• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.201-206
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• 2016

Objective: Direct current cardioversion for atrial fibrillation could be associated with the risk of thromboembolic events. Anticoagulation therapy with warfarin (INR 2.0-3.0) is recommended 3 weeks before and 4 weeks after cardioversion to reduce the risk of thromboembolism. This study evaluated warfarin therapy in pharmacist-managed anticoagulant services (ACS). Methods: This retrospective study was performed in 106 patients with atrial fibrillation from 2012 to 2013. The primary efficacy endpoint was the composite of stroke, transient ischemic attack, myocardial infarction, and cardiovascular death. The primary safety measure was major bleeding. To evaluate the peri-procedural effects of warfarin treatment, we studied whether target INR was maintained, as well as the maintenance period of the therapeutic range. Quality of treatment was measured by time in therapeutic range (TTR) by using the Rosendaal method. Results: There were no thromboembolic events, but TEE examination at time of cardioversion showed a left atrial thrombus in three patients (2.8%). Bleeding complications after cardioversion occurred in 2 patients (1.9%). The average INR value at the time of cardioversion was $2.59{\pm}0.8$, and was within the therapeutic range in 83 patients (78%). Analysis of the patients in whom the value was within the therapeutic range twice consecutively showed that the ratio of TTR was 80% and the therapeutic range was maintained in 67 patients (63%) for an average of 4.90 weeks prior to cardioversion. Similarly, 76 patients (72%) had a stable INR within the therapeutic range for an average of 5.70 weeks and a mean TTR of 83%. Conclusion: Pharmacists significantly contributed to appropriate warfarin treatment with close monitoring during cardioversion. Likewise, active pharmacist monitoring and systemic management should be considered to reduce thromboembolism and bleeding complications in the peri-cardioversion period.

• Journal of Digital Convergence
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• v.13 no.4
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• pp.227-233
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• 2015

The recent health care is growing rapidly want to receive offers users a variety of medical services, can be exploited easily exposed to a third party information on the role of the patient's hospital staff (doctors, nurses, pharmacists, etc.) depending on the patient clearly may have to be classified. In this paper, in order to ensure safe use by third parties in the health care environment, classify the attributes of patient information and patient privacy protection technique using hierarchical multi-property rights proposed to classify information according to the role of patient hospital officials The. Hospital patients and to prevent the proposed method is represented by a mathematical model, the information (the data consumer, time, sensor, an object, duty, and the delegation circumstances, and so on) the privacy attribute of a patient from being exploited illegally patient information from a third party the prevention of the leakage of the privacy information of the patient in synchronization with the attribute information between the parties.

• Korean Journal of Clinical Pharmacy
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• v.10 no.3
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• pp.111-119
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• 2000

The objective of this study was to evaluate the efficacy and the pattern of regimens prescribed for the treatment of peptic ulcer disease in a regional community hospital. 226 patients were treated as an outpatient and followed for one year. 88 patients $(38.9\%)$ had gastric ulcer (GU) alone, 6 patients $(2.7\%)$ had duodenal ulcer (DV) alone, 5 patients $(2.2\%)$ had gastroesophageal reflux disease (GERD) alone, 25 patients $(11.1\%)$ had both GU and DU, 88 patients $(38.9\%)$ had both GU and GERD, and 14 patients $(6.2\%)$ had both DU and GERD. During this study period no one was treated for Zollinger-Ellison Syndrome. The disease showed higher occurrence in male population (139 patients, $61.5\%$) and among the ages of 30 and 40 $(62.4\%)$. The average age of these patients was 41.3 years and there was no difference between the genders. $81.4\%$ of these patients underwent CLO test to check for the existence of Helicobacter and $66.3\%$ of these Patients showed the positive response. $65.6\%$ of patients with GU and $80\%$ of patients with DU showed the positive response and there was no difference between the genders $(65.4\%\;vs.\;67.6\%)$. 184 patients $(81.4\%)$ were deemed to be cured based on the disappearance of their symptoms after completing the regimens. Compliance rate did not differ for gender or different diseases, while showing a difference in age. Patients between the ages of 20 to 30 years old showed the worst compliance rate. In addition, the compliance was lower among the patients who had previous occurrence of the disease, and this was more evident among female patients. Although 184 patients out of the total 226 patients were deemed to be cured, 36 patients $(20.65\%)$ of these returned to the hospital for relapsed diseases within one year. The factors that affected for patients to relapse were the diseases accompanied by ulcer and social environments, such as smoking, alcohol consumption, and previous history of the diseases (smoking P<0.001, alcohol consumption P<0.02, previous history of disease P<0.05). The regimen using $H_2$ receptor antagonists+tripotassium dicitrato bismuthate+clarithromycin showed the lower rate of relapse, and the regimens of omeprazole (OMP)+amoxicillin+tripotassium dicitrato bismuthate and OMP+amoxicillin+metronidazole showed better compliance rate. Patient education by pharmacists on the importance of compliance to regimens and the risk factors fer relapse can provide a better patient care. This would ultimately result in more cost-effective treatments by preventing additional cost for treating relapsed symptoms in approximately $20\%$ of patients.

