• 약학회지
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• 제57권1호
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• pp.63-69
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• 2013

The objectives of the study are to investigate pharmacy remuneration levels stratified by the number of prescriptions dispensing and the type of nearby medical facilities using the Korean National Health Insurance (NHI) database, and to classify community pharmacies based on the characteristics. Claims data of all community pharmacies were extracted from the Korean NHI database from January 1 to June 30, 2010. A total of 14,985 pharmacies were included for the analysis. The remuneration amounts per pharmacist were directly associated with the number of prescription dispensing, and varied by the type of nearby medical facilities where more than 90% of prescriptions dispensed at the pharmacy are issued from. We classified pharmacies to six groups according to the number of prescription dispensing and the type of nearby medical facilities; (1) pharmacies with equal to or less than 200 prescriptions per month per pharmacist, (2) pharmacies near a general hospital, (3) pharmacies near a regular hospital, (4) pharmacies near a clinic, (5) pharmacies near multi clinics, and (6) pharmacies that do not belong to the above types. Compared to pharmacies near a clinic or multi clinics, pharmacies near a general hospital showed a lower number of prescription dispensing per pharmacist, but the income from dispensing fees was higher (p<0.05). The new taxonomy of community pharmacies can be a useful basis for further policy development in pharmacy remuneration system.

• 동의생리병리학회지
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• 제23권1호
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• pp.15-26
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• 2009

The purpose of this report was to provide the information about activity and safety of Yukmijihwang-tang by analyzing domestic/international papers and theses about Yukmijihwang-tang. Domestic/international papers and theses related to Yukmijihwang-tang were reviewed and analyzed. These papers were then classified by year, experimental method, and activity subject. The following results were obtained in this study. The study of Yukmijihwang-tang started from 1978 and was rapidly increased after 1990s. The study of Yukmijihwang-tang was continuously increased now and was mainly forcused on experimental model rather than clinical study. The paper of SCI journal or non-SCI journal was 27 volume and the other domestic paper was 64 volume. The total papers of Yukmijihwang-tang, 91 volume was analysed in this study. Allatoin, gallic acid, loganin, morroniside, paeoniflorin, paenol, urosolic acid were determined in Yukmijihwang-tang by using HPLC and HPLC-MS-MS. In classified Yukmijihwang-tang paper by experimental method and animal, more than a half study was in vivo experiment used rat. Furthermore clinical experiments were performed variously. As these studies were classified by subject, papers related to renal function were most abundant by 16 papers. Besides there were several papers related to cognitive vitality, anti-diabetic effect, immuno-regulation, reproductive activity, anti-oxidant effect, liver function, anti-cancer and blood pressure depress. According to basic research and clinic research data, it is supported that Yukmijihwang-tang was useful prescription in renal function, cognitive vitality, anti-diabetic effect and reproductive activity. Many study of basic and clinic research were performed and reported variously on Yukmijihwang-tang in domestic/international journal. According to basic research and clinic research data, it is supported that Yukmijihwang-tang was useful prescription in renal function, cognitive vitality, anti-diabetic effect and reproductive activity. However, studies on efficacy and mechanism of Yukmijihwang-tang should be conducted at the molecular biology level and studies on safety of Yukmijihwang-tang need to be completed at the clinical level.

• 한국의료질향상학회지
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• 제5권2호
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• pp.202-215
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• 1998

