• 제목/요약/키워드: drug-age precaution

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Tiering 'Drug Combinations to Avoid' and 'Drug-age Precaution' DUR Alerts by Severity Level and its Application (병용금기, 연령금기 경고 등급화 방안과 DUR 처방변경률 분석)

  • Lee, Soo Ok;Je, Nam Kyung;Kim, Dong-Sook;Cheun, Bang Ok;Hwang, In Ok
    • YAKHAK HOEJI
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    • v.59 no.6
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    • pp.278-283
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    • 2015
  • The computerized prospective Drug Utilization Review (DUR) program supported by the Korean government has provided alerts to physicians and pharmacists since December 2010. This study aims to propose and apply the tiering system in "drug combinations to avoid (DCA)" and "age-precaution" alerts based on severity to improve the compliance of users. To propose the severity and clinical importance of 647 DCA alerts and 140 age precautions, a Delphi evaluation survey was conducted. An expert panel comprising 5 clinical pharmacists and 5 physicians were participated in mail surveys. Based on the results of Delphi survey, DCA pairs were classified into 3 groups; group 1 (70.6%), 2 (26.9%), and 3 (2.8%). Drug-age precaution ingredients were also classified into three groups; group 1 (53.6%), group 2 (40.7%), and group 3 (5.7%). When this grouping was applied to claim data from 2011 to 2013, the majority of alerts had occurred in the groups of high severity. Presenting DUR alerts with severity level is expected to improve the compliance of clinicians. The implementation of tiering system in DUR criteria should be considered.

Nuri-curriculum Daycare Programs Analysis for 3 to 5-year-olds Based on Child Welfare Act Safety Education-Based Content (3-5세 누리과정에 기초한 어린이집 프로그램의 안전교육 내용 분석: 아동복지법을 기준으로)

  • Nam, Hyunjoo;Lee, Sangehee
    • Korean Journal of Childcare and Education
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    • v.15 no.3
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    • pp.39-60
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    • 2019
  • Objective: The purpose of this study was to analyze the Nuri-curriculum daycare programs for 3, 4, and 5-year-olds based on the Child Welfare Act. Methods: Data were analyzed according to the analysis criteria for 195 children's safety education programs in the Nuri-Program. The analyzed data used frequency and percentages. Results: First, life safety education was the most important element. And after looking at the contents category of the Child Welfare Act, the results in order are as follows: "raffic safety"; "Health and hygiene management, including the prevention of contagious diseases and drug abuse"; "Safety measures against disasters"; "Precaution and prevention of disappearance and abduction"; and "Prevention of sexual violence and child abuse." Second, there were many safety education activities in accordance to chronological age (3-to 5-years old). Health and safety by subject, season, and life tools were more frequent. By type of activity, conversation and language activity, fairy tales, and plays were the most common activities. Conclusion/Implications: This suggests the need to systematically plan safety education content through a program that links safety-related laws and elements related to the Nuri curriculum in child care centers.

Effects of Liver Function in Blood of Drug Users(Herbal and Western) in Koreans (한.양약 복용이 간기능에 미치는 영향-피부과치료 한약복용 환자를 중심으로-)

  • Lee Jung-Seok;Lee Sun-Dong
    • Journal of Society of Preventive Korean Medicine
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    • v.8 no.1
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    • pp.59-74
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    • 2004
  • We have conducted questionnaire and measured serum liver function tests on 153 patients whom have received a treatment at a local Oriental medicine clinic in Seoul from Sept. 1, 2002 to Dec. 31, 2002. Patients were categorized into the groups of control(10), decoction group(41), herbal group(5), western medicine group(45), and the group taking both herbal and western medicines(55) concurrently or separately. This study was conducted to investigate how these treatment methods can affect the liver functions. Following results were obtained : 1) Most of the research subjects were male(l03 individuals) living in large urban area, with drinking habit, highly educated, and with normal marriage. For the treatment history, 45 individuals received western medicine treatment(28.85%), 46 with Oriental medicine (29.49%), and 55 patients(35.26%) experienced both forms of treatment. 2) Measuring SD of serum liver functions for all the research subjects, T-protein was 6.95(0.73)g/dl, 4.07(0.51)g/dl for albumin, 0.44(0.19)mg/dl for T-bilirubin, 23.18(18.68)U/L for ALT, 27.42(27.43)U/L for AST, and 22l.27(64.58)mg/dl for LDH. 3) Among the research subjects with the liver functions outside of normal range were 0.64% for T-protein, 3.21% for T-bilirubin and ALT, 36.62% for AST, 0.64% for LDH, and none for Albumin. 4) Confusion variables which may affect the liver functions such as age, smoking, drinking, occupation, and residence were eliminated in calculation and no significant differences were witnessed between the control and experiment groups. 5) In measuring affects of treatment duration on the liver functions, no statistical significances were shown in multiple regression's ,${\beta}$(SE) values. 6) The values of odd ratio in the experiment groups compared to the control were in the range of $0.26(0.22){\sim}0.62(1.23)$. but T-bilirubin of the group receiving both Oriental and western medicine was 1.47(1.90) which showed statistical increase(p<0.001). 7) Factors affecting the liver functions are drinking volume per round duration of alcohol intake, western medicine treatment, gender, and age difference caused significant influences. 8) 57 individuals with serum liver functions out of normal range were mostly male, living in large urban area, median age of 38.89, with normal marriage, highly educated drinking less than once a week with less than 2 bottles per round, and with prior treatment in either western or Oriental medicine. Summarizing above results, we can carefully deduce that taking herbal medicine (both decoction and pills) or western medicine doesn't cause much affect in the liver functions. But taking two forms of medication simultaneously or altering dosage affect significant increase in the T-bilirubin level, thus one needs to take precaution when taking both. Further research is needed in this field to verify this evidence.

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