• The Korean Society of Law and Medicine
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• v.12 no.1
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• pp.43-67
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• 2011

Humankind history is faced with one gigantic turning point due to development of Living genetically Modified Organisms. Food production by means of LMO is on the acceleration in an effort to solve the shortage of food problems. Food is also used as alternative energy source. Use of LMO product is not only limited to food and energy, but is actively utilized in various fields of medicines. This paper is first to check out the state of biomedicine developed and associated problems from industries that use LMO, after which we made an attempt on legislative approach to find out means of relief, through examples of such laws legislated for the sufferer from the adverse effect of the biomedicine. As for the liable subject to bear the responsibility for compensatory damage in a way of relieving the victim owing to adverse effect of biomedicine, those who manufactured and sold biomedicine and who are related to the damage to the victim due to the accident and medical doctors and pharmacists who prescribe and administer the medicine in question have been looked into. Accidents involving medicines and medical supplies could take place without reason for imputation on part of the liable subjects or fault of the victim, in which case the victim can't receive damage compensation from any of both parties. When such accidents happened turn out to be no fault accidents, introduction of damage relief measures might have to be reviewed against side effects of medicine and medical supplies as no fault compensation in order for actual relief to be possible. Talking about technicality of legislation, we can suggest a method of strengthening the accountability of manufacturer for stereotypical agenda on biomedicines by newly legislating special regulation with an issue that resists claim on risks associated with the development of medicine and incorporating the same into Manufactured Product Liability Law. After all, when an accident happens associated with biomedicine, the damage will be done to the consumer. And the consumer will be exposed to fatal danger even without the time to cope with potential risks associated with medicine and medical supplies they take. Therefore, it is necessary to protect the potential victim by having the manufacturer of biomedicines bear the liability of medical risks.

• Health Policy and Management
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• v.29 no.4
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• pp.382-393
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• 2019

The right to petition is a classical right of the people in constitutional states, and in Korea, it is a statutory right in the Constitution, the National Assembly Law, the Petition Law, and the Local Autonomy Act. The healthcare community first made a successful petition to the National Assembly when it achieved the amendment of the Government Organization Act through a petition to the National Assembly for the independence of the Ministry of Health, and this achievement served as the basis for further petitions. Since then, the healthcare community has successfully achieved the enactment and amendment of related occupational laws through National Assembly petitions, such as the amendment of Article 41, Paragraph 7 of the former Medical Insurance Act (Korean Medical Association, 14th Assembly), enactment of the Dental Health Act (Korean Dental Association, 15th Assembly), and amendment of the Health Functional Foods Act (Korea Pharmaceutical Association, 16th Assembly). Its petition accomplishment rate is higher than the total petition accomplishment rate of the Health and Welfare Committee of the National Assembly. However, along with the overall decrease in the number of National Assembly petitions, the Korean Medical Association and Korea Pharmaceutical Association have not achieved any results through petitioning since the 16th Assembly (June 2000), and the Korean Hospital Association and Korean Nurses Association have not achieved any results through petitioning since the 17th Assembly (April 2004). Furthermore, no National Assembly petitions have been made at all for 5 years (2014-2018). The Korean Medical Association and Korea Pharmaceutical Association previously showed a high petition accomplishment rate through their accumulated experience with National Assembly petitions and vigorous policy assistance from doctors/pharmacists/nurses turned lawmakers. More specifically, healthcare organizations have achieved results by actively conducting organized activities with the National Assembly, as implemented by a national assembly director and employees, and in case of petitions for legislation, each group has established infrastructure for reviewing the relevant laws by appointing a legislative director, as well as a legal advisor and advisory counsel. Although the organization that has submitted the most petitions to the National Assembly is the Korean Hospital Association, the group with the highest petition success rate is the Korean Medical Association, which may be linked to the relatively high proportion of doctors who have become lawmakers. Furthermore, the fact that other healthcare organizations were highly interested in petitioning the National Assembly has had major implications for the petition activities of healthcare organizations.

