• Korean Journal of Clinical Pharmacy
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• v.25 no.1
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• pp.18-26
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• 2015

Background: The recent change in pharmaceutical education system following the paradigm shift to patient-oriented pharmacy service requires an in-depth discussion to reorganize a future direction and establish a basis for maximizing social values of community pharmacy service. Objective: This study was conducted to review the current status of community pharmacy service provision in Korea based on published literatures. Methods: The electronic databases of National Digital Science Library and Electronic National Assembly Library were used to search the journal articles and dissertation papers. A search term "community pharmacy" was used and the published period was limited to papers published after year 2001, when the legal separation of prescribing and dispensing was implemented. Relevant study reports were also searched manually. Information about pharmacy service provision and study outcomes were retrieved from the selected papers, and classified by predefined individual service scope. Results: A total 33 papers reporting services provided by community pharmacies were selected (journal article 11, dissertation paper 17, and study report 5). Pharmacy services identified in these papers could be classified into prescription dispensing service, pharmaceutical care service, self medication service, other products service, and health promotion service. Twenty papers reported prescription dispensing services, three papers reported pharmaceutical care service, and only two papers reported health promotion service. Current community pharmacy services are highly dependent on prescription drugs while expanded services such as pharmaceutical care and health promotion are peripheral. Most prevalent research topic was medication counseling service (18 papers), reflecting that community pharmacists generally consider it to be the most important and fundamental service. Overall, current pharmacy services are very limited and focus on prescription dispensing service. Conclusion: At this point of time requiring expansion and quality improvement of community pharmacy services, we suggest further lively discussion to strengthen pharmacist's functional identity and set conditions for providing socially expected services.

• The Journal of Korean Medical History
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• v.26 no.2
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• pp.175-185
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• 2013

Purpose : The current Medical Law and the Pharmaceutical Affairs Act, which are incapable of utilizing the research results and the advanced academic, clinical, and pharmaceutical system of the present-day Korean (Oriental) medicine, have limitations and create a paradox by provoking social conflict among the professionals in the field. The aim of this study was to find out the legal and systematic problems that contributed to a complicated conflict amongst Korean (Oriental) medicine doctors, doctors, pharmacists, and Korean (Oriental) pharmacists regarding the classification of their functions. Methods : We reviewed the history and characteristics of the legislation regarding the duties of Korean (Oriental) medicine doctors and Korean (Oriental) pharmacists as well as the relevant and important public health policies since the enactment of the National Medical Services Law in 1951. We focused on the laws and regulations that are made in the process of the separating functions of physicians and pharmacists and the dispute between the Korean (Oriental) medicine doctors and the Korean (Oriental) pharmacists in the 1990s and 2000s. Results : The legislations and amendments of the medical and pharmaceutical laws and regulations that reflect the modern academic, clinical, and pharmaceutical system of the Korean (Oriental) medicine and the research results could be summarized as follows: 1) A partial amendment of the Medical Law in 1987, which added the provision of "Oriental health guidance" as one of the duties of Korean (Oriental) medicine doctors, assured a place for Korean (Oriental) medicine doctors in the field of public health. 2) A partial revision of Pharmaceutical Affairs Act in 1994 established a new system for Korean (Oriental) pharmacists, bringing about the creation of dualistic pharmaceutical system that complements the dualistic medical system. 3) The Promotion of the Research and Development of Wonder Drugs by Using Natural Substances Act was legislated in 2000 in order to stimulate research and development of Korean (Oriental) medicine and its industrialization. 4) Oriental Medicine Promotion Act in 2003 was enacted to lay foundation to specify and promote technology and industry that are related to Korean (Oriental) medicine. Discussions and conclusions : Although the dualistic medical and pharmaceutical system is set up by the Medical Law and Pharmaceutical Affairs Act, it is shown that the relevant regulations have been developed from a perspective of the western medicine.

