• Journal of Korean Academy of Rural Health Nursing
• /
• v.18 no.1
• /
• pp.1-10
• /
• 2023

Purpose: This study was to evaluate the effects of a social prescribing program on cognitive function and depression of the elderly in the rural community. Methods: A non-equivalent control group pretest-posttest design was used for this study. The experimental group (n=76) completed a 8-week intervention of social prescribing, while the control group (n=39) only participated in pre- and post- need assessment from April 2021 to October 2022. A Wilcoxon signed rank test was conducted to evaluate the effectiveness of a social prescribing program on the level of cognitive function and depression of the participants. Results: The level of cognitive function was improved significantly in the experimental group (p<.05) while there was no significant change in the control group. Depression has been significantly decreased in the experimental group (p<.01), but there was no statistically significant change in the control group. Conclusion: The results of this study suggest that the social prescribing program is effective for improving cognitive function and reducing depression of the elderly living in the rural area. Therefore, a social prescribing program can be utilized as a preventive program for dementia and depression of the elderly.

• 대한예방의학회:학술대회논문집
• /
• 2001.10a
• /
• pp.173-174
• /
• 2001

• Health Policy and Management
• /
• v.30 no.4
• /
• pp.513-521
• /
• 2020

Aging populations and the increasing mental health issues among them have set a new challenge for the international community, governments, and people. Given this, society's role is very important, and involving the local community in resolving the problems can play a pivotal role. The current study presented the systematic review of the financing mechanism and cost-effectiveness of the "social prescribing" (SP) project in the United Kingdom and how SP can be adapted for other settings. The data showed comparatively low running costs and the overall effectiveness of SP projects. The running cost of SP projects varied between £54,525 and £1.1 million. The cost-effectiveness of the projects reported as 12% and the return of investment was about 50% depending on the type of analysis and the activities implemented. This type of intervention can be one of the options that support solving the issues of aging populations and their accompanying mental disorders.

• Quality Improvement in Health Care
• /
• v.12 no.2
• /
• pp.93-112
• /
• 2006

This study reviewed published studies on interventions used by hospitals, health insurance programs, or governments to improve use of medicines in foreign countries. Interventions to improve use of medicines are classified into two categories: 1) information strategies-dissemination of educational materials, group education, one-to-one educational outreach, drug utilization review, and feedback; 2) managerial strategies- formularies, prior authorization, and financial incentives. Dissemination of educational materials, which is a common intervention, was unsuccessful in changing physicians' prescribing behaviors. Problem-based small group education was more likely to change behaviors than didactic large group education. One-to-one educational outreach(academic detailing) was among the most effective strategies used to change prescribing behaviors. Prospective drug utilization review (DUR) program was more successful in improving use of medicines than retrospective DUR program. Feedback intervention has been reported to be ineffective to change behaviors. Formularies are frequently used to control medication use by most health insurance programs. Financial incentives provide physicians economic incentives according to appropriateness of prescribing. However, few published studies have assessed the efficacy of formularies or financial incentives. Prior authorization requires physicians to get authorization from health insurers before prescribing a certain group of drugs which is usually of high costs or risk. There is no magic bullet for quality use of medicines. Multifaceted interventions that help to predispose, enable, and reinforce desired behaviors are more likely to be successful.

• Korean Journal of Clinical Pharmacy
• /
• v.12 no.2
• /
• pp.85-90
• /
• 2002

The aim of this study was to examine the current turnover status of hospital pharmacists and to analyze the factors which affected the turnover of them after the separation of prescribing and dispensing practice. We surveyed 19 managers of hospital pharmacies and 154 hospital pharmacists. Results are as follows. Pharmacist manpower of hospital pharmacies was only $63.99\%$ in tertiary hospitals and $76.78\%$ in general hospitals respectively of the number of pharmacists before the separation of prescription and dispensing practice. The ratio of those who left hospital pharmacies during the period of January 2000 and October 2001 was $80.23\%$ for tertiary hospitals, and $100.84\%$ for general hospitals. Decrease in the number of pharmacists brought the increase of work load and night duty. Major factors which affected the turnover of hospital pharmacists were found as following: income gap between hospital pharmacists and community pharmacists, increasing workload especially at night and on holidays, infrequent chance for the promotion, and low chance to provide clinical pharmacy services after the separation of prescribing and dispensing practice. Adequate manpower is the basic factor for providing hospital pharmacy services and improving clinical pharmacy services. The study suggested that proper number of hospital pharmacists is to be ensured through strengthening the legal requirement for the hospital pharmacists and improving health insurance reimbursement rate for the pharmaceutical services at hospital.

• Journal of Hospice and Palliative Care
• /
• v.27 no.1
• /
• pp.45-49
• /
• 2024

Purpose: This study investigated palliative care physicians' attitudes regarding social issues related to opioid use. Methods: An email survey was sent to 674 physicians who were members of the Korean Society for Hospice and Palliative Care (KSHPC). Results: Data from 66 physicians were analyzed (response rate, 9.8%). About 70% of participants stated that their prescribing patterns were not influenced by social issues related to opioid use, and 90% of participants thought that additional regulations should be limited to non-cancer pain. Under the current circumstances, pain education for physicians is urgently needed, as well as increased awareness among the public. Half of the respondents identified the KSHPC as the primary organization responsible for providing pain education. Conclusion: Palliative care physicians' prescribing patterns were not influenced by social issues related to opioid use, and these issues also should not affect cancer pain control.