• YAKHAK HOEJI
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• v.59 no.6
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• pp.270-277
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• 2015

There is a lack of evidence on the impact of pharmacist interventions in diabetes care in South Korea. The aim of this study was to investigate the effects of pharmacist counseling on clinical and humanistic outcomes in patients with type 2 diabetes. An uncontrolled before-and-after study was conducted at the outpatient diabetes clinic in a teaching hospital in Gyeongnam, South Korea between January 2 and November 30, 2014. A total of 37 patients were enrolled. During the study periods, the participants and pharmacists met every 2 weeks via follow-up telephone calls in addition to face-to-face meetings upon returning for care visit. At each meeting, a structured patient counseling was performed and the average duration of each meeting was 15~30 minutes. The participants were requested to record daily self-care activities. At the end of this study, patients' satisfaction on pharmacist care was evaluated using the questionnaire developed by us. Compared to baseline, significant reductions (mean${\pm}$standard deviation, p<0.05) in HbA1c were observed at each follow-up period: $-0.32{\pm}0.72%$ from baseline to 3 months; $-0.52{\pm}0.76%$ from baseline to 6 months; $-0.72{\pm}0.76%$ from baseline to 9 months. Over the same follow-up period, the proportions of patients achieving target HbA1c (defined as HbA1c<6.5%) were 3.1%, 10.3%, and 20%, respectively. The proportions of patients who never missed a dose during the same follow-up period were 43.8%, 31.0%, and 20.0%, respectively. The results from the patient satisfaction survey indicated that pharmacist counseling improved patients' knowledge about diabetes and possible drug interactions. Especially, the information on a healthy diet and lifestyle was the most satisfying. To conclude, follow-up telephone calls combined with face-to-face meetings improved clinical and humanistic outcomes in patients with type 2 diabetes mellitus.

• Korean Journal of Clinical Pharmacy
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• v.19 no.1
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• pp.1-17
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• 2009

Adverse drug reactions (ADR) caused by inappropriate prescription are responsible for major socioeconomic loss. Drug-drug interactions (DDI) has been recognized as a major part of ADRs and, therefore, healthcare professionals should prevent possible DDIs to minimize preventable ADRs. This study aimed to examine DDI information in drug information references and Korea Food & Drug Administration (KFDA) drug labeling information. Drug ingredients from the formulary of Health Insurance Review and Assessment Service in Korea (HIRA) were included for the study. DDI information source used for the study were Micromedex Drugdex and Drug Information Facts (DIF) with the DDI severity level of "moderate" or more. The DDI information in KFDA drug labeling were collected and compared. Drug ingredients were classified with KFDA Drug Classification and ATC Classification of WHO for the analysis. Among the total 1,355 drug ingredients satisfying inclusion criteria, 738 ingredients involved at least one DDI, which was described in Micromedex and/or DIF. Drug Ingredients of 176 involved DDI only described in KFDA drug labeling, but not Micromedex nor DIF. Drug ingredients of 35 which DDIs were described in Micromedex or DIF did not have DDI based on KFDA drug labeling. Micromedex and DIF retrieved 7,582 and 3,071 DDIs, respectively 57.6% and 58.5% of DDIs were also described in KFDA drug labeling. Central nervous system (CNS) drugs, cardiovascular system (CVS) drugs and the antiinfectives appeared to have higher frequency of DDIs among all drug classes. The highest number of DDIs with high severity level ("contraindicated" or "major") were the DDIs of CNS drugs. The antiinfectives are the second drug group having serious DDIs. The DDI pairs of the CNS drug and the antiinfective had the highest contraindication risk (13.6%). DDI information from Micromedex and DIF were not consistent with the result that only 465 ingredients' DDIs are common in both literature (total DDI numbers were 715 vs 488, respectively). And 1,652 DDI information are common in both references among 7,582 vs 3,071 DDIs, respectively. Only 55.2% of DDI information in the database contained in the KFDA drug labeling. Prescribers and pharmacists should pay attention to the drugs for CV system, CNS and infections because of higher risk of possible DDIs compared to other drug classes. KFDA drug labeling is not likely to be recommended as a good information source for DDI due to significant inconsistency of information. Drug information providers should be aware that DDI information from different sources are not consistent and therefore multiple references should be used.

