• Health Policy and Management
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• v.27 no.2
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• pp.128-138
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• 2017

Background: The purpose of this study is to analyze the effects of differential coinsurance policy on prescription drug coverage of outpatients by types of medical institutions. Methods: In this study, we used a sample cohort database of the National Health Insurance Service and frequency analysis and marginal logistic regression model using generalized estimating equation were used for statistical analysis. Results: The summary on the major research is followed. First, about 16% of patients who used only tertiary or general hospital due to 52 ambulatory care sensitive conditions before policy implementation moved to hospitals and clinics. However, about 57% of them still use tertiary or general hospital. Second, the factors influencing the utilization of hospitals and clinics after the implementation of the policy were gender, age, and income level. As a result, the policy is effective to reduce the medical use of outpatient mental patients in tertiary or general hospital, but the effect is not significant. Conclusion: Therefore, in order to achieve the purpose of the policy for establishing the health care delivery system, it is necessary to adjust the co-payment so as to feel the burden on the co-payment when the outpatient for 52 ambulatory care sensitive conditions is used at the tertiary or general hospital.

• The Journal of Dong Guk Oriental Medicine
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• v.2 no.1
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• pp.167-176
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• 1993

The purpose of this study is to invesigate the effect of Yook-Gun-ja-Tang on the side effect of cyclophosphamide to splenical tissue in the rat. The experimental animal were divided into normal group, control group, sample group by way of method treatment of the drug. Each group was sacrificed and stained in accordance with the schedule and observed under light microscope. The results of this study were as follow : 1. After treatment of Yook-Gun-Ja-Tang, rat's weight and volume were more increased than normal group and control group. 2. The decrease of the numbers of the splenical tissue after administration of cyclophosphamide were recovered with prescription of the Yook-Gun-la-Tang ; The decreases of white pulp, red pulp, marginal zone, central artery were recovered. 3. Increased macrophages in red pulp of splenical tissue of rats with administration of cyclophosphamide were decreased after treatment of Yook-Gun-Ja-Tang. These results appeared to suggest that Yook-Gun-Ja-Tang might be effective on the: side effect of cyclophosphamide to splenical tissue of rat's and applied to the prescription for the recovery of the side effect of drug.

• Korean Journal of Clinical Pharmacy
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• v.10 no.2
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• pp.57-61
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• 2000

Gastrointestinal (GI) medications have been administered to many patients without any gastrointestinal diseases. The objectives of this study were to evaluate use of GI drugs and assess related factors. Medical records of 600 outpatients were reviewed from January 1997 to December 1997 at A Hospital, Kyunggi-do, Korea. Fifty patients every month among all outpatients were randomly selected up to total 600 patients. Surgical patients, visitors for regular health examination and inpatients were excluded. GI symptoms included nausea, vomiting, diarrhea, dyspepsia, constipation, heartburn, dysphagia and abdominal pain. The prescribed gastrointestinal drugs were antacids. $H_2$-antagonist, sucralfate, cisapride, omeprazole, laxatives, digestive enzymes and antidiarrheal agents. Patients without GI symptoms were 348 out of 600 outpatients who were screened. Two hundred and eighty two of 348 patients $(81\%)$ were given GI drugs though they did not have any GI symptoms. There were no differences in regard to sex and age of patients. Most of medical departments prescribed gastrointestinal drugs for these patients. The most frequently prescribed drugs were in order of digestive enzyme, antacids and $H_2$-antagonists. In view of economic aspects, patients paid 12.28 percents of total cost per prescription for unnecessary medicines. The medical practice of prescribing GI drugs should be assessed to define appropriate subgroups to have benefits with prophylactic administration and to reduce adverse effects caused by drug interactions. Pharmacists would have a significant role to promote rational drug therapy.

• Health Policy and Management
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• v.7 no.2
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• pp.89-108
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• 1997

The purpose of this study is to investigate drug information sources which influence physician's prescriptions, and to compare the differences of drugh information sources between private practitioners and hospital physicians. In addition, the ultimate goal of this study is to provide better quality of drug information for both groups of physicians through the professional drug information system. 264 physicians, including general practitioners and all types of specialists who were working in hospitals and private clinics in Taejon and Chungnam area, participated in this study which was conducted by mail. The results are summarized as follows ; 1. Both physician groups received drug informations mainly from medical journals, but there were differences in secondary sources of drug information. Namely, hospital physicians got drug information from annual meetings and textbooks, and private practitioners got it from detail men and colleagues. 2. Drug effect was the first consideration for drug selection in both physician groups. But, in the 2nd consideration, private practitioners concerned about the price, insurance and rebates, but hospital physicians were not. 3. Only 9.2% of the private practitioners satisfied with the sufficiency of drug information, whereas 22.0% of hospital physicians satisfied with it. The most insufficient area of information was drug interaction in both groups and 91.9% of the physicians suggested that a professional drug information system should be introduced. 4. Both physician groups had contacted with detail men frequently. However, it was rare for them to contact with a pharmacist. This phenomenon was more severe in the case of private practitioners. 5. Neither physician groups knew very much about drug informatio centers. However, they would be willig to participate if a professional drug information system were established. Also, they indicated that the information most required was drug interaction.

