Objectives: To suggest direction for improving policies by understanding current management of narcotics or psychotropic drugs and analyzing their distributions and usage. Method: We conducted a comparison analysis between health insurance claims and the amount supplied to health care institutions for narcotics or psychotropic drugs through health insurance claims data and drug distribution supply data from 2010 to 2012 collected from Korea Pharmaceutical Information Service Center (KPIS). Furthermore, we carried out literature investigation and online search to comprehend the current management of narcotics drugs in Korea. Results: The amount supplied to medical institutions for all drugs in 2012 was 19.4 trillion won, which increased from 19.5 trillion in 2011 by 0.54%. For narcotic drugs, the amount supplied was 318.4 billion won in 2011 and increased to 335.1 billion won by 5.3% in 2012, which exceeded the rate of increase for the amount supplied for all drugs. The proportion of amount claimed in the total amount supplied to medical institutions for all drugs was 60.5% in 2012, whereas the proportion of amount claimed for narcotic drugs was 55.6%, which showed that narcotic drugs were used relatively less within health insurance. Furthermore, management of the current domestic distribution supply data focuses on manufacturing and medical institution supply stages. Conclusion: Hereafter, the management of narcotics or psychotropic drugs needs to be improved by reinforcing active monitoring in optimal prescription and usage in patients by collecting and analyzing information on drug usage of patients.
Objective: Codeine may result in death or respiratory depression in children, particularly who are rapid metabolizer of CYP2D6, therefore it should be used cautiously among children under 12 years of age. This study was to investigate the prescribing pattern of codeine among children according to the age group, prescribed diagnosis, type of medical service and medical specialties. Method: We used Korea Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) database. Study subjects included inpatients or outpatients, who were prescribed codeine between January, 1, 2011 and December, 31, 2011. Contraindicated use of codeine was defined as the use of codeine at least one times under aged 12. Age groups were subclassified according to the <2 years, 2-4 years, 5-8 years, and 9-11 years. Frequently prescribed diagnosis (ICD-10), type of medical service, and medical specialties were also described among codeine users under aged 12. Results: Codeine users were 6,411 inpatients (9,958 prescriptions), and 3,397 outpatients (6,258 prescriptions), respectively. Codeine prescription under 12 years of age were 2.1% (210 prescriptions) among inpatients, and 12.3% (776 prescriptions) among outpatients (p-value<0.05). Outpatient prescriptions of codeine under 12 aged were issued mostly from primary care clinics and frequent diagnosis were unspecified bronchopneumonia (51.6%), and vasomotor rhinitis (23.7%). Conclusion: This study found prescribing of codeine under 12 aged is common in outpatient and primary clinics. Nationwide and community-based efforts should be needed to reduce inappropriate prescribing among children.
Objective: The purpose of this study was to investigate the oriental cause and treatment of the polyhidrosis of hands and feet. Methods: It was studied 47 kinds of Oriental Medical literature for polyhidrosis of hands and feet Results: Polyhidrosis of hands and feet due to lowered superficial resistance brought on by deficiency of qi. Main pathogenesis(病因病機) is the heat in the middle energizer(中焦熱) such as heat in the stomach(胃熱) and the spleen and stomach heat stagnation(脾胃積熱), deficient in Yin and Yang, qi and blood(陰陽氣血), and retention of undigested food(食積) due to improper diet(飮食不能). Treating method(治法) is eliminating dampness and regulating the stomach(淸熱燥瀑和中), invigorating, replenishing spleen qi(補益脾氣), and nourishing the stomach Yin(滋養胃陰). Treating prescription(治方) is presented as Palmultang with Additional Ingredients Rhi.zoma Pinelliae, Pona for principle drug Rhi.zorm Typfwnii Radix Aconiti for adjuvant