• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제21권3호
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• pp.174-181
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• 2010

Objectives: To identify the factors affecting long-term adherence to methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). Methods: A retrospective medical record review of 239 ADHD patients (mean age $9.3{\pm}2.6$ years, range 6.0-17.4 years) who had visited the child and adolescent psychiatry clinic at a university hospital, in Seoul, Korea from March 2005 to February 2008. Subjects were diagnosed as ADHD based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision version (DSM-IV-TR) and underwent neuropsychological tests including the continuous performance test (CPT). Treatment discontinuation was defined as the last prescription date when the medication possession rate (MPR) became less than 0.80. Subjects were divided into three groups and labeled as Group I, non-adherence without pharmacotherapy, Group II, non-adherence with short-term pharmacotherapy, and Group III, adherence with long-term pharmacotherapy. Results: Ninety (37.7%) patients were grouped as non-adherent (Groups I+II) and 149 (62.3%) as adherent (Group III). The adherence group exhibited lower intelligence, higher symptom severity, and a higher number of comorbid psychiatric disorders than controls. The use of stimulants was significantly associated with long-term adherence to treatment. Additionally, the duration of interval between the date of the first visit and the date of the first prescription was positively associated with long-term adherence. Conclusion: About two-thirds of patients diagnosed as ADHD adhered to the treatment six months after the first visit. With respect to patient evaluation and the development of treatment strategies, factors affecting early drop-out and longer follow-up must be considered.

• 한국임상약학회지
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• 제30권3호
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• pp.185-195
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• 2020

Objective: This study aimed to explore a veteran patients' behavior of prescribing drug use and of which influencing factors from the veteran patients' perspective through qualitative interviews. Methods: We recruited veteran patients through purposive sampling and interviewed 30 veteran patients aged 20 and over who had been taking prescription drugs. We developed and utilized an interview guide consisting of three themes for data collection. We made verbatim transcripts and analyzed data using the framework analysis. Results: Participants were aware that they had large amounts of prescribing medicines and discarded the medicines. They often used improperly by the person himself or his family or acquaintances. The factors that influenced these inefficient prescription drug usage were grouped into 'factors procuring more drugs than necessary' and 'factors being prescribed more drugs than necessary'. Anxiety about downgrading from the upper class to the lower among reward classes for veterans, and suspicion or dissatisfaction with the veteran policy caused the participants to procure more drugs than necessary. Additionally, they received too many medicines due to long-term prescriptions and lack of communication with their doctors, and poor quality of veteran health services. Conclusion: To improve the medication use behavior of veteran patients, providing information or introducing interventions for the proper medication use is not enough. Efforts should be made to improve their negative recognition over relevant policies and health care services.

• 대한한의학방제학회지
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• 제24권2호
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• pp.71-79
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• 2016

Objectives : To verify the equivalence between Atractylodis Rhizoma Alba herbal prescription(HP-ARA) and Atractylodis Rhizoma Alba herbal sub stance(HS-ARA). Methods : Safety tests by microbial regulation and heavy metal analysis (total heavy metal, Pb, As) and a stability test by long term shelf test for HP-ARA according to notification of the Ministry of Food and Drug Safety were carried out. Then, multi component profile of HP-ARA and HS -ARA were analyzed by HPLC. Results : The safety and stability of HP-ARA confirmed by several tests. Correlation coefficient of equivalence of HP-ARA and ARA-HS showed 0.992. Conclusion : Based on this result of equivalence between HP-ARA and HS-ARA, HP-ARA can substitute HS-ARA used to make herbal medicines (herbal decoction, pills and powder).

• 대한한의학회지
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• 제21권4호
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• pp.159-173
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• 2000

Objectives : First, to restore reliability of oriental prescriptions that are effective against incurable diseases, Second, in the short term, to secure the validity of traditional remedies with the help of accumulated data and in the long term, develop new therapeutic methods and prescriptions in order to broaden its aspect in the field of medicine. Third, to maintain predominance on oriental therapeutic methods and put it into practical use based upon the results obtained by this paper. Methods : In the primary sub-thesis(herbalogical analytic methods applied on unknown oriental prescriptions), models of analytic method and in gathering information that could be put into practice are being revised In the secondary sub-thesis(method in gathering and analysing in dealing with oriental prescription), several statistical approaches and analysis on data that has been gathered are being revised. In the tertiary sub-thesis(research on legal guarantee of the offerer rights), an alternative scheme that covers the limitations of the legislative content in dealing with offerer rights is being revised Results : This research has revealed several problems, including those which were foreseen, in proceeding with the project. The prospect of the involvement of the medical personnel engaging in the field of oriental medicine was remarkably bright. Given the condition that the project will proceed as it follows, unknown oriental prescriptions and remedies which have been particularly ignored will eventually play an important role in clinical practice. Conclusions : It is clear to everyone that these oriental remedies will remain ignored by the public unless they gain popularity. Strict verifications on these oriental remedies are definitely needed in order to overcome this limitation. Finally, it should provide a momentum in the field of medicine in gaining popularity to the public.

• 한국임상약학회지
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• 제30권2호
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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.

