• Title/Summary/Keyword: drug consultation

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Clinical pharmacist services in general wards and perception and expectation of healthcare providers towards the services at a tertiary healthcare center (상급종합병원 병동담당약사 업무 현황 및 의료인의 인식과 기대 분석)

  • Kim, Jeongun;Baek, Sijin;Choi, Nayae;Jeon, Sujeong;Namgung, Hyung Wook;Lee, Junghwa;Lee, Euni;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.1
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    • pp.20-26
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    • 2022
  • Background and objective: The Seoul National University Bundang Hospital (SNUBH) implemented ward-based clinical pharmacy system with designated pharmacists in 10 general wards. Designated pharmacists conduct inpatient medication review, medication intervention, and medication consultation, and provide drug information for health care providers. This study aimed to evaluate the clinical pharmacy services and to examine the perception and expectations of health care providers on the services provided by the designated pharmacists in general wards. Methods: A survey was constructed to include questions on the health care providers' recognition, satisfaction, and perceived needs of designated pharmacists. We determined the frequency and type of interventions of ward pharmacist and their acceptance rate through a retrospective observational study using electronic medical records. Results: A total of 59 health care providers responded the questionnaire and 79.7% of the respondents reported moderate to high levels of satisfaction. Satisfaction with the services was positively associated with clinical interventions and nutrition support team (81.4%). Of 59 respondents, 88.1% agreed that preventing drug-related problems by designated pharmacists' activities were effective. The most common interventions included inadequate dosage (27.4%), omission and additional prescription (14.6%) and inadequate drug form (9.6%). The acceptance rate of intervention was 91.5%, and 151 potentially serious risks and 523 significant risks were prevented by the intervention. Conclusion: Positive results were confirmed in the awareness, satisfaction, and perceived needs of the health care providers for designated pharmacists. Expansion of the ward-based clinical pharmacy system with designated pharmacists to other wards may be considered.

A Study on Intensive Major Course of Department of Nursing in College (전문대학 간호과 전공심화과정 운영방안)

  • Park, Song-Ja;Je, Mi-Soon
    • The Journal of Korean Academic Society of Nursing Education
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    • v.10 no.1
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    • pp.64-74
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    • 2004
  • This study was conducted to investigate what contents nurses want in the intensive major course of junior nursing college. Data were collected for four months from October 2002 to February 2003 by structured questionnaires. Subjects were 240 registered nurses in working at five hospitals and four public health centers and elementary or middle schools in the capital and its suburbs and country. The collected data were analyzed using SPSS 8.0 program. The results of this study were summarized as follows : 1. Nurses working at hospitals want the programs which involve the contents as follows : emergency nursing/CPR, infection control, critical care, caner pt. care, pain control, hospice, pulmonary disease pt. care, analysis of lab. exam, heart disease pt. care, chronic disease pt. care, DM pt. care, digestive-system disease pt. care, nervous-system disease pt. care, elderly pt. care, immune-system disease pt. care, endocrine-system disease pt. care. 2. Nurses working at public health centers want the programs which involve the contents as follows : home nursing, family nursing, management of DM, HT, degenerative disease, and chronic liver disease, elderly pt. care, health education, maternity nursing, rehabilitation nursing. 3. Nurses working at elementary or middle schools want the programs which involve the contents as follows : prevention of drug abuse or misuse, sex education and consultation, health education, consultation technique, emergency care, prevention of child obesity, prevention and management of adult disease in children, teaching method, method of school health room management.

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Development of Warfarin Talk: A Messenger Chatbot for Patients Taking Warfarin (와파린 복용 환자를 위한 메신저 기반 챗봇 개발)

  • Lee, Han Sol;Kim, Yu Ri;Shin, Eun Jeong;Jang, Hong Won;Jo, Yun Hee;Cho, Yoon Sook;Kim, Jung Hoon;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.4
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    • pp.243-249
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    • 2020
  • Background: Despite the increased use of direct-acting oral anticoagulants, warfarin is still recommended as first-line therapy in patients with mechanical valves or moderate to severe mitral stenosis. Anticoagulation management services (AMSs) are warranted for patients receiving warfarin therapy due to the complexity of warfarin dosing and large interpatient variability. To overcome limited health care resources, we developed a messenger app-based chatbot that provides information to patients taking warfarin. Methods: We developed "WafarinTalk" as an add-on to the open-source messenger app KakaoTalk. We developed the prototype chatbot after building a database containing seven categories: 1) dosage and indications, 2) drug-drug interactions, 3) drug-food interactions, 4) drug-diet supplement interactions, 5) monitoring, 6) adverse events, and 7) precautions. We then surveyed 30 pharmacists and 10 patients on chatbot reliability and on participant satisfaction. Results: We found that 80% of the pharmacists agreed on the consistency of chatbot responses and 44% agreed on the appropriateness of chatbot. Furthermore, 47% of pharmacists said that they were willing to recommend the chatbot to patients. Of the seven categories, information on drug-food interaction was the most useful; 90% of patients said they were satisfied with the chatbot and 100% of patients said they were willing to use it when they were unable to see a pharmacist. We updated the prototype chatbot with feedback from the survey. Conclusion: This study showed that warfarin-related information could be provided to patients through a messenger application-based chatbot.