• The Journal of Korean Medical History
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• v.29 no.2
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• pp.35-47
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• 2016

"JeSeBoGam (濟世寶鑑)" was a medical document authored by Moon Gi-hong during the Japanese colonial rule in 1933, and the author acted as a Korean medicine doctor, an acupuncturist, a medicine practitioner and an apothecary. Since its first publication in 1933, it has been published three times in 1966 and 1975, from the Japanese colonial period to the liberation period. "JeSeBoGam" is largely divided into Preface part, "List of drugs according to symptoms [隨症用藥目錄]", "JeSeBoGam-Gap (濟世寶鑑甲)", and the Appendix includes "Key points for diagnosing the disease [察病要訣]" "Key points of acupuncture and pulse [脈訣]" "Key points of acupuncture and moxibustion treatment [針灸訣]" in the back of the book. In 1933, there are attached exam books and license application forms related to Korean medicine doctor and pharmacist, so strict regulations on them during the Japanese occupation period can be confirmed. "JeSeBoGam-Gap" contains 208 prescriptions from 143 prescriptions taken from "BangYakHapPyeon" and 65 prescriptions from other books. It divided into Gap (甲) Eul (乙) Byung (丙) Jung (丁). These prescriptions were placed in "List of drugs according to symptoms [隨症用藥目錄]" according to a symptom 1,286 times. Considerable parts of organization and prescription drug composition of "JeSeBoGam" are closely related with "BangYakHapPyeon", but there were adjustments in all medicinal ingredients and capacity for the rest of them except 23 prescription drugs. Compared to "BangYakHapPyeon", there was a tendency to substitute the basic prescription in "JeSeBoGam" for prescriptions used for the same disease. Though only 65 prescriptions were taken from books other than "BangYakHapPyeon", 575 times were reflected in "List of drugs according to symptoms [隨症用藥目錄]", and the rate of utilization is high compared with the number of prescriptions of "BangYakHapPyeon". It is thought that the circumstances of the Japanese occupation period, limits in medicinal ingredients composition due to regional characteristics, and changes in a patient's condition and the treatment method might have an influence on the author's drug use tendency. "JeSeBoGam" is similar to "BangYakHapPyeon" in composition, but it is a new practical medical book in which the author's clinical records are concentrated.

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.746-760
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• 2005

Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objectives of this study were to determine the causes of nontherapeutic INRs, and to identify the factors associated with nonadherences to warfarin therapy in Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997b to September, 2000. The data on 868 patients (5,304 visits) who were at least 6 months post-valve replacement were included. All possible causes of nontherapeutic INRs were documented for each patient visit. The association of covariates to noncompliance was investigated by univariate analysis. Result: The reasons for nontherapeutic INRs were identified as follows: inadequate dosage adjustment $(21\%)$, nonadherences to dosing regimen $(13\%)$, drug/herbal interactions $(12\%)$, changes in diet $(7\%)$, and indeterminate cause $(42\%)$. Younger age, shorter duration of ACS and longer duration of warfarin therapy were associated with nonadherence. Conclusion: In this study, nonadherence and interactions between diet and medications were found to be important factors influencing nontherapeutic INRs. Longer duration of enrollment in the ACS affected the adherence to warfarin therapy Positively whereas younger age and longer duration of warfarin therapy affected negatively.

• Journal of the East Asian Society of Dietary Life
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• v.15 no.5
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• pp.516-523
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• 2005

This study was performed to investigate dietary behaviors and consumption of health food in cancer patients. The subjects were 163 cancer patients recruited from the general hospital in Seoul, Korea. The data were obtained by the structured self administered questionnaire. The mean age of subjects was 51 years. Most of subjects didn't eat the visual fat of meat and chicken skin. The mealtime of the subjects was generally regular and most of subjects had breakfast. The subjects of this survey liked to eat foods with sweet taste but disliked to eat hot, salty and sour taste ones. The preference for fish, marine products and vegetables was high but that for instant foods and frying foods was very low. Most of subjects consumed the foods that is generally known as anticancer foods such as vegetables and fruits. On the other hand, most of subjects didn't intake butter, margarine, and frying foods that is known as risk factors of cancer. The majority of subjects$(84.7\%)$ consumed the health food The main reasons for taking health foods by subjects were to cure disease$(58.0\%)$, to prevent disease$(45.3\%)$, to supply nutrients$(39.3\%)$, to maintain the mental state$(12.7\%)$ and to recover fatigue$(10.7\%)$. Majority of subjects$(66.0\%)$ spent money more than 200,000 won/month to buy health foods. The purchasing channels of health foods by subjects were recommendation by family or friend$(64.0\%)$, by physician/pharmacist$(18.0\%)$ and by nutritionist or dietician(6.0), and advertisement through TV or radio$(12.0\%)$. The types of taking health foods of the subjects were vegetable extracted food$(60.0\%)$, mushrooms$(51.3\%)$, Lactobacillus food$(25.3\%)$, enzyme food$(22.6\%)$ calcium containing food$(20.0\%)$ and so on. The results of the current study show that although many cancer patients already practice healthy dietary behaviors, there is a substantial proportion who do not and most of cancer patients consume health foods.' Further intervention is needed to explore the effect of health foods in cancer patients