and messenger drug(八物湯加半夏 茯笭君 白附子 川烏爲在使), Daeshihotang(大柴胡湯), Cheongbisan(淸脾散), Moryeosan(牡蠣散) etc. The external treatments(外用法) are described as ways of washing hand and foot after steaming with boiled Decoction(牡蠣散) of AJurnen(白礬); Radix Puerariae(乾葛), Radix Astragali(黃?); Radix Puerariae(乾葛), Herba Schiwnepetae(荊芥); Radix Saposhnikoviae (防風), 白礬(AIumen). The acupuncture recipes (鍼治療法) are the toninfication(補) of Buryu(KI 7)(復溜) ; Eumgeuk(HT 6)(陰?), tonification(補) methods of Buryu(KI 7)(復溜) ; Gihae(CC 6)(氣海) and reduction(潟) of Hapgok(LI 4)(合谷), the reduction(潟) of Hapgok(LI 4)(合谷), tonification of Buryu(Kl 7)(復溜), reduction(潟) of Jigu(TE 6)(支溝) ; Taechung(LR 3)(太衝) ; Yangneungcheon (GB 34)(陽陸泉). and selection of points of Hapgok(Li 4) (合谷) and Nogung(PC 8)(勞宮). The Tui-na therapies (推拿療法) are removing heat from the stomach meridian(淸胃經O) and so on.
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.
Objectives: The aim of this study was to review the clinical research on antihypertensive effects of Korean herbal medicines that function by inducing diuresis. Methods: Literature searches were performed using PubMed, Cochrane, CNKI, Wanfang, Cinii, Oasis, KISS, NDSL, RISS, DBPia, with the keywords "利水", "利尿", "高血壓", "hypertension", and "lishui." The search range included only randomized controlled trials that verified the effects of Korean herbal medicine interventions on hypertension. The selected studies were assessed by risk of bias (RoB). Results: 26 reports were selected from a total of 532 identified. For these reports, meta-analysis was performed using Revman 5.3. From this analysis, it was observed that the combined treatment of Korean medicine and antihypertensive drugs had a significantly higher total effective rate (TER) and improvement in systolic blood pressure (SBP) and diastolic blood pressure (DBP) than did the use of a single antihypertensive drug. The risk ratio of TER for lowering blood pressure was 1.25. The mean differences of SBP, DBP were -19.63 mm Hg (95% confidential interval (CI), -22.45 mm Hg, -16.80 mm Hg, p<0.00001), and -5.39 mm Hg (95% CI, -7.36 mm Hg, -3.42 mm Hg, p<0.00001) respectively. The use of Korean medicine only did not improve blood pressure, as compared to the use of an antihypertensive drug. Most of items of RoB were unclear, and the methodological quality was low. Conclusions: The combination of antihypertensive drugs and Korean medical treatment can effectively improve SBP, DBP, and TER. This finding could be widely utilized in clinical practice in Korean medicine.
Fan, Yu-Ling;Fan, Bing-Yu;Li, Qiang;Di, Hai-Xiao;Meng, Xiang-Yu;Ling, Na
Asian Pacific Journal of Cancer Prevention
/
v.15
no.18
/
pp.7611-7615
/
2014
Aims: To prepare 5-fluorouracil (5-Fu) nanoparticles with higher encapsulation efficiency and drug loading, and then investigate interaction with the SGC-7901 gastric cancer cell line. Materials and Methods: Prescription was optimized by orthogonal experiments, the encapsulation efficiency and loading capacity were tested by high-performance liquid chromatography, and inhibition of proliferation by 5-Fu nanoparticles and 5-Fu given to cells for 24, 48 and 72 hours was investigated by methyl thiazolyl tetrazolium assay (MTT). In addition, 5-Fu nanoparticles were labeled by fluorescein isothiocyanate (FITC), and absorption into cells was tested by flow cytometry. Results: The optimal conditions for preparation were concentrations of 5-Fu of 5mg/ml, of $CaCl_2$ of 60 mg/ml and of chitosan of 2 mg/ml. With a stirring speed of 1200rpm, encapsulation efficiency of 5-Fu nanoparticles was $55.4{\pm}1.10%$ and loading capacity was $4.22{\pm}0.14%$; gastric cancer cells were significantly inhibited by 5-Fu nanoparticles in a time and concentration dependent manner, and compared to 5-Fu with slower drug release, in a certain concentration range, inhibition with 5-Fu nanoparticles was stronger. 5-Fu nanoparticles were absorbed by the cells in line with the concentration. Conclusions: 5-Fu nanoparticles can inhibit growth of gastric cancer cells in vitro to a greater extent than with 5-Fu with good adsorption characteristics, supporting feasibility as a carrier.
