• Journal of Internet Computing and Services
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• v.19 no.5
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• pp.97-105
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• 2018

In this paper, we present our recent effort on the development of a portable OCS system (SCH-mOCS), which provides minimal but essential functionalities of conventional OCS systems. SCH-mOCS is targeted for the environment where Internet connection is not available and fast processing of essential patient information is needed. The main usage could be found at the outdoor environment, such as voluntary medical services at challenged regions. The target of the first usage of the system is in the rural area of Cambodia where medical service and ICT infrastructure is poor. We have been conducting voluntary medical services for 15 years in Cambodia, where the services usually run for 3 days and include outpatient diagnosis/consultation, medication, and simple surgeries. This medical service started in 2002, where about 20 SoonChunHyang University Bucheon Hospital staffs (doctors, nurses, and pharmacists) participated. We realized that a system like SCH-mOCS is needed: we have to consult many patients in a short period, so that a prompt response and prescription to the patients are very important. However, the conventional OCS system is not suitable, because the service is usually conducted outdoor environment where Internet connected computers cannot be installed. Moreover, since the service needs only a subset of the conventional hospital information system and fast system response, application of a full OCS is not practical. The adequate system is a bare minimal OCS system, with very simple and quickly manageable patient admission, consultation, and prescription functionalities. In this paper, we describe hardware as well as the software aspect of a mini-OCS we have developed for the purpose. We named the system SCH-mOCS (SoonChunHyang mini-OCS). We also describe the usage scenario of SCH-mOCS in order to demonstrate that the system is general enough to apply for other similarly challenged regions.

• Korean journal of food and cookery science
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• v.27 no.3
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• pp.81-93
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• 2011

We investigated perception and educational demand for health functional foods among nutrition teachers and dietitians working in schools. The subjects were 229 nutrition teachers (57.2%) and dietitians (42.7%) working in Chungbuk elementary, middle and high schools. Approximately 67% of the subjects had experience consuming health functional foods. Most of the subjects did not have experience with the side effects after consuming health functional foods. Subjects who were unaware of the legal specifications, classification, and labeling standards for health functional foods (78-91.2%) were much more common than those who were aware of those issues. Most of the subjects perceived health functional foods as a food (45.0%) or as a product between a food and a medicine (44.5%). The subjects recommended themselves (43.1%) or medical doctors/pharmacists (40.8%) as consultation/education specialists for health functional foods. Approximately 66% of the subjects had experience conducting nutritional consultation/education in their schools, but only 3.2% had experience with health functional foods. Only 17.8% of the subjects had experience receiving education on health functional foods. Most subjects (88.2%) demanded education on health functional foods for themselves. The results suggest that an effective education is needed for nutrition teachers and dietitians working in schools for them to play an active role in educating students and their parents about health functional foods in the near future.

• YAKHAK HOEJI
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• v.51 no.5
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• pp.327-335
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• 2007

This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.

• Safety and Health at Work
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• v.2 no.3
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• pp.273-281
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• 2011

Objectives: Studies examining healthcare workers' exposure to antineoplastic drugs have focused on the drug preparation or drug administration areas. However, such an approach has probably underestimated the overall exposure risk as the drugs need to be delivered to the facility, transported internally and then disposed. The objective of this study is to determine whether drug contamination occurs throughout a facility and, simultaneously, to identify those job categories that are potentially exposed. Methods: This was a multi-site study based in Vancouver, British Columbia. Interviews were conducted to determine the departments where the drugs travel. Subsequent site observations were performed to ascertain those surfaces which frequently came into contact with antineoplastic drugs and to determine the job categories which are likely to contact these surfaces. Wipe samples were collected to quantify surface contamination. Results: Surface contamination was found in all six stages of the hospital medication system. Job categories consistently found to be at risk of exposure were nurses, pharmacists, pharmacy technicians, and pharmacy receivers. Up to 11 job categories per site may be at risk of exposure at some point during the hospital medication system. Conclusion: We found drug contamination on select surfaces at every stage of the medication system, which indicates the existence of an exposure potential throughout the facility. Our results suggest that a broader range of workers are potentially exposed than has been previously examined. These results will allow us to develop a more inclusive exposure assessment encompassing all healthcare workers that are at risk throughout the hospital medication system.