• Korea Journal of Hospital Management
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• v.7 no.2
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• pp.37-51
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• 2002

It has been 2 years since the implementation of the separation of prescription and drug dispensing policy. This study analyzes the effects of the policy on the job contents and personnel structure of hospital pharmacy. The main purposes of the analysis are to determine if the policy has causes the increase of professional activities of pharmacists in hospital and to investigate whether the hospital pharmacy is equipped with enough manpower to provide high quality pharmaceutical service as intended by the policy. The level of professionality of pharmacists' activities is measured by the number of activities of direct involvement in inpatient care such as participation in patient rounding, medication consultation, the number of hospital committee the pharmacists involved and the number of continuous education pharmacists took. The adequacy of personnel structure to provide high quality pharmaceutical care is measured by the level of compliance to the governmental standard of hospital pharmacy personnel. In order to collect the data, surveys were performed for two periods: year 1999 (before the implementation of the policy) and year 2001 (after the implementation of the policy). The results show that the pharmacists' participation in inpatient rounding decreased and that the inpatient medication history management activities, operation of ward pharmacy, participation in hospital committee increased. In personnel structure, the average number of pharmacist per hospital decreased and the number of prescription processing per pharmacist increased. Based on the results this study concludes that the professional activities of hospital pharmacists has increased a little and there were structural changes in hospital pharmacy service activities to increase the professionalism in providing care. However, the pharmacy departments were understaffed hampering the strive to increase the provision of professional pharmaceutical service in hospitals.

• Korean Journal of Clinical Pharmacy
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• v.30 no.2
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• pp.81-86
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• 2020

Background: The number of patients with dementia continues to increase as the age of aging continues to grow. Psychiatric symptoms caused by senile dementia are controlled using antipsychotics. However, these antipsychotics can lead to Parkinson's disease, and abuse of dopamine derivatives such as levodopa among Parkinsonian drugs can lead to psychosis. Therefore, we evaluated the patterns of prescribed antipsychotics and antiparkinsonian drugs in patients with senile dementia. Methods: We used data from the sample of elderly patients from the Health Insurance Review and Assessment Service (HIRA-APS-2016). We analyzed the patterns of prescribing antipsychotics and antiparkinsonian drugs including prescribed daily dosage, period of prescription, and number of patients with both antipsychotics and antiparkinsonian drugs for senile dementia. Results: Among the 159,391 patients with dementia included in this analysis, 4,963 patients (3.1%) and 16,499 patients (10.4%) were prescribed typical and atypical antipsychotic drugs, respectively. The most frequently prescribed typical antipsychotic was haloperidol (4,351 patients with dementia), whereas the atypical agent was quetiapine (12,719 patients). The most frequently prescribed antiparkinsonian drugs were in the order of levodopa/carbidopa, benztropine, and ropinirole. In addition, 1,103 and 3,508 patients prescribed typical and atypical antipsychotics, respectively, were co-prescribed antiparkinsonian drugs. Conclusions: Atypical antipsychotics were the preferred prescription in patients with senile dementia. The prescription dose was relatively low; however, the average treatment duration was mostly long-term. Selection of antipsychotics and/or antiparkinsonian drugs should be made carefully in senile dementia and the causal relationship of adverse drug reactions needs further study.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.6
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• pp.1365-1380
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• 2007