A study was conducted during the period of August 13 to August 18, 1974 to obtain information on knowledge and attitude of the rural area housewife toward health care and antibiotics using. Interviewed 242 housewives dwelling in Soodong and Hwado Myun, Yangju Gun, Kyunggi Do, a typical rural area in Korea and the following results are obtained: 1. Of 242 housewives interviewed, 20.2% were illiteracy, 68.2% was graduated from primary school, 9.1% from middle school and 2.5% from high school. 2. Of those interviewed, 8.7% were Christian, 5.0% Bueldist, 2.9% Confucianism, and 83.4% of those were no religious preference. 3. Utility rate according with the kind of mass media in home was 85.1% of respondants possessed radio, 16.1% of magazine, 12.8% of newspaper, and 4.1% of television. 4. In the case of patients occure in a family, 13.0% out of 242 respondants had chosen physician's clinics for inicial medical care place, 58.4% drug stores, 0.9% herb medicine and 27.7% of those had chosen folk medicine at home. 5. Antibiotics effective complaints listed by the respondants were skin diseases with 43.8%, suppurated wound 30.0%, URI like symptoms 18.2%, diarrhea 14.5%, low back pain 12.9%, fever 6.2%, loss of appetite 3.3%, all kind of diseases 2.5%, urethral discharge 2.1% and tuberculosis 0.8% respectively. 6. Only 14.7% of respondants had obtained antibiotics for medical care from physician's clinics and 85.3% of the respondants had obtained antibioties from drug store (70.7%), village shop (10.4%), and salesmen in street market without any physician's prescription. 7. Eighty-nine percent of the respondants were understanding on patient care activity as the local health subcenter but only 11.0% of those on M.C.H., 29.0% of those on family planning, 21% on vaccination, and only 6.6% on tuberculosis control activity. 8. Utility rate of the local health subcenter was 71.9% out of the patients indicated medical care of medical facilities.
Objective: The provision of pharmaceutical care service in compliance with good pharmacy practice (GPP) standards is important, but there is lack of studies to investigate the barriers that significantly hinder community pharmacies in Korea from adhering to the standards. This study was aimed to identify the major barriers to provision of pharmaceutical care service in compliance with the proposed pharmacy practice standards which have been developed based on the GPP standards recommended jointly by WHO and FIP. Methods: Questionnaires reviewed by the expert committee were posted for 32 days on the website which is most frequently accessed by community pharmacists. The respondents completed them by checking the scores (Max=5, Min=1) for major barriers to provision of pharmaceutical care service focusing on patient information management and drug use review process in prescription fillings. The answered scores were automatically collected using online data processing. Mean differences between scored data were assessed by ANOVA. Results: Total 321 pharmacists participated in the survey. Results indicated that 'difficulty of diagnosis identification' (m=3.92, SD=1.21), 'lack of time' (m=3.48, SD=1.22) and 'lack of updated clinical information' (m=3.17, SD=1.10) were the major barriers to provision of pharmaceutical care service in patient information management. The main barriers to drug utilization review were 'lack of time' (m=3.32, SD=1.21), 'lack of updated clinical information' (m=3.11, SD=1.17), and 'negative feedbacks or refusals from prescribers' (m=3.00, SD=1.38). There were significant differences among the groups by location, employed number of pharmacists and acceptability to the proposed GPP standards. Conclusion: Difficulties in managing patient clinical information and lack of time were found to be the major barriers in providing pharmaceutical care services in community pharmacies in Korea. Further research is recommended to determine ways to reduce these barriers in order to provide quality pharmaceutical care service that is in compliance with the internationally recognized GPP guidelines.