• Korean Journal of Clinical Pharmacy
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• v.23 no.1
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• pp.42-48
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• 2013

Background: Patients diagnosed with cancer tend to have multiple risk factors for drug related problems such as old age, comorbid conditions, self-medication, additional medications for supportive therapy, and the cancer treatment itself. Objective: The aim of this study was to investigate notable polypharmacy and related problems in oncology patients during hospitalization or following clinic visit. Method: The electronic medical records of patients who were discharged from oncology division at Seoul National University Hospital (SNUH) from June $1^{st}$ to June $30^{th}$, 2011 were retrospectively reviewed. Results: A total of 334 discharged patients were included in this study. Among them, 221 patients had pre-admission medications. Forty percent of the patients, including 60.3% of elderly patients (over 65 years of age) were prescribed more than 5 kinds of medications. Twenty percent of the patients were prescribed to take medications more than 7 times a day. Medication duplications were observed in 2.4% of patients. In 10.5% of the reviewed patients, 47 cases of potential drug-drug interaction including 3 cases of contraindication and 17 cases of major clinical implication according to Micromedex were detected. Medication changes were made in 88% of patients during hospitalization and in 94.7% of patients at their first visit after discharge. Antidiarrheal agent (loperamide) was prescribed along with laxatives in 18.5% of the prescriptions and inadequate instructions on how to take it were observed in 63% of the prescriptions. Conclusion: This study identified the prevalence of polypharmacy and related problems in cancer patients, which presents the need for an active role of pharmacists in pharmaceutical care in oncology wards.

• 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.

• Proceedings of the PSK Conference
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• 1999.06a
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• pp.30-60
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• 1999

In spite of many studies of The Korean Association of College of Pharmacy for improvement of the Korean pharmacy education and decrearing to change 4 year curriculum for pharmacy education to 6year curriculum from 1998 by The Ministry of Health and Wellfaire, there are many problems right now in view of the student-oriented education in front of the revolution program of The Ministry of Education. So the student-oriented reformation for pharmacy education in Korea was studied not only by observations of worldwide pharmacy education and pharmacy system, but also by 416 questionaires from many kinds of man and women such as pharmacists in drug store and hospital(159), administraters of The Ministry of Health and Wellfaire (59), professors in college of pharmacy (65), researchers in pharmaceutical company (31) and seniors in college of pharmacy(102).It shows that our Korean pharmacy education was a type of teacher-oriented education which is caused by the short time-education, a lots of subjects in the examination for pharmacy license and egoism of professors for their subjects, and so our teacher-oriented education have to change to the student-oriented education for the most function of pharmacist which is the pharmaceutical care for patients. For the preparing the clerkship/externship for one year, we have to change 4 year curriculum to 6 year curriculum for clinical pharmacy edu-cation, and also subjects of pharmacy in the national examination for pharmacy liciense have to reduce within 3-4 subjects of totally non-subject examination. The Korean Association of Collage of Pharmacy of Pan-pharmaceutical Revolution Association must purchase them and their program can be begun right now in spite of loss of the pharmacist supplement for 2 year and preparing the program of 6 years curriculum. Our teaching purposes of departments of pharmacy and manufacturing pharmacy were respectively clinical pharmacy, and development of new drug and compounding of many kinds of commercial drugs, but we have been not gone to their goals, respectively, because of short time-education for pharmacy as compared as world-wide pharmacy education containing the clerkship/externship and same twelve subjects in their examination for pharmacy license. Most function of pharmacist in Korea are the development of new drug, and social and administrative pharmacy in health care for patients, and so we have to teach them in the department of maunfacturing pharmacy.