• Journal of Preventive Medicine and Public Health
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• v.33 no.4
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• pp.436-448
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• 2000

Objectives : To identify the factors affecting users' satisfaction with the Order Communicating System(OCS) and to highlight the factors important for the successful establishment of OCS. Methods : A Users Satisfaction survey was sent to 4,513 people, consisting of 1,503 doctors, 2,379 nurses, 255 pharmacists and 370 administrative workers in 16 hospitals which had introduced OCS. The response rate was 63.9%. Measurement of users' satisfaction was peformed with the instrument which was used in Doll's study. Some aspects of Doll's instrument were adjusted according to the aims of this study. The classifying sections of this survey included age, job and status classification, computer experience, OCS education, duration of daily OCS use, type of order entering, number of personnel in the Hospital Information System's department, cost of OCS, problem frequency, proportion of work managed by hand, OCS type, and Hospital establishment type. Results : There was a positive correlation between satisfaction level and managerial status throughout all job classifications. Irrespective of the importance of OCS education as a factor relating to users' satisfaction, the additional work load caused by OCS lowered users' satisfaction. Different factors affected users' satisfaction according to job and status classification. The composition of factors affecting the pharmacist and administrative worker satisfaction levels was simpler than that of the doctor and nurse levels. There were no statistically significant differences between the actual computer experience duration of daily OCS use and users' satisfaction with OCS. Conclusions : There was an understandable relationship between users' attitude to OCS and factors affecting users' satisfaction. The results of this study could be used as a basis for the successful expansion of the operation of OCS. But more detailed studies on users' satisfaction and further improvements of methodologies are required for the successful establishment of OCS.

• The Journal of Korean Society for School & Community Health Education
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• v.4
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• pp.97-115
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• 2003

Middle and high school girl students' menstruation characteristics, appearance of menstruation dysmenorrhea, and coping with the menstruation dysmenorrhea were examined in order to give information in instructing girl students about menstruation dysmenorrhea, in delivering health education in the school, and establishing health policy. 970 girl students in middle and high schools in Cheju-do were selected and surveyed using the questionnaire the author developed based on the previous studies. The findings are as follows. First, the age of first menstruation was average $12.9{\pm}1.22$ years. The younger they were, the earlier their first menstruation came. The most common menstrual cycle was such one that continuously irregular from the beginning or that regular and irregular cycle run together. The first irregular menstrual cycle changed regular one within 1 or 2 years. Most of the respondents had normal menstrual cycle of $21{\sim}35$ days and menstruation period of $3{\sim}8$ days. Second, symptom of menstruation dysmenorrhea was orderly; hurt in the underbelly, tired, hurt in the waist, and headache. It was higher with high school students than middle school students. For the most part, time of heavy menstruation dysmenorrhea was the 2nd day after menstruation starts and period of menstruation dysmenorrhea was 2 days. More than the half of the respondents felt that the present menstruation dysmenorrhea was similar with the first one and they felt not comport in daily life due to menstruation dysmenorrhea, and 'hard to live a normal life' was higher with the high school girl students than with the middle school students. Third, how to cope with menstruation dysmenorrhea was enough sleep, relax and rest, taking a hot water shower, listening to music or watching a movie, taking medicine, and doing excercise. Few of the respondents have ever visited a doctor due to menstruation dysmenorrhea, and the reason was mostly irregular menstruation and heavy dysmenorrhea. Forth, when they took medicine due to menstruation dysmenorrhea, they gathered information on the medicine from family members and friends, while extremely low from a pharmacist or a doctor. The most of them have ever took medicine during menstruation once and took standard dose. While excess dosage was higher with high school students than with middle school students. From these findings, a good many girls are experiencing menstruation dysmenorrhea since their first menstruation. To discover early the severely abnormal findings and to treat, more interest from home and school, counseling and sexual education on time, and expert's diagnosis are necessary. Rather than unconditionally taking pain-relievers which can plainly solve the pain, continuous health education at home and in the school should be carried on for the girls to practice proper measures one think effective or an expert recommends.