Park, Yong Seok;Kim, Jae Hyun;Lee, Jihong;Chang, Gyu Tae
The Journal of Pediatrics of Korean Medicine
/
v.34
no.4
/
pp.77-100
/
2020
Objectives The purpose of this study is to investigate recent clinical studies on the effect of herbal medicine for pediatric tonsillitis in China, and to seek better methods to treat and study for pediatric tonsillitis in Republic of Korea. Methods We searched clinical studies from the China National Knowledge Infrastructure (CNKI) by search formula (SU='扁桃体炎'+'扁桃炎'+'扁桃腺炎'+'乳蛾'+'喉蛾'+'蚕蛾'+'石蛾'+'珠蛾'+'肉蛾'+'乳蛾風'+爛乳風'+'tonsillitis') and (SU='中樂'+'中医樂'+'本草'+'湯'+'丸'+'散'+'方'+'顆粒'+'膠囊'+'自擬'+'herb'+'herbal'+'decoction'+'remedy'+'Chinese medicine'+'Korean medicine'+'kampo'+'formula'+'herbal drug'+'Chinese drug'+'plant'+'Chinese prescription'+'traditional medicine'+'Medicine, East Asian Traditional'+'Herbal Medicine') in professional search from January 2016 to August 2020. We analyzed the literature focusing on the treatment methods and results. Results Among 1464 searched studies, 35 randomized controlled trials were selected and analyzed. In most studies, the effectiveness of oral administration of herbal medicine on pediatric tonsillitis was significant. Most commonly used herbs were Fructus Forsythiae (連翹), Radix Glycyrrhizae (甘草), Radix Scutellariae (黃芩), Herba Menthae (薄荷), Fructus Arctii (牛蒡子), Radix Scrophulariae (玄蔘), Radix Platycodi (桔梗), Flos Lonicerae (金銀花), Radix Isatidis (板藍根), Radix Bupleuri (柴胡), Fructus Gardeniae (梔子), Rhizoma Belamcandae (射干), Radix et Rhizoma Rhei (大黃), Gypsum Fibrosum (石膏). Conclusions By analyzing the improvement of indicators such as total effective rate, cured rate, symptom disappearance time and symptom score, we found that herbal medicine treatment can help improve pediatric tonsillitis. However, additional studies are needed to solidify these findings.
Park, Juhee;Choi, Won Suk;Lee, Hye-Yeong;Kim, Kyoung-Hoon;Kim, Dong-Sook
Health Policy and Management
/
v.28
no.4
/
pp.402-410
/
2018
Background: Monitoring appropriate medication categories can provide early warning of certain disease outbreaks. This study aimed to present a methodology for selecting and monitoring medications relevant to the surveillance of acute respiratory tract infections, such as influenza. Methods: To estimate correlations between acute febrile respiratory tract infection and some medication categories, the cross-correlation coefficient (CCC) was used and established. Two databases were used: real-time prescription trend of antivirals, anti-inflammatory drugs, antibiotics using Drug Utilization Review Program between 2012 and 2015 and physicians' number of encounters with acute febrile respiratory tract infections such as influenza outbreaks using the national level health insurance claims data. The seasonality was also evaluated using the CCC. Results: After selecting six candidate diseases that require extensive monitoring, influenza with highly specific medical treatment according to the health insurance claims data and its medications were chosen as final candidates based on a data-driven approach. Antiviral medications and influenza were significantly correlated. Conclusion: An annual correlation was observed between influenza and antiviral medications, anti-inflammatory drugs. Suitable models should be established for syndromic surveillance of influenza.
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