hamper safe medication utilization among the study participants. Difficulty reading medication information and may take the wrong medication or incorrect doses of medication, resulting in serious consequences, including overdose or inadequate treatment of health problems. Visually impaired patients report increased anxiety related to medication management and must rely on others to obtain necessary drug information. Pharmacists have a unique opportunity to pursue accurate medication adherence in this special population. This article reviews literature illustrating how severe medication mismanagement can occur in the visually impaired elderly and presents resources and solutions for pharmacists to take a larger role in adherence management in this population. Conclusion: The visually impaired had difficulties reading medication information and identifying medicines, and took incorrect doses of medications. Public support for safe medication use and medication management among the visually impaired is necessary.

• Korean Journal of Health Education and Promotion
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• v.21 no.3
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• pp.117-131
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• 2004

Purpose: This study was conducted to evaluate the health behaviors and to find out risk factors of blood pressure of adult women in a rural area. Method: The convenient sample consisted of 159 adult women who lived in G-gun. The data was collected using a self-report questionnaire for health behaviors and mercury type sphygmomanometer for BP, between Jun I and August 15, 2003. Health behaviors measured smoking, alcohol, salt, lipid, stress, exercise, coffee, BMI and medication. To accomplish the goal of study, descriptive statistics, t-test, $x^2$-test, ANOVA and multiple regression analysis were. performed with SPSS 10.0. Results: The average age of subjects was 49.2(SD7.34)years old. The average SBP and DBP of subjects were 126.22mmHg(SDl6.73) and 8 1.25mmHg(SDl 0.31). There were significant differences in smoking(p=.000), cigarette consumption(p=.001), smoking duration(p=.000), BMI(p=.033), medication (p=.001), family history(p=.000) between normotensive and hypertensive. The main risk factors on SBP were medication, age, BMI, family history and smoking duration by 35.7% of the total variance these variables explained SBP. The main risk factors on DBP were BMI, education and medication by 17.60% of the total variance these variables explained DBP. Conclusion: These results suggest that health professional have to emphasize prevention of obesity, lasting medication and no smoking for prevention and management of hypertension in community health promotion program.

• YAKHAK HOEJI
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• v.57 no.5
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• pp.369-375
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• 2013

Objective: Using the Korean Health Panel data (KHP) of 2008 and 2009, this paper analyzed the effect of antihypertension medication adherence on the changes in medical service utilization and medical expenditure in the next year. Method: Through a face-to-face interview survey, KHP has provided an extensive data on demographic characteristics, medical utilizations behavior, medical expenditure and health behaviors of the targeted households and their members since 2008. KHP is recognized as highly accurate regarding medical expenditure in that it makes the target households to record 'Health diary' whenever they use healthcare service, which could minimize their cognitive bias or memory distortion. The 2010 KHP data was based on the interview from 6,432 households and 19,697 household members. Two part model was used to explore the effects of medication adherence on medical use (logistic regression analysis) and medical expenditures (OLS). Result: Our study result demonstrated that the 74.7% of the patients who strictly adhere to their medication in both years, in 2008 and in 2009, were likely to use inpatient service in 2010. This shows the noncompliant patients were in fact use emergency service less than the compliant patients. Conclusion: Based on our analysis, this paper concludes that the high medication adherence of hypertensive patients could contribute to reduce the emergency service use. Therefore it is highly recommendable for the Korean government and the insurer, NHIS, to actively invest in developing education and promotion program to improve medication adherence among hypertensive patients.

• Korean Journal of Health Education and Promotion
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• v.31 no.2
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• pp.41-53
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• 2014

Objectives: The purpose of this study was to evaluate the education contents on safe use of medications in healthcare textbooks for elementary, middle and high schools. Methods: We examined 6 textbooks for the $5^{th}$ grade, 4 textbooks for middle school, 3 textbooks for high school, and 5 education materials published by the Korea Food and Drug Administration, National Health Insurance Service, and Seoul City Government. To evaluate the contents in health textbooks, we developed the 30 evaluation items. Results: Middle school textbooks had the most educational contents followed by high school and elementary school textbooks. Public education materials for the teenagers included more educational contents than those for children. The education material published by National Health Insurance Service had the highest score and the rest of the books earned under 15. And there were no core contents in medication education. Conclusions: Medication education through health textbooks should be strengthened to raise the level of medication awareness, to use medications safely, to prevent the drug abuse and misuse, and to establish the responsible judgment of medication information in the mass media. The current contents were found to be insufficient to meet these goals of medication education.