A Comparative Study Concerning the Psychopathologies between the Patients with Peptic Ulcer and Those with Essential Hypertension - Focused on Medically-Ill Out Patients - (소화성 궤양과 본태성 고혈압 환자의 정신병리에 관한 비교 연구 - 내과외래환자를 중심으로 -)

  • Choi, Hyun-Kyoung;Kim, Chan-Woo;Lee, Dong-Gun;Kwak, Chung-Whan;Park, Seung-Ken;Park, Hee-Ouk;Ok, Jong-Whan;Kim, Jeong-Gee
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.2
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    • pp.149-158
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    • 2003
  • Objectives: The authors studied the anxiety, depression and psychological characteristics of medical out-patients, which are diagnosed as peptic ulcer disorder and essential hypertension. We also examined the state of psychiatric consultation. Methods: The subjects were composed of 56 patients with peptic ulcer disorder, 44 patients with essential hypertension and 116 controls. STAI, BDI and SCL-90R was administered to all subjects. Chart review, telephone interview and Self report questionnaire of etiology and severity of illness, drug compliance and so forth were performed in disease groups. Results: Considerable depression was noticed in 39.3% among the patients with peptic ulcer disorder, 27.7% in hypertension and 12.1% in control group by BDI. State anxiety was noticed in 44.6% among the patients with peptic ulcer disorder, 54.5% in hypertension and 18.1% in control group by State anxiety. Trait anxiety was noticed in 42.9% among the patients with peptic ulcer disorder, 34.1% in hypertension and 25.8% in control group by Trait anxiety. The higher SOM, BDI, STAI, the lower drug compliance and rapport. Psychological problems are considered of the most important etiology in 48.2% of peptic ulcer group and 45.7% of hypertensive group. But psychiatric consultation is made only in 1.8% of peptic ulcer group and 2.3% of hypertensive group. Conclusions: Anxiety and depression are common phenomena in medical outpatients. In comparison with the normal control group, peptic ulcer group showed significantly higher trait anxiety and depression and hypertensive group higher state anxiety. These characteristics are related to the drug compliance and doctor-patient relationship. These results suggested the needs of active psychiatric consultation.

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Effect of Lifestyle Modification Program on Blood Pressure Improvement in Patients with Hypertension (고혈압 환자에서 생활습관 개선 프로그램의 혈압개선효과)

  • Lee, Sang-Uk;Oh, Chang-Mo;Oh, In-Hwan;Yoon, Tai-Young;Choi, Joong-Myung
    • Korean Journal of Health Education and Promotion
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    • v.27 no.4
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    • pp.105-112
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    • 2010
  • Objectives: The purpose of this study was to know different effect with uncontrolled hypertension patients after providing health promotion program which consisted with medicine, exercise, nutrition. Methods: The subjects of this study was comprised by uncontrolled hypertension patients in spite of medication and didn't care the pressure by medication. The health promotion program was progressed by group exercise three times a week, nutrition education once a week and medical consultation once a month for 12 weeks. Subjects were measured for body composition(weight, fat mass, % body fat and body mass index), hemo-dynamics(systolic blood pressure(SBP), diastolic blood pressure(DBP), and resting heart rate), and physical fitness (cardiopulmonary endurance, muscular strength, muscular endurance, balance, and flexibility). Results: Groups showed significant improvement in every measure except resting heart rate. SBP is decreased both taking drug group about 18.4mmHg and without taking drug group about 19.4mmHg.(p<0.001) DBP is decreased both taking drug group about 8.7mmHg and without taking drug group about 9.0 mmHg.(p<0.001) Conclusion: There are no statistical significant differences of SBP and DBP decreasing effects by medication, Since effects of decreasing pressure are not different by medication, I think the health promotion program is effective to uncontrolled hypertension patients to decrease pressure.

Current Status of Herb-Drug Interaction Information and Information Database in Korea (국내 한약-양약 상호작용 연구논문 분석을 통한 상호작용 정보 현황파악 및 제공방안에 대한 연구)

  • Park, Soo-Jin;Kwon, Young-Kyu;Shin, Jae-Gook
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.4
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    • pp.543-552
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    • 2010
  • The objectives of this study are to examine the current status and problems of herb-drug interaction (HDI) information and information database in Korea and suggest the better way to establish useful HDI database. We collected HDI studies that published in Korea and analyzed according to objective, methods, selection criteria of herbs, number of study, correlation between study subject and frequently used herbal medicine (HM). Then we selected representative HM database on the internet made by Korea Food and Drug Administration (KFDA) among the several databases and analyzed its contents related to HDI. Several HDI studies were carried out from laboratory based research to clinical trials and HM databases have been developed for providing information about different aspects of traditional Korean medicine. But the information of HDI and information database are still far from practical applications because there are no coherence to select study subjects and methods among researchers. So, it is necessary to build up HDI database led by the government for providing systematic HDI information. HDI information database is expected to be able to provide useful evidence for health professionals in prescription and consultation to reduce the chance of adverse effects and improve the quality of medical care.

