• 약학회지
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• 제55권3호
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• pp.185-194
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• 2011

Therapeutic duplication (TD) is frequently reported inappropriate drug use in healthcare settings in Korea. This study was aimed to develop TD criteria for psycho-nervous system drugs (KFDA classification 117 and 119). ATC classification was used to determine therapeutic and/or chemical similarities among the 93 ingredients reviewed. Clinical practice guidelines, textbooks and product labels were referenced for principles and evidences of possible drug combination usage. 16 groups that listed ingredients to be considered as TD were established and the criteria would be helpful to prevent TDs.

• 한국임상약학회지
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• 제20권1호
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• pp.39-49
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• 2010

The present study was aimed to examine the occurrence and influencing factors therapeutic duplication (TD) of medications for anxiety disorders by analyzing the relevant prescription data. In this study, the prescription data issued on March 19, 2008 in domestic medical institutes were utilized. TD was defined as more than two medications under the same therapeutic classification per prescription based on the Anatomical Therapeutic Classification (ATC) code. The assessment of TD was performed based on the number of cases and on the ratio determined. To identify the influencing factor of TD, the variables related to the differences in the TD ratio were analyzed based on the results of the Chi-Square test conducted with the variables; patients, medical institutes, diseases, and treatments. The number and ratio of TD were determined to be 1,333 out of the total of 19,219 anxiety disorder cases, and 6.94%, most cases involving benzodiazepine derivatives, respectively. The TD ratio was found to be higher in relation to males than to females. Patients with national health insurance benefits have a higher TD ratio compared to the medical-aid beneficiaries. The TD ratios were highest in clinics, psychiatry divisions, and Gyeongsang district. The TD ratio of the cases with more than two anxiety disorders was found to be higher than that of the cases with only one anxiety disorder. As the number of medications per prescription increased, the TD ratio was shown to have become gradually higher. In conclusion, in order to prevent TD, the concurrent DUR system should be implemented. The prescribers and pharmacists must be educated regarding duplicated medications to promote the safe and effective use of medicines, without unnecessary TD.

• 보건행정학회지
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• 제24권2호
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• pp.120-127
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• 2014

Background: Since December 2010, online computerized prospective drug utilization review (pDUR) has been implemented in Korea. pDUR involves the review of each prescription before the medication is dispensed to the individual patient. The pDUR is performed electronically by Health Insurance Review & Assessment Service (HIRA), which is a Korean governmental agency, and then HIRA provides medical institutions and pharmacies with information that can be helpful to them in preventing potential drug problems such as drug/drug interactions or ingredient duplication. The aim of this study was to assess the impact of the Korean pDUR implementation on the proportion of drug-drug interactions (DDIs) using claims data from HIRA. Methods: A before-after comparison of the prevalence of DDIs between prescription was conducted, using HIRA administrative claims data of medical institution from January 2010 to December 2011. The analysis unit was the prescription issued and pairs before and after. The main outcome measures were the proportion of DDIs within- (control group) or between- physician encounters. To examine the difference, a paired t-test was applied. Results: We found that DDIs proportion between prescription decreased significantly (t=3.04, p=0.0026) after the implementation of pDUR, whereas there is no significant reduction within prescription (t=1.15, p=0.2518). With respect to the prevalence of DDIs between drug groups, the most dramatic reduction was occurred between 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors and anti-fungal agents. Conclusion: It seems effective that giving a direct feedback to prescribers by a prospective DUR. Further research is needed to assess the impact of DUR to final outcomes such as hospitalization.

• 한국독성학회:학술대회논문집
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• 한국독성학회 2005년도 춘계 국제심포지엄 및 학술대회
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• pp.206-206
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• 2005

• 한국임상약학회지
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• 제33권3호
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• pp.168-177
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• 2023

Background & Objectives: Fixed-dose combinations (FDCs) offer advantages in adherence and cost-effectiveness compared to free combinations (FCs), but they can also complicate the prescribing process, potentially leading to therapeutic duplication (TD). This study aimed to identify the prescribing patterns of FDCs for dyslipidemia and investigate their associated risk of TD. Methods: This was a retrospective cohort study involving drugs that included statins, using Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) data from 2018. The unit of analysis was a prescription claim. The primary outcome was TD. The risk ratio of TD was calculated and adjusted for patient, prescriber, and the number of cardiovascular drugs prescribed using a multivariable Poisson model. Results: Our study included 252,797 FDC prescriptions and 515,666 FC prescriptions. Of the FDC group, 46.52% were male patients and 56.21% were aged 41 to 65. Ezetimibe was included in 71.61% of the FDC group, but only 0.25% of the FC group. TD occurred in 0.18% of the FDC group, and the adjusted risk ratio of TD in FDC prescriptions compared to FC was 6. 44 (95% CI 5. 30-7. 82). Conclusions: Prescribing FDCs for dyslipidemia was associated with a higher risk of TD compared to free combinations. Despite the relatively low absolute prevalence of TD, the findings underline the necessity for strategies to mitigate this risk when prescribing FDCs for dyslipidemia. Our study suggests the potential utility of Clinical Decision Support Systems and standardizing nomenclature in reducing medication errors, providing valuable insights for clinical practice and future research.