Purpose : To shorten processing time for variety of medical affairs of the patient at the outpatient clinic of a big hospital is very important to qualify medical care of the patient. Therefore, patient's waiting time for drug delivery after doctor's prescription is often utilized as a strong tool to evaluate patient satisfaction with a medical care provided. We performed this study to investigate factors influencing patient satisfaction related with waiting time for drug delivery. Methods : The data were collected from July 21 to August 12, 1998. A total 535 patients or their families who visited outpatient clinics of Inha University Hospital were subjected to evaluate the drug delivery time and the level of their satisfaction related, which were compared with those objectively evaluated by Quality Improvement Team. The reliability of the scale was tested with Cronbach's alpha, and the data were analyzed using frequency, t-test, ANOVA, correlation analysis and multiple regression. Results : The mean drug delivery time subjectively evaluated by the patient (16.1 13.0 min) was longer than that objectively evaluated (10.9 7.6 min) by 5.2 min. Drug delivery time objectively evaluated was influenced by the prescription contents, total amount or type of drug dispensed, etc, as expected. The time discrepancy between two evaluations was influenced by several causative factors. One of those proved to be a patient's late response to the information from the pharmacy which the drug is ready to deliver. Interestingly, this discrepancy was found to be more prominent especially when waiting place for drug delivery was not less crowded. Other factors, pharmaceutical counseling at the pharmacy, emotional status or behavior of a patient while he waits for the medicine, were also found to influence the time subjectively evaluated. Regarding the degree of patient satisfaction with the drug delivery, majority of patients accepted drug delivery time with less than 10 min. It was also found to be influenced by emotional status of the patient as well as kindness or activity of pharmaceutical counselor. Conclusion : The results show that, besides prescription contents, behavior pattern or emotional status of a patient, environment of the waiting place, and quality of pharmaceutical counseling at the pharmacy, may influence the patient's subjective evaluation of waiting time for drug delivery and his satisfaction related with the service in the big hospital. In order to improve patient satisfaction related with waiting time for drug delivery, it will be cost effective to qualify pharmaceutical counseling and information system at the drug delivery site or waiting place rather than to shorten the real processing time within the pharmacy.

• 약학회지
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• 제59권3호
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• pp.85-91
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• 2015

Highly active antiretroviral therapy (HAART) has reduced AIDS-related morbidity and mortality; however, it has been associated with metabolic abnormalities including dyslipidemia and dysglycemia depending on the regimens used. The aims of this study were to analyze the prescription patterns of antiretroviral agents and to examine the prevalence of lipid abnormalities among the prescriptions of HAART. The electronic medical records (EMR) of HIV patients were retrospectively reviewed from January 2007 to September 2012 based on our inclusion criteria. The patients who had taken HAART for at least 3 months were included in this study. The lipid profiles of patients on antiretrovirals (ARTs) were collected from his or her laboratory data, and dyslipidemia was defined as total cholesterol (TC) ${\geq}240mg/dL$ and triglycerides (TG) >200 mg/dL. Eighty-four prescriptions were discovered during the study period. Twenty-three prescriptions were the combination of two nucleoside reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor (NNRTI). Fifty-three prescriptions were the combination of two NRTIs and one protease inhibitor (PI) and thirty-nine prescriptions of them included a PI booster. Eight prescriptions were the combination of two NRTIs and one integrase inhibitor. The Incidence of hypertriglyceridemia among the patients receiving HAART was totally about 41.7% (2NRTIs+PI regimen vs. 2NRTIs+NNRTI regimen vs. 2 NRTIs+integrase inhibitor regimen, 52% vs. 12.5% vs. 25%), but there was no incidence of hypercholesterolemia. This study investigated that the prescription medication patterns and dyslipidemia associated with lipid abnormalities among HIV patients receiving HAART. The types of HAART prescription regimens had an effect on the occurrence of hypertriglycemia. Further studies related to metabolic abnormalities and adverse effects of HIV patients on ARTs are needed in the near future.