Cost-benefit Analysis of Mandatory Prescription in Korea (의약분업의 비용-편익 분석)

  • Kim, Han-Joong;Park, Eun-Cheol;Kang, Hye-Young;Jee, Young-Keon
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.4
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    • pp.484-494
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    • 2000
  • Objective : To evaluate the relative benefits and the costs associated with the introduction of the new pharmaceutical provision called 'Mandatory Prescription System' which separates the role of physicians from that of pharmacists with respect to the prescription and dispensation of from the perspective of consumers (i.e., patients). Methods : The costs of the system were measured by considering both direct and indirect costs. Direct costs included additional payments for ambulatory care and dispensing fees that occurred under the new system. indirect costs consisted of transportation expenses and costs related to time spent for physician consultation, waiting for the prescriptions to be filled, and extra traveling. Benefits identified in this study were the reduction of drug misuse and overuse, and the overall decrease in drug consumption among the Korean population. Sensitivity analysis was peformed for the inclusion of benefits for outpatients of hospitals, price elasticity, and increased fees for established patients. Results : The net benefit was estimated to be about minus 1,862 billion won and the benefit-cost ratio was 0.478. This indicates that the costs of 'Mandatory Prescription' outweigh its benefits, relative to the previous system. The sensitivity analysis results for all the variables considered in this study consistently showed the benefit-cost ratio to be less than 1. Conclusion : The results of this study suggest that implementing Mandatory Prescription System in Korea might be inefficient from the consumer's perspective. The results of this study do not coincide with the results of previous studies, presumably because of the differences in study design and in which items of costs and benefits were considered.

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Transitional care for high-risk elderly patients pre/post discharge by collaboration between general hospital and community pharmacy: a pilot study

  • Park, Mi Seon;Lee, Ji Hee;Lee, Heung Bum;Kim, Ju Sin;Choi, Eun Joo
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.1
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    • pp.27-36
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    • 2022
  • Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.

Analysis of Drug Compliance Status for the Hormone Replacement Therapy (HRT) Treatment Patients (호르몬대체요법 환자의 복약실태분석)

  • Hong, Sun Shik;Lee, Eui Kyoung
    • Korean Journal of Clinical Pharmacy
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    • v.10 no.1
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    • pp.7-12
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    • 2000
  • This study is intended to provide information to menopausal women so they can control their symptoms. The basic data was gathered by interviewed 200 postmenopausal women on a HRT program. The women were questioned about their perception of menopause and compliance to the therapy with the fellowing result $71.7\%$ of the women experianced hot flushes, and $64.1\%$ experienced short term memory loss and some psychological symptoms. The women reported that these symptoms reduced their quality of life. $53\%$ of the women responded that menopause is a natural state and $59.1\%$ agreed to HRT based on their doctor's recommendation. $76.2\%$ of the women reported that HRT was effective, with $74.7\%$ reporting reduced hot flush symptoms $67.3\%$ of the women reported compliance with the medication schedule. and $43.9\%$ reported periodic non-compliance. Although HRT has been shown to be an effective treatment, the study found that less than $10\%$ of postmenopausal women are currently being treated and these treated women are generally negligent in continuing with HRT, The study recommends that a program be developed that explains the benefits and risks of HRT to be distributed to patients being treated by doctors and pharmacists. In conclusions, It is very important for hormone replacement therapy on menopausal women to take more intensive medication consultation to increase medication compliance and effectiveness of pharmacotherapy.

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Radiographic changes of mandibular cortical bone in bisphosphonate drug holiday

  • Lee, Dae-Hoon;Seo, Ja-In;Song, Seung-Il;Lee, Jeong-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.4
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    • pp.219-224
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    • 2022
  • Objectives: There have been few studies to date on the residual effect of bisphosphonate. This study investigated the radiographic changes of mandibular cortical thickness upon bisphosphonate drug holiday. Materials and Methods: This retrospective study includes 36 patients diagnosed with MRONJ (medication-related osteonecrosis of the jaw) at Ajou University Dental Hospital in 2010-2021. All patients stopped taking bisphosphonate under consultation with the prescribing physicians. Panoramic radiographs were taken at the start of discontinuation (T0), 12 months after (T1), and 18 months after (T2) discontinuation of bisphosphonate, respectively. Mental index and panoramic mandibular index were calculated using Ledgerton's method. Paired t-tests were used to analyze differences over time. Results: The difference in indices (mental index and panoramic mandibular index) between T0 and T1 was not statistically significant (paired t-test, P>0.05). However, the difference in these indices between T1 and T2 was statistically significant (paired t-test, P<0.05). Conclusion: The cortical thickness of the mandible decreased in the late stage (after 18 months) as observed by panoramic radiograph.