Based on the theories and clinical data of oriental medicine, traditional medicinal prescriptions known to be effective to diabetic nephropathy were collected. The prescriptions were carefully examined and analyzed in order to be used as fundamental material for experiments and in clinicals. More than 40 publications related to diabetes were arranged and analyzed. Of the complications, diabetic nephropathy part of the publications were specifically focused during analysis. Data were analyzed and classified according to the quantity, prescription, differentiation of symptoms, signs and addition and subtraction of each medicine. Frequently used medicines were statistically analyzed. The most frequently used prescription was Yukmigihwang-tang(六味地黃湯) based medicine and prescriptions of its addition and subtraction, which was 15% of the total prescriptions cited. The most frequently used medicine was Astragali Radix, mentioned 192 times in the prescriptions. Hoelen was next with 180 citations, followed by Dioscoreae Rhizoma with 147 times, Rehmanniae Radix with 140, Corni Fructus with 131, Salviae Miltiorrhizae Radix with 106, Angelicae Gigantis Radix with 101, Alismatis Rhizoma with 95, Rhei Rhizoma with 90, Atractylodis Rhizoma Alba with 84, Rehmanniae Radix Preparata with 78, Leonuri Herba with 74, Moutan Cortex Radicis with 66, Aconiti Lateralis Preparata Radix with 66 Cnidii Rhizoma with 65, Pseudostellaria heterophylla with 62, Liriopis Tuber with 55, Lycii Fructus with 52, Rhei Rhizoma with 49, Codonopsis Pilosulae Radix with 44, Paeoniae Radix Rubra with 44, Schisandrae Fructus with 42, Polyporus with 42, Achyranthis Radix with 41 and Euryales Semen with 40. Medicines prescribed more than 30 grams a day included Astragali Radix, Imperatae Rhizoma, Benincasae Pericarpium, Leonuri Herba, Dioscoreae Rhizoma, Plantaginis Semen, Polyporus, Hoelen, Halloysitum Rubrum, Achyranthis Radix, Arecae Pericarpium, Phaseoli Angularis Semen, Coicis Semen, Rhei Rhizoma, Salviae Miltiorrhizae Radix, Sargassum, Ostreae Concha, Pseudostellaria heterophylla, Epimedii Herba, Rehmanniae Radix, Scrophulariae Radix and Polygonati Rhizoma. No scientific reports on the traditional medicinal aspects of diabetic nephropathy was searched. This analysis report would be able to provide the basis of developing new drug candidates for the treatment of diabetic nephropathy, as well as securing the EBM for the traditional medicines already being prescribed to the patients.

• Korean Journal of Biological Psychiatry
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• v.3 no.2
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• pp.149-155
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• 1996

Doctors who treat pregnant women ore usually cautious in writing their prescription for the drugs. The problem of which psychotropic medications ore sale during pregnancy seems to remain unsolved for many years. Although the rate of absorption is reduced due to a reduced rate of gastric emptying, the extent of absorption of drug is generally unchanged during pregnancy. Plasma volume and total body water increase during pregnancy. There is suggestion that drug metabolizing activity may be increased in pregnancy. Since the pregnancy increase the glomerular filtration rate significantly, drugs mainly eliminated by renal excretion will be cleared more quickly. Factors contributing to the potential teratogenecity of a drug include the type of compound, dose and duration of use, developmental stage of fetus at the time of exposure, and the effect of the drug on fetal pharmacokinetics. All major classes of psychotropic agents should be assumed to diffuse readily across the placenta to the fetus and to be present in some quantity in the breast milk. To decide when and how to start the drug treatment depends on an assessment of the risks related both with and without drug treatment of psychiatric disorders.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.2
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• pp.67-73
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• 2011

The purpose of licensing system is to ensure that the medicines are examined for safety, efficacy and quality. Nevertheless, off-label or unlicensed drug usages in pediatric practice is widespread in Korea and worldwide. Psychotropics are one of the most commonly used off-label or unlicensed drugs. The most valid approach to face this dilemma will be to have more evidences from pediatric pharmacological studies. Clinicians, in addition, need to monitor closely their off-label or unlicensed drug prescriptions to minimize the trial and error in practice. Researchers should publish their experiences and provide guidelines. Pharmaceutical companies, regulatory authorities, and consumer organizations should endeavor altogether for the children's right to get safe and efficacious drugs as adults do. Here, the definition as well as the current status of off-label and unlicensed drug prescriptions will be introduced. Critical issues regarding the off label drugs are discussed. In addition, I will describe the present condition as to the off-label and unlicensed drugs in child and adolescent psychiatry and the authorization process of off-label drug prescription in Korea. Lastly, direction we should like to take in this field will be mentioned.

• Journal of Ginseng Research
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• v.48 no.3
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• pp.253-265
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• 2024

Orally administered ginsenosides, the major active components of ginseng, have been shown to be biotransformed into a number of metabolites by gastric juice, digestive and bacterial enzymes in the gastrointestinal tract and also in the liver. Attention is brought to pharmacokinetic studies of ginseng that need further clarification to better understand the safety and possible active mechanism for clinical application. Experimental results demonstrated that ginsenoside metabolites play an important role in the pharmacokinetic properties such as drug metabolizing enzymes and drug transporters, thereby can be applied as a metabolic modulator. Very few are known on the possibility of the consistency of detected ginsenosides with real active metabolites if taken the recommended dose of ginseng, but they have been found to act on the pharmacokinetic key factors in any clinical trial, affecting oral bioavailability. Since ginseng is increasingly being taken in a manner more often associated with prescription medicines, ginseng and drug interactions have been also reviewed. Considering the extensive oral administration of ginseng, the aim of this review is to provide a comprehensive overview and perspectives of recent studies on the pharmacokinetic properties of ginsenosides such as deglycosylation, absorption, metabolizing enzymes and transporters, together with ginsenoside and drug interactions.