• Korean Journal of Clinical Pharmacy
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• v.26 no.2
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• pp.172-180
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• 2016

Background: Ischemic heart disease is the most common type of heart disease and an important cause of death in Korea. Among marketed anti-anginal medications, molsidomine, nicorandil, and trimetazidine are approved in Korea with unique mechanism of actions. As these drugs are not approved by the US Food and Drug Administration, the access to the up-to-dated and comprehensive safety-related information has been less than optimal from drug information resources used by Korean pharmacists. Methods: A systematic review was conducted using Embase and Korean manuscripts to compile safety updates for these medications. Out of 418 articles from keyword searches, 52 studies were reviewed in full to compare adverse effects (AEs) with the approved package inserts (PI). Results: Molsidomine related adverse effects were mostly mild or moderate, but anxiety, palpitation, epigastric pain, and sexual potency reduction were additional AEs found from the review not listed in PI. Although PI has included ulceration in oral cavity and gastrointestinal tracts including anus by nicorandil, the Korea FDA recently recommended adding corneal, genital, and skin ulcers to the approved PI. Trimetazidine induced Parkinsonism, worsening of the symptoms for patients diagnosed with Parkinson's disease, gastrointestinal burning, and muscle cramps were additionally identified AEs not listed in PI for trimetazidine. Conclusion: Continuous evaluations of the safety profile of these agents are needed to balance the risks and benefits to provide evidence-based safety counseling to the patients. In addition, more focused efforts on spontaneous reporting are warranted by healthcare professionals to safeguard patients against AEs.

• Korean Journal of Clinical Pharmacy
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• v.24 no.1
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• pp.53-61
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• 2014

Background: The use of health functional food (HFF) is increasing and will continue to rise worldwide. Concerns about HFF-drug interactions are increasing as HFF are becoming more widely used. Therefore, awareness of consumers' perceptions and behaviors associated with HFF use may help health care providers improve their communications with patients. Purpose: The aim of this study was to assess the characteristics, perceptions, and behaviors associated with HFF use in South Korea. Method: The online survey was conducted from September 21th to October 7th, 2013. With the aid of Social Network Service (SNS) and google, the questionnaire was posted online on internet website targeting people aged 15 years or older so that self-reported data covering 4 domains were collected from 257 Koreans. Results: A total of 257 people responded the questionnaire. Among them, 81.3% reported experiences of HFF use. Female were more likely than male to use HFFs. There were no differences in demographic characteristics between HFF users and non-users in relation to age, education, and household income. Higher level of education was associated with high-level perception of HFF function (OR 3.9, 95% CI 1.48, 10.1) and a positive relationship was observed between the maximum number of HFFs used concurrently and age of the respondents. Among the HFF users, 42.6% reported concurrent HFF-medication use. However 73.3% of them did not disclose their use to physician or pharmacist and only 30.2% were informed about potential drug-HFF interactions. Pharmacy was most commonly reported as the source from which the respondents were informed about potential interactions. Conclusion: Many people had used HFF and medications concurrently while not being informed about potential HFF-drug interactions. Pharmacists and physicians should be vigilant for risk of the interactions and actively determine whether the patient is using an HFF before prescribing and administrating medications.

• Korean Journal of Clinical Pharmacy
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• v.24 no.1
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• pp.1-8
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• 2014

Objective: Currently, rivaroxaban is widely used clinically for thromboprophylaxis after surgery. However, there are concerns on effectiveness and safety of rivaroxaban for its proper use. We aimed to evaluate the effectiveness and safety of rivaroxaban in orthopaedic patients after total hip replacement surgery in a large medical centre after the preferred formulary was switched from enoxaparin to rivaroxaban. Methods: The study was conducted on the patients who underwent hip arthroplasty surgery at the department of Orthopaedic Surgery at Seoul St. Mary's Hospital, South Korea. Electronic medical records were retrospectively reviewed to identify patients treated with rivaroxaban following total hip replacement between February 2011 and March 2012. Evaluation criteria included indications for use, dose, initiation and duration of therapy, drug interactions, adverse reactions, and status of health care reimbursement. The patients who were on enoxaparin were also reviewed as a reference. Results: We identified 57 patients who received rivaroxaban and 50 who received enoxaparin. All patients were prescribed the drugs for Korean Food and Drug Administration-approved indications. No thromboembolic or bleeding events were observed in either group. However, only 5.3% of rivaroxaban- treated patients had an appropriate length of prophylaxis and only 3.5% began rivaroxaban treatment at the recommended time. Surprisingly, 47.4% of rivaroxaban-treated patients received rivaroxaban despite being ineligible for reimbursement benefits. Conclusion: Rivaroxaban was generally well tolerated clinically. However, the duration of treatment, the time of initiation and patient eligibility for reimbursement require improvements, emphasising the need for education which indicates the area of pharmacists' involvement.