• 대한본초학회지
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• 제33권5호
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• pp.19-37
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• 2018

Objectives : Oryeong-san was composed of Alismatis Rhizoma, Atractylodis Rhizoma Alba, Poria Sclerotium, Polyporus, Cinnamomi Cortex, and known to have hundreds of chemical compounds. The aim of this study was to screen chemical compounds constituting Oryeong-san with the drug-likeness and oral bioavailability from the analysis of their physicochemical properties. Methods : A list of chemical compounds of Oryeong-san was obtained from TM-MC(database of medicinal materials and chemical compounds in Northeast Asian traditional medicine). To remove redundant compounds, the SMILES (Simplified Molecular Input Line Entry System) strings of each compound were identified. All of the physicochemical properties for the compounds were calculated using the DruLiTo(Drug Likeness Tool). Drug-likeness was estimated by QED(Quantitative Estimate of Druglikeness) and OB(Oral bioavailability) was checked based on the Veber's rules. Results : A total of 475 compounds were obtained by eliminating duplication among 544 compounds of 5 medicinal materials. Analysis of the physicochemical properties revealed that the most common values were MW(molecular weight) 200~300 g/mol, ALOGP(octanol-water partition coefficient) 1~2, HBA(number of hydrogen bond acceptors) 0~1, HBD(number of hydrogen bond donors) 0, PSA(polar surface area) 0~50 angstrom, ROTB(number of rotatable bonds) 1, AROM(number of aromatic rings) 0, and ALERT(number of structural alerts) 1. QED had 93% of the values between 0.2 and 0.7, and OB had 90% of the value of TRUE. Conclusions : We in this paper screened the candidate active compounds of Oryeong-san using the QED and Veber's rules. In the future, we will use the screening results to analyze the mechanism of Oryeong-san based on systems pharmacology.

• 약학회지
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• 제56권5호
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• pp.333-345
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• 2012

A product labelling is one of key tools in ensuring that a patient uses drugs safely and effectively in self-care without professional support. This study aimed to explore the readability and comprehensibility of the information contained on two package inserts of medicines. Two package inserts were tested with first year college students. Fifty-one potential consumers underlined words they could not understand and answered 10 scenario questions. Any differences among groups with different characteristics were statistically tested. Secondly, the readability of two package inserts was assessed with comparison to the level of the 6th grade Korean textbooks. As results, more than 80% of participants properly replied to straightforward questions concerning indication, dosage, duplication, use in pregnancy and contraindication, and 73% about formulation. Less than half answered correctly in multiple choice questions about pediatric use (41%) and side effects (35%). Little discrepancy was observed in the comprehensibility between participants' characteristics. Drug inserts contained about 20% more professional-level words than 6th grade textbooks. In conclusion, Korean consumers may face challenges to understand drug information due to professional terminology and outdated expressions in the current package inserts. To secure safe and effective use of over-the-counter agents, greater efforts should be made to develop more consumer friendly labels. In the other hand, educational supports are required to prepare consumers in a proper level of knowledge for the safe use of drugs.

• 보건행정학회지
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• 제34권2호
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• pp.178-184
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• 2024