• The Korean Society of Law and Medicine
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• v.21 no.3
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• pp.77-116
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• 2020

The use of drugs that reflect the experiences and achievements of modern science has given human being the benefits of treating diseases and improving health conditions. However, in addition to the benefits of those, medicines have inherently inevitable adverse reactions. Many countries are taking measures such as market entry regulations or post-marketing surveillance to minimize damage caused by drug side effects, but the occurrence of side effects cannot be eliminated. Although the damage is force majeure, in some cases, the doctor who prescribed the drug or the pharmacist who administered the drug may have to compensate for the damage. The liability depends on whether the side effects were known in advance, the type of medicine, etc. On the other hand, in some cases, drug manufacturer may have to take liability for the side effect itself. As it is not easy for victims to be compensated for damages in those cases, many countries, including Korea, are setting to protect victims through the Product Liability Act. Drugs are also one of the product, so liability set by the Product Liability Act may apply. Even before the enactment and enforcement of the Product Liability Act, damage caused by drug has occurred. To resolve them, precedents have developed case law, which have many similarities with the Product Liability Act, but also have differences. Damage caused by drug manufactured prior to the enforcement of the Product Liability Act may occur in the future. In this context, the legal principles of the case laws will remain valid and be applied. This is an important reason to review the case law of precedents.

• Korean Journal of Clinical Pharmacy
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• v.29 no.2
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• pp.125-132
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• 2019

Objective: To examine the perceptions and attitudes toward spontaneous adverse drug reaction (ADR) reporting system among community pharmacists and identify factors that influence reporting, by implementing a survey. Methods: A structured questionnaire was developed and distributed online. Request for the survey was posted on the website of pharmacy's billing program, and the survey was conducted for 8 days. We collected the participants' response on their work environment, experience of ADR reporting, and their perception and attitude on the reporting system. Multivariate logistic regression was used to evaluate factors influencing ADR reporting. Results: A total of 382 pharmacists participated in the survey. Significant contributing factors for reporting level were age (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.84-0.96), knowledge of reporting method (OR, 53.56; 95% CI, 9.10-315.41), installation of reporting program (OR, 31.92; 95% CI, 4.16-244.75), and encouragement from the Korean pharmaceutical association (OR, 4.13; 95% CI, 1.11-15.35). Regarding the attitude toward spontaneous ADR reporting system, 'lack of time for reporting' (OR, 0.29; 95% CI, 0.15-0.53) and 'complexity of reporting procedure' (OR, 0.51; 95% CI, 0.31-0.84), were associated with a low likelihood of reporting. Conclusion: Our results indicated that the knowledge of ADR reporting method, installation of the reporting program, and encouragement from the Korean Pharmaceutical Association contribute to active reporting. It is necessary to simplify the reporting method, make the ADR reporting program user-friendly, and provide educational interventions to increase participation in spontaneous reporting by the community pharmacists.

• Korean Journal of Clinical Pharmacy
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• v.32 no.2
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• pp.116-124
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• 2022

Background: High-alert medications (HAMs) are medications that bear a heightened risk of causing significant patient harm if used in error. To facilitate safe use of HAMs, identifying specific HAM lists for clinical setting is necessary. We aimed to develop the national level HAM list for acute care setting. Methods: We used three-step process. First, we compiled the pre-existing lists referring HAMs. Second, we analyzed medication related incidents reported from national patient safety incident report data and adverse events indicating medication errors from the Korea Adverse Event Reporting System (KAERS). We also surveyed the assistant staffs to support patient safety tasks and pharmacist in charge of medication safety in acute care hospital. From findings from analysis and survey results we created additional candidate list of HAMs. Third, we derived the final list for HAMs in acute care settings through expert panel surveys. Results: From pre-existing HAM list, preliminary list consisting of 42 medication class/ingredients was derived. Eight assistant staff to support patient safety tasks and 39 pharmacists in charge of medication safety responded to the survey. Additional 44 medication were listed from national patient safety incident report data, KAERS data and common medications involved in prescribing errors and dispensing errors from survey data. A list of mandatory and optional HAMs consisting of 10 and 6 medication classes, respectively, was developed by consensus of the expert group. Conclusion: We developed national level HAM list for Korean acute care setting from pre-existing lists, analyzing medication error data, survey and expert panel consensus.