• Korean Journal of Clinical Pharmacy
• /
• v.31 no.2
• /
• pp.115-124
• /
• 2021

Background: With an increase in the number of breast cancer survivors, greater importance is attached to health-related quality of life, particularly pain and symptom control. This study aimed to identify the factors that are associated with pain in cancer patients based on the patterns of prescribing opioid, non-opioid, and adjuvant analgesics. Methods: This analysis included new patients who had developed breast cancer between 2003 and 2012. The degree of pain was analyzed based on the socio-demographic (age, income quintile, number of hospitalizations, and duration of disease), indicator (Body Mass Index; BMI, Charlson Comorbidity Index; CCI, Cumulative Analgesic Consumption Score; CACS), operation (mastectomy, lymph node dissection), and therapy (chemotherapy, radiation therapy), as well as complication-related variable (lymphedema). Results: As for the patterns of prescribing analgesics by stages, non-opioid and opioid analgesics constituted 30.7 and 69.3%, respectively. The mean value and variance of CACS were 5.596 and 12.567, respectively. The factors that significantly affected the degree of pain were age (≥50; IRR: 1.848, 95% CI 1.564-2.184, p=0.000), income quintile (IRR: 0.964, 95% CI 0.938-0.991, p=0.008), BMI (≥ 25; IRR: 1.479, 95% CI 1.222-1.795, p=0.000), CCI (≥ 4; IRR: 1.649, 95% CI 1.344-2.036, p=0.000), and lymphedema (yes; IRR: 1.267, 95% CI 1.006-1.610, p=0.047). Conclusions: It is necessary to develop systematic and comprehensive pain control measures to improve the quality of life for breast cancer survivors, especially for those who are 50 years or older, lie in the lower-income quintile, have BMI of ≥25 and CCI score ≥ 4, or have lymphedema.

• Korean Journal of Schizophrenia Research
• /
• v.24 no.1
• /
• pp.36-43
• /
• 2021

Objectives: Despite the high discontinuation rate of clozapine in refractory schizophrenia, there is limited evidence regarding the suggested treatment after clozapine discontinuation. Methods: The medical records of 37 patients who discontinued clozapine were retrospectively reviewed. The prescription patterns of antipsychotics, mood stabilizers, and antidepressants were compared at three points before and after clozapine treatment and at the most recent visit. Results: After clozapine discontinuation, 75.6% of the subjects were receiving antipsychotic polypharmacy, and 32.4% were taking more than 3 antipsychotics. The frequently used antipsychotics were olanzapine (21.5%), quetiapine (21.5%), and paliperidone (12.7%). The rates of augmentation with mood stabilizers and antidepressants were 43.2% and 29.7%, respectively. Furthermore, valproate was the most commonly used mood stabilizer (87.5%). Conclusion: Antipsychotic polypharmacy and augmentation are inevitable in schizophrenia patients for whom clozapine has been discontinued. Further research is required to improve the outcomes of polypharmacy and augmentation in schizophrenia patients.

• Korea Journal of Hospital Management
• /
• v.7 no.3
• /
• pp.84-101
• /
• 2002

This study estimated the influence of 'the separation of prescribing and dispensing roles' (SPD) policy, which implemented in July 2000, on the community pharmacies in Korea, by using data on the revenues and expenditures in the previous researches. We first assumed the rate of drug price differential was 20% with four different models which was based on various data of studies carried out in the similar period. Later, we applied different rates for the sensitivity analysis. According to the results, all community pharmacies made the net profit of 118.9 billion won (0.552 million won monthly per one pharmacy) after the SPD policy. The ratio of net profit to net sales dropped by 7.41%p from 22.19% to 14.78%. Additional sensitivity analysis indicated there were wide range of differences about whether net profit or net gain, and that extent which either existed.

• Korea Journal of Hospital Management
• /
• v.8 no.4
• /
• pp.121-148
• /
• 2003

This study is designed to evaluate the contents of the separation of prescribing and dispensing roles(SPD) policy based on the theoretical backgrounds. The results are as follows; Considering the purpose of SPD policy, 'increasing the efficiency in manpower management by separating the role of medical doctor and pharmacist and improving the quality of SPD service through specialization of function' as a policy objective is valid and very important agenda in health care. But the objectives are not working well by no keeping the detail means to actualize it. Also, some policy objectives are unclear or inappropriate and it makes the focus of that policy obscure or misleads inadequate policy alternatives. In terms of means of policy, it is evaluated to have some limits in effectiveness, efficiency, equity, rationality, technical feasibility, economic feasibility, administrative feasibility, social and time feasibility. In conclusion, it's necessary to investigate the some problem mentioned in this paper with empirical evidence. Also, it should be needed to improve the validity of policy by correcting policy objectives and means in execution of policy.