• Journal of Korean Public Health Nursing
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• v.19 no.1
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• pp.117-128
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• 2005

Purpose: The study examines the condition of medication counseling to determine the patient customers' demands, with the purpose of providing a basic data to improve the condition of medication counseling for phamacists and clinical nurses. Method: Questionnaire was completed by 150 nursing students. For data analysis, the SPSS win 10.0 program was used. Result: The contents of medication counseling given by the pharmacists in order of frequency were($100\%$ means 'always'): way of use$(78.7\%)$, period of taking medicine $(63.3\%)$, dosage$(46.7\%)$, effect$(27.3\%)$, drug name$(18.7\%)$, diet$(12.7\%)$, question of taking other drug$(12.7\%)$, giving a notice$(12.0\%)$, way of storage$(7.3\%)$, side effects$(6.0\%)$, drug interaction$(3.3\%)$' The needs and demands desired by the patients in order of frequency were('the most important' is given 10 points, followed by the others in numerically decreasing order until 0): effect(8.68), way of use(7.60), side effect(7.20), giving a notice(6.38), dosage (5.95), drug name(5.67), a period of taking medicine(5.60), drug interaction(4.37), diet(3.63), the way of storage(3.03). Most of the respondents were satisfied with the pharmacists' kindness$(62.7\%)$. Some recognized the medication counseling was quite good$(16.7\%)$, but the majority felt it was modest$(50.8\%)$' Nearly half of them felt the medication counseling time was quiet short$(47.3\%)$' The communication was mostly oral$(83.3\%)$, while others used sticker$(6.0\%)$ or leaflet$(6.0\%)$ additionally. There was a significant correlation between pharmacists' kindness and medication counseling content(p<,01), and also recognition(p<.001). The correlation between the number of medication counseling which gave to the patient customer and the recognition was also significant (p<.001). As the number of medication counseling increased, the patient felt the medication counseling time was adequate(p<.05). The correlation between the medication counseling recognition and the adequate time was also very significant(p<.001). Conclusion: These results revealed the situation of medication counseling to be poor and to be differ from the patient customers' demands. Therefore optimal medication counseling, especially regarding possible side effects and drug interaction should be emphasized. Pharmacists and clinical nurses should give qualitative medication counseling which reflects the patients' demands.

• Korean Journal of Clinical Pharmacy
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• v.25 no.4
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• pp.231-237
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• 2015

Backgrounds: Patient counseling has been forced since June. 19, 2014. Prior to this, there was no study to try to standardize medication counseling to improve quality. Purpose: This study was to investigate satisfaction level and comprehension level between the pharmacist group and the patient group about standardized medication counseling sheet. Methods: Questionnaires to assess standardized patient counseling sheet were posted at online survey software (Qualtrics) to pharmacists who worked at community pharmacy and patients who had visited community pharmacy before. Results: Three hundred thirty five patients and three hundred nineteen pharmacists were responded to the questionnaire (Response rate: 72.9%). More than half of each group were satisfied with standardized medication counseling sheets 'for the general public', 'for the pregnant women and nursing mothers', 'for the chronic patient', and 'for the aged' and patient group were more satisfied than pharmacist group. Similarly, more than half of each group comprehended with the medication counseling sheets 'for the general public', 'for the pregnant women and nursing mothers', 'for the chronic patient', and 'for the aged'. Patient group tended to expect longer patient counseling time per one drug than pharmacist group. Also, the majority of both groups wanted to provide standardized medication counseling sheets constantly and extend for all drugs. Conclusion: Both groups were satisfied and comprehended standardized medication counseling sheets, and agreed to expand standardized medication counseling sheets to all drugs. So, it is necessary to build the standardized medication counseling of all drugs.