• 한국임상약학회지
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• 제26권3호
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• pp.207-212
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• 2016

Objective: Prescription rate of dabigatran and rivaroxaban, which are the direct oral anticoagulants (DOAC), has increased. We have analyzed the prescription trend and medication use of dabigatran and rivaroxaban in patients with non-valvular atrial fibrillation (NVAF). Methods: It was retrospectively studied from September 2012 to April 2014 using the electronic medical records and the progress notes. Patients with NVAF (n=424) were evaluated on the medication use, prescribing preferences, adverse drug reactions (ADRs) and the availability of prescription reimbursement of dabigatran (n=210) and rivaroxaban (n=214). Results: Dabigatran was prescribed higher than rivaroxaban (23.3% versus 7.5%, p<0.001) in the neurology department, but rivaroxaban was prescribed higher compared to dabigatran in the cardiology department (87.4% versus 74.3%, p<0.001). Dabigatran was prescribed more than rivaroxaban in high risk patients with CHADS2 score ${\geq}3$ (44.3% versus 31.3%, p=0.006). Dabigatran patients seemed to have more ADRs than patients with rivaroxaban (25.2% versus 11.2%, p<0.001), but no serious thrombotic events and bleeding were found. Only 35.6% (n=151) were eligible for prescription reimbursement by the National Health Insurance (NHI). Bridging therapy (86, 31.5%) and direct-current cardioversion (57, 20.2%) were main reasons of ineligibility for reimbursement. Conclusion: Prescription preferences were present in choosing either dabigatran or rivaroxaban for patients with NVAF. Inpatient protocols and procedures considering patient-factors in NVAF need to be developed.

• 약학회지
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• 제47권4호
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• pp.244-251
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• 2003

Asthma is a chronic inflammatory disease of the airway and the prevalence rate is increasing. As the burden of asthma to the society is significant due to the increasing hospital admissions and emergency visits, National Heart, Lung and Blood Institute (NHLBI, USA) and World Health Organization (WHO) have developed comprehensive guidelines to help clinicians and patients make appropriate decisions about asthma care. The aim of study was to analyze the pattern of asthma prescriptions based on the national asthma guidelines for the patients visiting primary health care providers. Prescription data for asthma were obtained from the Korean National Health Insurance claims database of January 2002. Ten percent of the primary health care providers were sampled based on their specialty areas, and 20％ of the claim cases were randomly chosen. Study results showed that prescription rate for oral beta-2 agonists was 44.3％, and that for oral theophylline was 46.9％. Oral steroids were prescribed for the 28.2％ of the claims. Utilization of inhalers was low for both bronchodilators (20.3％, beta-2 agonists inhalers), and steroids (8.4％ steroids inhalers). Bronchodilators were more preferred to the longterm anti-inflammatory controllers among the primary health care providers. Prescription rate for antibiotics was 46.0％ for asthmatic patients. Also gastrointestinal drugs were prescribed for 59.0％, antitussives 65.3％, antihistamines 25.3％ and analgesics 29.4％, respectively. This study presented that the prescribing pattern of the primary health care providers for the asthma was quite different from the national and international guidelines. More efforts need to be made to reduce the gap between the present pattern of asthma prescription and the guidelines.

• Journal of Pharmaceutical Investigation
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• 제23권2호
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• pp.97-102
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• 1993

Hospital pharmacy services are divided into dispensing affairs for inpatients and outpatients, pharmaceutical service, stock control, intravenous admixture service, drug information service, pharmacokinetic consultation service, education and research work, etc. But among those affairs, dispensing affair for outpatient is perceived as the most important work in Korea, because it is linked directly with hospital service for patients. Therefore, total computer system for dispensing area was adopted from opening point of hospital in 1989 in Asan Medical Center. Utilization of computer system for outpatient dispensing area is as follows; 1) Order communication system of prescription by Total Hospital Information System, 2) Automatic print-out system of direction for use by sticker connected with on-line net work, 3) Use of automatic tablet counting and packaging machines connected with on-line net work. Those computer system resulted in curtailment of pharmacy manpower and shortening of waiting-time for outpatient.