• Korean Journal of Clinical Pharmacy
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• v.28 no.1
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• pp.1-9
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• 2018

Polypharmacy is increasing owing to an increase in the elderly population and multimorbidities associated with the increased risk of administration of potentially inappropriate medications (PIMs). The negative effects of polypharmacy on various health conditions and aspects, such as fall, fracture, mortality, cognitive function, and dementia, have been reported. The management of excess and inappropriate polypharmacy through proper interventions and local or national guidelines has been highlighted. The purpose of polypharmacy management is to appropriately prescribe medicines that are essential to treat diseases in patients and to avoid inappropriate polypharmacy, such as interactive or duplicate medicines under prescription and PIMs for specific diseases. Community pharmacists in Australia, the EU, USA, and Japan are collaborating with prescribers to review medications to ensure that the patients can be prescribed appropriate medications. The service cost is reimbursed by public or private insurers. A study in the United States has shown that even with medication review costs, the overall medication cost has reduced. In Korea, various projects such as Drug Utilization Review service and safe use of medicines have been conducted; however, no national guidelines or management measures have been established. It is necessary to implement a national long-term plan on polypharmacy management. Furthermore, a phased implementation plan is required. Shortly, active medication review services and education programs for healthcare professionals with the support of the government should be considered in Korea with reference to other countries in order to raise awareness of seriousness and risks of inappropriate polypharmacy.

• Korean Journal of Clinical Pharmacy
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• v.28 no.3
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• pp.250-253
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• 2018

When stenting is applied to treat myocardial infarction, antiplatelet agents are administered to prevent thrombosis, which increases the risk of bleeding. Patients with myocardial infarction are also more likely to have osteoarthritis simultaneously, because both diseases occur frequently in elderly patients. Patients with osteoarthritis often use analgesics, especially nonsteroidal anti-inflammatory drugs (NSAIDs); hence, patients with both diseases use analgesics and antiplatelet agents simultaneously. The risk of bleeding increases with the use of antiplatelet agents and this is further increased when NSAIDs are added. We would like to report a case that reflects this situation. A 60-year-old man underwent stenting after ST-elevation myocardial infarction, and was treated with aspirin and clopidogrel. This patient also received a pelubiprofen prescription from another physician to treat osteoarthritis. After the patient took pelubiprofen twice, he found a bruise on his wrist and reported it to the pharmacist. It is unlikely that this is rare in community pharmacies, so pharmacists should pay careful attention to the concomitant administration of analgesics to patients receiving antiplatelet agents and should provide appropriate education to patients.

• Journal of The Association for Neo Medicine
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• v.2 no.2
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• pp.253-295
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• 1997

It is very critical to specify certain medical personnels in defining the history of certain era. Due to the limited source of information and lack of thorough research, there still aren't enough study grounded on concrete historical investigation. Authors attempted to investigate those medicinal personnels engaged in Three Kingdoms period in terms of the activity area, relation with religion and their role in medical system and medical exchange. The sum of recorded medical personnels in Three Kingdoms period numbers 50 of which 6 belonged to Kokooryo, 18 to Baekje, 7 to Shilla and 19 to Unified Shilla. There might existed far more medical personnels who tried to alleviate the suffering of the people and were not recorded in the documents. The more earlier in times, the more medicine gets the religious tinge. This is not the exception for the period of the Three Kingdoms and those medicine men, wizard doctors and priest doctors were playing important role in healing people and processing crude drugs. The system of royal physician and medical education facility were established and doctors and pharmacists, shamanic doctor, herb collectors, Kongbong's doctor(供奉醫師), Kongbong's diviners(供奉卜師) took leads in medicine in those times. Those folkloric healers also took part in. Korea imported chinese medicine and Japan employed chinese medicine via Korea or directly from China and developed into traditional japanese medicine. In this process those who emigrated from Baekje and Kogooryo and their offsprings took an active part. Since the limited source of information of Three Kingdoms, we only can infer the me야cal environment of those times by featuring the activities of medical personnels.