Lee Mi Jin;Park Hae Kwan;Park Kyu Nam;Choi Seung Pil;Lee Won Jae;Kim Se Kyung
Journal of The Korean Society of Clinical Toxicology
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v.2
no.2
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pp.123-128
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2004
Purpose: In recent review of physician suicides] the relative risk of physicians is higher than the general population. The majority of physician suicide were by poisoning. The purpose of this study was to analyse the medical personnels with suicide by poisoning compared with the general population. Methods: We reviewed medical records of 15 medical related personnels with suicide by poisoning who visited the emergency medical centers of St. Mary's and Kangnam St. Mary's hospitals from March 1998 to Aug 2004. For the comparison with general population in analysis] the collected data was acquired from medical records of 677 intoxicated patients in St. Mary's Hospital during the same period. Results: Fifteen suicides of physicians (n=7), nurses (n=4), medical students (n=2), pharmacist (n=1) and medical assistant technician (n=1) was evaluated with regard to the method of poisoning. Preferred methods were ingestion of medications orally ($54\%$) and by infusion/injection ($46\%$). The results were compared with the general population group (n=677: oral ingestion of medications $98\%$, inhalation $1.6\%$). Intoxications by infusion/injection predominated more clearly in physicians than in the total collective. Conclusion: Comparing with the general population, the tendency to a method of suicidal poisoning being typical of the profession rises among physicians and related occupations with the degree of specialization, caused by increasing knowledge, easier access to appropriate drugs and methods.
Adverse drug reaction (ADR) may increase hospital admission, morbidity and mortality and adding extra cost to healthcare expenditures. AIMS: This study was performed to identify the types of ADR being reported in a tertiary hospital, and to find out the ways to improve current ADR monitoring system. To investigate the attitudes of hospital pharmacists towards, and their understanding of ADR reporting. METHODS: Of 117 reports submitted to the pharmacy department during 3 months survey period, A questionnaire survey of 75 randomly selected hospital pharmacists was conducted. RESULT: Of the report was from patients aged between 60 and 70. The medical department with the high frequency in ADR reporting was Internal Medicines $(60\%)$. The most common ADR manifestations were gastrointestinal complaints $(47.8\%)\;and\;80\%$ of the reported cases were mild in their severity. The most common drugs suspected of causing ADR were CNS drugs which accounted for $38.4\%.\;55.5\%$ of respondent were aware of the need to education and information about ADR monitoring. The important reasons for unreporting ADR were unknown of how to report ADRs $(94.6\%)$. CONCLUSIONS: An ADR reporting system based on reporting by staff pharmacists has been effective increasing the number of reported reactions and pharmacist involvement in monitoring patients for ADRs. Pharmacists have the knowledge and responsibility to contribute to ADR reporting program. A great opportunity exists for pharmacists to contribute in this area of patient care.
This study was done to investigate the perception and need of the nutrition counseling of the people living in Daejon. Results were as follows: Nutrition knowledge score increased with education level. It showed tendency that women's scores were higher than men's. Only 15.5% of the participants were experienced in nutrition counseling mostly with medical doctor or nurse in the general hospital. Their satisfaction level was above average, which means positive reaction on nutrition counseling. In the case of the people who paid nutrition counseling fee, they thought that fee level was reasonable. Participants whose education level was higher thought less frequently that the nutrition counseling fee charged currently in the general hospital was expensive. The prevalent contents they want in the nutrition counseling included the prevention and the treatment of the specific disease and food safety (pesticides and food-born illness). As means of nutrition counseling they preferred internet (or PC) and interview. The higher the education status and the less the age, the higher preference, there was for internet or PC. As a source of nutrition knowledge, participants gave high credit on the professional books, academic journals, and advices from dietitian, nutritionist, medical doctor and pharmacist; in the other hand, they gave low credit on the newspaper, magazine, TV or radio, and advices from family or relatives, and friends. They thought most of the adult-onset disease (especially obesity, hyperlipidemia, and diabetes) were closely related to diet. However, percentage of the participants who thought that diet and kidney disease were related was relatively low.