• 대한한의학방제학회지
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• 제15권2호
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• pp.9-19
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• 2007

Nineteen Medicaments of Mutual Antagonism currently belong to pharmaceutical incompatibility and some of them cannot be used in a same prescription: if they are used in a prescription, the treatment effect is rather reduced or toxic response may be produced. Therefore. inthisstudy, it was intended to look about how Nineteen Medicaments of Mutual Antagonism were defined through survey of literatures and to review the meaning and clinical potential. According to "Sinnongbonchogyeong," "Medicaments contain the substance that suppress toxins and the toxins may be removed with use of mutual restraint or mutual detoxication substances" and they have been used in terms of this concept. Since Tang and Song era, mutual restraint and mutual inhibition were confused and were difficult to be distinguished. In terms of pharmaceutical incompatibility, the original meaning of mutual restraint was deteriorated in "Sinnongbonchogyeong". That is. mutual restraint has been used as the concept of mutual inhibition or incompatibility. When various literatures were reviewed. it could be found that Nineteen Medicaments of Mutual Antagonism were firstly included in the phrases of songs and then in "seven emotion." It could be supposed that Nineteen Medicaments of Mutual Antagonism was created based on the clinical experiences of the author and the influence of doctors. Such supposition means indicates that the interactions among medicaments could effectively be applied and mutual restraint did not belong to pharmaceutical incompatibility. However. many doctors used mutual restraint and mutual inhibition in clinical practice with no distinguishment since Song era and. especially, it is supposed that. when medicaments were used with mixing. the pharmaceutical incompatibility of "Nineteen Medicaments of Mutual Antagonism" or "Eighteen Incompatible Medicaments" were emphasized and influenced on the efficacy of pharmaceutical preparations or acted as an obstacle in treating diseases. That is. an error was transferred: mutual restraint and mutual inhibition were not distinguished and were discretionally added or deleted through common people or professionals with no specific verification. The pharmaceutical preparations that belong to Nineteen Medicaments of Mutual Antagonism belong to pharmaceutical incompatibility but. when reviewed various literatures and clinical reports. they are not thought to be the ones that can never be used. Therefore. systematic literature review and experimental research should be performed.

• 한국멀티미디어학회논문지
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• 제21권2호
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• pp.271-280
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• 2018

Recently, big data has been growing rapidly due to the development of IT technology. Especially in the medical field, big data is utilized to provide services such as patient-customized medical care, disease management and disease prediction. In Korea, 'National Health Alarm Service' is provided by National Health Insurance Corporation. However, the prediction model has a problem of short-term prediction within 3 days and unreliability of social data used in prediction model. In order to solve these problems, this paper proposes a disease prediction model using medicine prescription data generated from actual patients. This model predicts the total number of patients and the risk of disease in each region and uses the ARIMA model for long-term predictions.

• 보건행정학회지
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• 제21권2호
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• pp.179-194
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• 2011

Although there have been studies regarding the separating policy of dispensary and medical practice, little study have provided a concrete empirical evidence to what extent the policy objectives are achieved. In this paper, we try to provide empirical evidence whether the policy separating dispensary from medical practice achieved the policy objectives, which representatively are reducing the mis-use or over-use of anti-biotic prescriptions and medicines, and decreasing the government spending for the cost of pharmaceutical support. By comparing the average of the rate of change of the number of medicines prescribed, the rate of anti-biotics prescribed, and the government spending for the cost of pharmaceutical support between the areas where the separation policy was implemented and the exceptional areas, we concluded that it is difficult to conclude that the policy separating dispensary and medical practice achieved its policy objects, as it first announced to achieve in the introduction of the policy in 2000. However, the limitation of this study is that the data, that can thoroughly analyze the effect of separating policy of dispensary from medical practice, cannot be collected as expected. Hence, we could not use a parsimonious empirical model to evaluate the effect of the policy introduced in 2000. Rather we used a simple statistical method to extract enough empirical evidence fro m the data available. In the near future, we would expect to see more research that analyze the exact effect of policy separating dispensary and medical practice with concrete empirical model using more sophisticated dataset.