연구배경: 본 연구는 의료질평가지원금 drug utilization review (DUR) 평가지표 도입 전·후의 DUR 점검률 및 의약품 중복처방 예방률 변화 차이를 비교하여 DUR 평가지표의 도입과 안전한 의약품 사용 간의 효과성을 파악하고자 한다. 방법: 본 연구는 2018년 건강보험심사평가원(Health Insurance Review and Assessment Service) DUR 자료(DUR 평가지표 도입 전)와 2023년 의료질평가지원금 평가 결과 산출 자료(DUR 평가지표 도입 후)를 활용하였다. 종속변수는 DUR 평가지표로, DUR 점검률과 의약품 중복처방 예방률 지표를 활용하였다. 독립변수는 DUR 평가지표 도입 여부이며, 통제변수는 의료기관 단위변수로, 종별 구분, 설립 구분, 소재지, DUR 청구 software 업체, 병상 수를 선정하였다. 결과: DUR 평가지표 도입 전·후의 의약품 중복처방 예방률 변화 차이를 분석한 결과, DUR 평가지표 도입 전·후의 의약품 중복처방 예방률은 통계적으로 유의미한 차이가 있었으며, DUR 평가지표 도입 후 의약품 중복처방 예방률이 유의미하게 증가하였다. 결론: 본 연구의 정책적 시사점은 다음과 같다. 첫째, DUR 시스템의 지속적인 평가 진행이 필요하다. 본 연구를 통해 DUR 평가지표 도입 후 의약품 중복처방 예방률이 유의하게 증가한 것을 확인하였다. 따라서 DUR 시스템의 효과를 계속해서 검토하고 의약품 사용의 안전성을 확대하기 위해 DUR 시스템의 지속적인 평가 진행이 필요할 것으로 판단된다. 둘째, DUR 시스템 정보를 활용하는 의료기관과 이를 관리하는 기관과의 협력 파트너십 구축이 필요하다. 의료기관의 적극적인 DUR 점검 참여와 관리기관의 다각적인 지원을 바탕으로 공동의 노력과 협력이 이루어진다면, DUR 시스템의 활성화를 통해 안전한 의약품 사용을 보장하고 국민건강을 보호하며, 의료의 질적 수준 향상을 불러올 것으로 판단된다.

• 치위생과학회지
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• 제21권1호
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• pp.1-7
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• 2021

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted primarily through droplets, and dental practitioners are at risk of occupational exposure to SARS-CoV-2 infection owing to direct contact with the patient's mouth, aerosols from dental procedures, and saliva. Wearing a mask is believed to be the best method of protection against infection, and a systematic literature review was conducted on whether the dental masks used in dentistry are effective in preventing Coronavirus Infectious Disease-19 (COVID-19). Methods: We used PubMed, Google Scholar, DBpia, NDSL, and KISS databases for this study. Of the 917 documents narrowed down by the search terms "Coronavirus, COVID-19, and dental," 83 documents were collected and studied. Ultimately, 42 of these papers were selected for analysis after considering duplication from the flow chart of the literature selection process. Results: While dental masks are often used when treating patients with unknown COVID-19 status, the Ministry of Food and Drug Safety stated that the use of dental masks is insufficient in preventing cross-transmission of COVID-19; instead, it was recommended that N95 masks, which correspond to KF94 masks, should be worn daily. On the other hand, wearing a dental mask and following precautions such as hand hygiene may not pose a significantly higher risk of infection than wearing an N95 mask when treating COVID-19 patients. Conclusion: There is an ongoing discussion regarding the use of dental masks when treating dental patients, and many argue that different types of masks should be selected according to the degree of infection and the individual's respiratory condition. By considering the safety and efficacy of dental masks in preventing infection, improvements can be made in the management of COVID-19 and dental-related infections.

• 대한골관절종양학회지
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• 제4권1호
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• pp.13-21
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• 1998

Taxol이 악성 골종양 세포에 어느 정도의 세포독성이 있는지를 평가하기 위해 한국세포주 은행에서 분양 받은 G-292, SaOS-2 및 HT-1080의 3가지 악성 골종양 세포들을 대상으로 기존의 항암제인 methotrexate, adriamycin, ifosfamide, cisplatinum과 함께 각각 투여하여 MTT분석법으로 정량 및 비교 분석하였으며, adriamycin과 taxol을 병용 투여하여 항암제의 상호작용을 isobologram 분석법으로 조사하여 다음과 같은 결과를 얻었다. 1. Taxol의 악성 골종양 세포 주들에 대한 $IC_{50}$는 G-292에서는 $2.7{\times}10^{-2}{\mu}g/ml$, $SaOS^{-2}$에서는 $1.0{\times}10^{-2}{\mu}g/ml$, $HT{\times}1080$에서는 $1.1{\times}10^{-3}{\mu}g/ml$이었다. 2. Taxol은 악성 골종양 세포주들에 대해 기존의 항암제들 보다 강한 세포독성을 보였으며, 기존 항암제의 세포 독성의 강도는 adriamycin이 제일 높은 역가를 보였으며 그 외 methotrexate, cisplatinum, ifosfamide순이었다. 3. Taxol과 adriamycin을 병용 투여하여 상호작용을 관찰한 결과 G-292와 SaOS-2 세포 주에서 상승효과가 관찰되었으며, HT-1080에서는 상승효과가 관찰되지 않았다.