• 한국임상약학회지
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• 제15권2호
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• pp.139-148
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• 2005

Appropriate drug classification is important fur rational drug consumption. This study was conducted to evaluate the appropriateness of current drug classification system and suggest possible ways for improving the system. Nonprescription drug market has been decreased. Since total 27,962 products had been classified (prescription 17,187 vs. nonprescription 10,775 products, 61.5% vs. 38.5%) in July 2000 for implementing separation of drug prescribing and dispensing system, there are no classification changes. Reclassification is not motivated by product holder and regulatory system did not lead classification change either. Consumers' ease access to some nonprescription drugs is demanded. But point of public awareness and cultural and health environmental views, saff drug use rather than advantages from broad supply of nonprescription drugs is more critical. We concluded that current 2-categorized (prescription and nonprescription) drug classification system is appropriate, and addition of general sale category should be approached carefully with long term Preparations such as establishment of better nonprescription drug consuming infrastructure by public information provision and education for improving public medicinal knowledge and strengthening self medication guidance, and review of current classification status of marketed drugs and switching possibilities. For systemizing and encouraging reclassification, introduction of regulatory renewal system as a continuous reevaluation program which is the best way to review appropriateness of drug classification as well as provision of detailed guidance for industry including policy, requirement and process fer reclassification application, are necessary.

• 대한한방내과학회지
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• 제25권4호
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• pp.300-305
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• 2004

Background : Due to increased interest in herbal medicines is recent years, medical circles have made studies of toxicity and side effects of herbal medicines. Particularly the kidney is sensitive to toxicity. A few reports concerning the side effects and toxicity of herbal medicine have been presented recently. This has bought on some distrust in herbal medicines among patients and western doctors. Objectives : The purpose of this study is to determine what effects long-term prescription of one herbal medicine may have on renal function. Methods : Nineteen patients took herbal medicine for eight weeks. Tests of their Blood Urea Nitrogen(BUN), Creatinine of blood plasma, and urine (chemical and microscopic) were taken before taking medicine and at the 2nd, 4th, 8th weeks. Results : After taking a herbal medicine, BUN and Creatinine decreased significantly or remained the same in comparison with the prior interval. Chemical and microscopic examination of urine showed no changes. Conclusions : The results suggest that taking this herbal medicine for a long time does not induce nephrotixicity. Further study is needed for investigating safety and toxicity of herbal medicines.

• 농촌의학ㆍ지역보건
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• 제12권1호
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• pp.102-110
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• 1987

One of the familiar medical facility that most people reach easily in Korea is the drug store. In Korea, it is possible to purchase all kinds of common drugs without physician's prescriptions, which caused some problems. In other words, such treatment without professional supervision has led to medical, social and economical problems. In view of the above, this study is aimed at revealing the actual status of long-term use of drugs in some urban residents. Long-term use of drugs is operationally defined as using certain drugs at least once a week for more than 3 months. This survey took the residents of Guro 6-Dong where was one of the target areas for Community Health Development Project managed by Korea University as a target population. A sample of 1,517 residents was selected by the multistage sampling method. The interview was conducted on September 21st and 22nd in 1985. The object of this study was to compare the result with that of the rural area which was obtained by the same method, tools and research team, prior to this study in 1984. The results were as follows; 1) The age-standardization of the study showed that 97 per 1,000 urban residents were actually on long-term drug use. The prevalance of long-term use is high in accordance with aging and low with education level. 2) Out of 1,000 urban samples the most popular item involved in the long-term drug use was antipyretic-analgesic-antiinflammatory drug (26), and next in order was vitamin (23), antibiotics (13), digestives (10) and antacids (7). In the rural samples as for compare, that was antipyretic-analgesic-antiinflammatory drug (100), antacids (36), digestives (23), adrenocortical hormones (12) etc. 3) With antipyrctic-analgesic-antiinflammatory drugs, 50% of the urban samples were taking for more than a year, whereas such were 82.7% of the rural samples. Using such a high percentage of antipyretic-analgesic-antiinflamatory drugs in the rural residents is probably due to the high prevalence rate of musculo-skeletal diseases. 4) The urban long-term drug users of antipyretic-analgesic-antiinflammatory drugs were influenced mostly by the mass media (43.6%), next in order was pharmacist (35.9%) and physician (10.3%). Comparing with the result from the rural areas the role of mass media was much more influencial in the urban areas. 60% of them consulted with pharmacists, 14.3% with physicians and 25.7% had no history of consultation in the urban samples. 5) Considering the incidence of knowing the possible side-effects of each drug, 28.2% of the urban residents had no recognition about side-effects prior to use antipyretic-analgesic-antiinflammatory drugs. In the rural residents, 29.67o had no knowledge about the side-effects before using the drug. 6) For the solution of the above problems, it is necessary to limit the advertisement of some drugs by the parmaceutical company. And therapeutic drugs which may bring on side effects in case of long-term use should not be sold at drug stores without physician's prescription.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1997년도 추계학술대회
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• pp.87-91
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• 1997

The range of disorders of old age that are thought potentially amenable to drug therapy is increasing. However, factors such as the growing costs of drug development and prescription, the novel pharmacological profile and enhanced potency of many new compounds, and the concerns that the elderly may have enhanced susceptibility to toxicity all make drug usage in the elderly patient an increasingly specialized topic. This is compounded by the high incidence of multiple disorders in frail elderly patients, and consequently the possibility of the long term use of several drugs, thus, adding the risk of drug interactions. Thus, clinical pharmacology in the elderly requires understanding of pharmacologic characteristic determinants of the physiological changes (Table 1) associated with aging in terms of pharmacokinetics and pharmacodynamics.

• 대한약침학회지
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• 제7권3호
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• pp.99-107
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• 2004

Background & Objective : Through the long-term clinical examination experience, interesting informations have been found and passed on to future scholars, enabling research and development without going through the same lengthy procedure, hoarding these precious information to be discovered and preserved as a contribution to Oriental Medical Science. Methods : Personal interviews with seventy-years-old practicing oriental medicine doctors and herbalists with more than 30 years of practice in Gangwon-do, Chungcheongbuk-do, Chungcheongnam-do, and Daejeon area from September to December 2002