• Korean Journal of Clinical Pharmacy
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• v.26 no.2
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• pp.128-136
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• 2016

Objective: This study was to explore the association between having a usual source of care and adherence to medicines in patient with chronic diseases. Methods: The 2012 Korea Health Panel was used as a data source. We analyzed 4,418 respondents that were diagnosed with chronic diseases and utilized health care services. Non-adherence to medication, a dependent variable, was defined as "not taking the medicines that were prescribed for treating chronic disease" or "not following the direction for medication". Whether having a usual source of care or not was used as a key independent variable, which was defined as having a regular site or a regular doctor for medical test, treatment, and consultation. Sex, age, education level, marital status, income, the type of health insurance, the number of chronic disease and CCI (Charlson Comorbidity Index) were included as covariates in the analysis. We conducted a multivariate logistic regression. Results: Totally, 30 percent of respondents reported to experience non-adherence to medication. Having a usual source of care was significantly associated with lower non-adherence to medication regardless its type, which is a regular doctor (OR=0.61, 95% CI=0.53-0.70) or a regular site (OR=0.67, 95% CI=0.58-0.78). Furthermore, having a usual source of care was associated with both of medication persistence (OR=0.66, 95% CI=0.54-0.81) and compliance (OR=0.65, 95% CI=0.56-0.76). Conclusion: Our results showed the possibility that usual source of care is able to conduct a positive role in improving adherence to medication with better management of chronic disease.

• Dementia and Neurocognitive Disorders
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• v.21 no.4
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• pp.117-125
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• 2022

Background and Purpose: Medication adherence is essential for effective medical treatment. However, it is challenging for cognitively impaired patients. We investigated whether an automated telephone reminder service improves medication adherence and reduces the decline of cognitive function in isolated patients with cognitive impairment. Methods: This was a single-center, randomized clinical trial. We enrolled mild cognitive impairment (MCI) or Alzheimer's disease (AD) patients who lived alone or with a cognitively impaired spouse. We provided an automated telephone reminder service for taking medication to the intervention group for 6 months. The control group was provided with general guidelines for taking the medication every month. The participants underwent neuropsychological assessment at the beginning and end of the study. Statistical significance was tested using nonparametric Wilcoxon rank sum and Wilcoxon matched-pairs signed-rank tests. Results: Thirty participants were allocated randomly to groups, and data for 29 participants were analyzed. The mean age was 79.6 (standard deviation, 6.0) years and 79.3% of the participants were female. There was no significant difference in medication adherence between the 2 groups. However, a subgroup analysis among participants with more than 70% response rates showed better medication adherence compared to the control group (intervention: 94.6%; control: 90.2%, p=0.0478). There was no significant difference in the change in cognitive function between the 2 groups. Conclusions: If a patient's compliance is good, telephone reminders might be effective in improving medication adherence. It is necessary to develop reminder tools that can improve compliance for cognitively impaired patients.

• Journal of Korean Academy of Nursing
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• v.36 no.7
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• pp.1135-1144
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• 2006

Purpose: The purpose of this study was to analysis the effects of a structured drug education program on knowledge and medication compliance for hemodialysis patients. Method: Hemodialysis patients were recruited from a kidney center, at a university hospital located in G city, Korea. Thirty subjects in the control group received no intervention and 30 subjects in the experimental group received a structured drug education program. Result: There were significant increases in medication knowledge and medication compliance in the experimental group compared to the control group. Conclusion: According to the above results, this education program for hemodialysis patients increased knowledge and medication compliance. These findings suggest that a structured drug education program can be used as an efficient nursing intervention for hemodialysis patients.

• Research in Community and Public Health Nursing
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• v.23 no.2
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• pp.189-200
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• 2012

Purpose: The purpose of this study is to identify factors associated with the stages of change in medication adherence in patients with hypertension. Methods: Participants were 323 patients with hypertension. Sociodemographic/medication-related characteristics, stages of change, processes of change, self efficacy and decisional balance were self-administered. Results: Stages of change were significantly different according to gender, age, job and living arrangement. A multinominal logistic regression analysis has revealed that gender, age, living arrangement, self-liberation, and self-efficacy were significantly associated with the precontemplation stage. Age and self-liberation were significantly associated with the contemplation stage. Gender, age, living arrangement, and self-liberation were significantly associated with the preparation stage. Gender and helping relationship were significantly associated with the action stage. This model explained 52.0% of the stages of change in medication adherence. Conclusion: The tailored intervention strategies based on the stages of change may be needed for improving medication adherence in patients with hypertension.