On the new medical system separating the prescription and dispensing of the drug, the qualification of pharmacist in substitution of prescribed medicine was restricted, except bioequivalence-certified drugs. Also, Korean Food and Drug Association(KFDA) revised the bioequivalence regulation on August, 2001 Among many changes from old guideline, impressive one is the statistical consideration. Specially, to estimate and analyze bioequivalence measures, AUC and $C_{max}$, the log-transformed model is recommended and the equivalence interval is modified from $\pm$20 rule to [In(0.8),In(1.25)] one. This meaningful act is very hope-for because it is statistically reasonable and is agreed with worldwide bioequivalence guideline, including USA, EU, Japan and Canada. In this paper, we introduce the new regulation of assessing bioequivalence, announced at August, 2001, mainly on statistical view points. Key points for the new regulation are discussed and the minimum sample size based on simulation studies are proposed.
The current method of rate adjustment for inflation is based on the evaluation of the financial performance of hospitals. The method has the disadvantage such as too complicated, expensive process as well as low reliability. This study, therefore, develops the 'Korean Medical Insurance Economic Index(MIEI)' as a new model for the rate adjustment with the use of the macro economic indices. In addition, we calculate the 1992∼1998 rate adjustment with the MIEI, and examines the validity of the MIEI by comparing with the conventional method. Medical costs are classified into nine categories : physician salaries, nurse·pharmacist·medical technician salaries, assistants & others salaries, material cost(by imports), material cost(by domestics), depreciation & rent paid(by imports), depreciation & rent paid(by domestics), power utilities, other administrative costs. Then the category weight which is the ratio of category in the total cost is calculated. Macro economic indices are selected for each cost category in order to reflect the concept of the each cost category and inflation during the year of 1992∼1998. Finally MIEI which integrate all category according to the category weight and selected macro indices is calculated. The mean of hospital MIEI which weighting by amount paid by insurers was cacluated. The result from the application of empirical data to the MIEI model is very similar to that of the current method. Furthermore, this method is very simple and also easy to get social consensus. This MIEI model can be replaced the current method based on the analysis of the financial performance for the adjustment of medical fees.
Metabolic syndrome is increasing nowadays and one of causes is obesity. Therefore prevention and treatment of obesity is very important to decrease of Metabolic syndrome. However currently many pharmacotherapy for obesity are popular in Korea and it may be dangerous. The aim of this study is to evaluate the purpose and relevance of obese treatment in two areas (capital & local) of Korea and suggest to guide for the right directions of pharmacotherapy in obesity treatment. We selected and surveyed 90 patients (88 females, 2 males, age of $23{\sim}60$) at random who received a prescription after consulting with a doctor at several clinics of Cheongju-area and Seoul-area, from May thru June, 2007. And we evaluated their prescriptions. In results, only 26.7% were obese (13.3%, 2325), most 73.3% patients were normal (65.6%, 18.5$m^2$). The purpose of treatment was for appearance (38.9%), health (41.1%) or both (18.9%, p<0.01). 94% patients had the past history of obese treatment. Prescriptions were consisted of CNS stimulant, anticonvulsants, antidepressant, laxatives, diuretics, or antianxietics. Obese treatment is very important for health to prevent disease such as Metabolic Syndrome. However it should not be abused. In conclusion, some patients of obese treatment is not relevant to obesity and pharmacist role is important to guide them for the right directions in obesity treatment.
Standardized parenteral nutrition is required to improve patient's safety, clinical appropriateness and to increase uniformity between institution and institutions. We assessed the consistency with the American society for parenteral and enteral nutrition (A.S.P.E.N.) practice guideline for PN by evaluating current practice process for parenteral nutrition formulation in inpatients pharmacies in Korea. Each question in this survey was based on 2007 A.S.P.E.N. recommendations of standard parenteral nutrition formulation, the American society of health-system pharmacists (ASHP), and the United State Pharmacopoeia (USP) Chapter 797 guideline for compounding parenteral nutritions. All 90 Korean society of hospital pharmacist (KSHP) member directors of pharmacy were requested to respond to the survey in order to compare the survey results to ASHP national survey of pharmacy practice in hospital settings (2002) in compliance with A.S.P.E.N. guideline. We had final response rate of 35.6%. 25 (100%) hospitals complied with this Garb guideline (response rate was 84.4%) which was the highest compliance. Only 17.9% of hospital pharmacies were actively involved in complications monitoring. Monitoring complications and efficacy were least in compliance with the A.S.P.E.N. guideline. 69.0% of Korean pharmacists adjusted medication dosage based on disease state or monitoring laboratory data in compliance with the A.S.P.E.N. guideline. Over 50% of the hospital pharmacies failed to provide and evaluate staff training in aseptic manipulation skills periodically. Korean hospital pharmacies need to comply with the standard practice guideline for compounding sterile preparation in order to provide better quality of parenteral nutrition service for specific patient population.
Drug identification service and other drug-related query service are becoming increasingly important in hospital pharmacy. The goal of this research was to investigate current situation of the service in hospital pharmacy, which recently implemented the services as part of provision of advanced hospital pharmacy service in order to assure national health improvement. We investigated the report performed from November 2006 through April 2007 in a university hospital located in Daegu, Korea. Number of drug identification service performed was 81 cases during the first three months period (period I), but it increased to 222 cases during the second three months period (period II), which suggested that the service was welcomed by medical staff in the hospital. Time to process each case was about 30 minutes in the period I while it was only 16 minutes in the period II. Proportion of the unidentifiable cases remained at about 25% during the entire period, which suggests that the system for the identification task appears to have some limitations such as unsatisfactory support from the Korea Pharmaceutical Association, laws, and regulations. A vast majority of drug-related queries were mostly from physicians (60.5%) followed by nurses and pharmacists. Time to process each drug-related query was 10.6 minutes in the period I while it was 6.9 minutes in the period II. Queries answered immediately were about 70% of all queries in the period I, but increased to about 85% in the period II.
To find out the amount of knowledge and the attitude which a group of students attending local universities have toward family health, I distributed 690 questionaires to three local universities which I chose. I arrived at the following conculsion after 628 questionnairs were returned. 1) 431 male students(89.8%) and 126 femals students (86.2%) felt that family health science is important enough to be part of the cirriculum. 2) 374 male students (74.5) and 132 female students (90.4%) answered that they get a basic knowledge of health and disease through massmedia. 3) Should an information bureau for health and diseare be retup, 369 students(63.2%) answered that they would join information bureau. 4) In regard to a basic knowledge of health, the report says that 419 ma1e students(83.4%) and 117 female students(80%) don't know about Blood pressure, and 422 male students(84%) and 124 female students (84.9%) don't know about normal pulse and 467 male students(93%) and 128 femal stdents(87.6%) don't know about normal respiration. 5) In regard to communicable disese, 186 male students(37.1%) and 61 female students(41.7%) have a basic knowledge of these disease. In regard to diseases which commonly afflict the eldrly, 157 male students (31.2%) and 62 female students (42.4%) have a basic knowledge of these diseases. In regard to other diseases, the finding of this report are that on the average male students(74.6%) and female students of(73.4%) don't have a basic knowledge of family health. 6) 182 male students (36.2%) and 50 female students (34.2%) anwered that the way to promote health and prevent disease is to have a medical examination regularly and also 142 male students (28.2%) and 33 female students(22.6%) answered that it is necessary to have knowledge about how to keep health. 7) 254 male students (50.4%) and 90 female students (61.6%) said that when they are sick they depend on help from the pharmacist.
Background: Medication counseling is important to improve qualify of pharmaceutical care, but there are lack of studies to investigate satisfied counseling practice in community pharmacies. Purpose: This study was to investigate current medication counseling provided by community pharmacists. Method: Questionnaires to assess medication counseling practices were mailed to nationwide 1,269 community pharmacists who were Sookmyung Women's University alumni. Result: One hundred sixty five pharmacists were responded to the questionnaires (response rate 13.63%). 16.8% of them all respondents had counseling room in their pharmacies. 75% and 29.9% of respondents provided patient counseling always for new and refilled prescriptions, respectively. Counseling was provided primarily by verbal, but especially for drug name, usage and storage, it was provided in written concurrently. 31.1% of respondents was satisfied with counseling practices by themselves, and a major barrier of unsatisfied counseling was lack of time in 64.6% of respondents. Majorities of respondents (66.3% and 76.3%) spent 1-3 minutes and <1 minute, for new prescription and refilled prescription, respectively. Approximate 99% of respondents presented necessity of standardized patient counseling information for drugs and 97.6% responded that quality of patient counseling would be improved by using software containing counseling information. Old respondent group had higher accumulative patient counseling practice scores and pharmacy owner group took much time for counseling, resulting in higher scores too. Conclusion: This study showed that qualified patient counseling practice has not been reached in community pharmacies. Much more discussion to seek ways to improve the quality would be necessary.
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