• Korean Journal of Clinical Pharmacy
• /
• v.32 no.3
• /
• pp.155-165
• /
• 2022

Background: Chronic obstructive pulmonary disease (COPD) is not completely reversible and requires long-term management with appropriate treatment. This study aimed to analyze trends in treatment regimens and medication costs for COPD patients using a national claims database. Methods: We conducted this analysis using National Patient Sample data from the Health Insurance Review and Assessment Service covering the period from 2015 to 2018. We have constructed a dataset comprising COPD disease classification codes J43.x and J44.x (based on KCD-7 code, J43.0 was excluded) and compiled a list of drugs fitting current guidelines. To identify trends, we calculated frequency, ratio, and compound annual growth rate (CAGR) using the numbers of prescriptions and patients. Results: The number of COPD patients was 7,260 in 2018, slightly decreased from 2015. Most of these COPD patients were aged 60 or older and included a high proportion of males (72.2%; 2018). The number of patients prescribed inhaled medications increased gradually from 2015 to 2018 (9,227 (47.1%); 2015, 9,285 (51.5%); 2018), while the number of patients prescribed systemic beta-agonists and Xanthines has decreased since 2015 (CAGR -14.7; systemic beta-agonist, -5.8; Xanthines). The per capita cost of medication has increased by 0.4% (KRW 206,667; 2018, KRW 204,278; 2015) annually during the study period. Conclusion: This study showed that treatment with inhaled medications had continuously increased in accord with changing guidelines, but oral medications were still widely used. It is necessary to emphasize the importance of inhaled medications in treating COPD to reduce additional economic burden through appropriate medication use.

• Korean Journal of Clinical Pharmacy
• /
• v.33 no.3
• /
• pp.168-177
• /
• 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.

• Asian-Australasian Journal of Animal Sciences
• /
• v.23 no.1
• /
• pp.131-148
• /
• 2010

Piglet health at weaning is compromised due to several stress factors. Following the ban of antibiotic growth promoters new alternatives are required to control these problems. This paper reviews the evidence available for the use of spray dried animal plasma (SDAP) as an alternative to antibiotics in weaning pigs. Data from 75 trials in 43 publications involving over 12,000 piglets (mean values) have been used to calculate the performance responses of piglets according to several factors including SDAP origin, protein source from the control diet being replaced, dose of inclusion, age and weight of the piglets at weaning, sanitary conditions and simultaneous use or not of medication. Although the use of SDAP of all origins results in positive responses, it appears that plasma from porcine origin has the highest efficacy. This could be explained by the specificity of its IgG against porcine pathogens. During the first week post-weaning the response to plasma appears to increase with the inclusion dose, although over the two-week pre-starter period an optimal inclusion level of 4-8% is suggested. SDAP improves feed efficiency more markedly when the piglets are challenged with an experimental infection or when feed does not contain medication, which could be indicative of a lower expenditure of energy and nutrients to build an immune response against the challenge. There is evidence supporting that SDAP IgG and other bioactive substances therein prevent the binding of pathogens to the gut wall and reduce the incidence of diarrhoea in the post-weaning phase. Overall, plasma can be postulated as an excellent alternative to in-feed antimicrobials for piglets in the post-weaning phase.

• The Journal of Korea CHUNA Manual Medicine
• /
• v.5 no.1
• /
• pp.67-76
• /
• 2004

Objectives : The purpose of this study is to research trends In the study of osteoporosis and to establish the future direction for its study. Methods: We reviewed oriental medicine papers published in last twelve years (1990-2002). Methods : We reviewed oriental medicine papers published in last twelve years (1990-2002). Results : 1. We researched 42 papers in 12 journals and patterns of study were as follows: experimental studies were 30 (71%), reviewed studies were 8(19%), clinical studies were 2 (5%) and etc were 2 (5%). 2. The experimental studies(30) were divided into papers on efficiency testing of herbal medications (22) and herbal acupuncture (7) and etc (1). 3. The reviewed studies showed that research has been carried out in the fields of cause, pathogenesis, principles for treating disease, herbal medication, herbal acupuncture, acupuncture and moxibustion, exercise to osteoporosis. 4. The clinical studies showed that the research was carried out in the fields of follow up surveys for the herbal medication efficiency testing, the relativity of osteoporosis to other diseases. 5. In consequence of researching the case reports, there was no prescription used meaningfully. Conclusions: We need more studies of osteoporosis by reaching for specific therapy.

• The Journal of Internal Korean Medicine
• /
• v.26 no.4
• /
• pp.864-874
• /
• 2005

This study was done as a general survey on oriental medical approaches for the detoxification and treatment of narcotics addiction. The treatment of narcotics addiction comprises the detoxification and the restoration of normal health. Medical detoxification in common use nowadays is largely divided into substitution therapy using opiate detoxicants and symptomatic therapy using non-opiate detoxicants. Experimentation was done on the supposition that non-opiate detoxicants provide a more viable therapy than opiate detoxicants in the treatment of narcotics addiction, because opiate detoxicants also produce a great dependency on a narcotic. At present, although the medication of oriental medicine that includes non-opiate detoxicants is not more effective in the detoxification than the opiate detoxicants, withdrawal symptoms are slight and few and there is a very low ratio of relapse, so treatment and restoration are relatively brief. Results of this survey suggest that detoxicants derived from oriental medical approaches are safe and effective, though further development of therapy with such detoxicants will be needed to provide reliable methods of treating narcotics addiction. Based on this survey, it is hoped that many more studies will be done on the issue of medication in the field of narcotics addiction treatment.

• Korean Journal of Clinical Pharmacy
• /
• v.27 no.3
• /
• pp.136-142
• /
• 2017

Background: Dementia is one of important social and economic healthcare issues in the aging age. Therefore, it signifies to analyze the relationship between chronic disease or cardiovascular drug use and the incidence of dementia to establish a basis for increasing or preventing the risk of dementia. The purpose of this study was to investigate the correlation between the prevalence of chronic diseases and the use of cardiovascular drugs in patients diagnosed with dementia. Methods: In this study, we used data from sample of elderly patients from the Health Insurance Review and Assessment Service. We analyzed by logistic regression analysis with age, gender, and medication as covariates. KCD-7 was used to diagnosis of the disease, and drugs were analyzed using ATC codes and Korean standardized drug classification codes. Results: A total of 1,276,331 patients were analyzed in the sample of the elderly population, of which 532,075 (41.7%) were male and 744,256 (58.3%) were female. The patients have the higher risk of dementia in the older, women, and lower socioeconomically status. Cerebral infarction and ischemic heart disease increases risk of dementia. Patients taking statins, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonists (ARB) showed low incidence of dementia. Conclusion: This study has been shown that ACEI, ARB, and statin drugs may associate with lower incidence of Alzheimer's and other dementia except vascular dementia.

• Journal of Korean Medicine for Obesity Research
• /
• v.7 no.1
• /
• pp.9-22
• /
• 2007

Objectives : This study was designed to collect the latest papers and to find more effective approach for childhood obesity. Methods : We searched 107 papers in English from Pubmed(www.ncbi.nlm.nih.gov) and selected 52 in favor of our study. In addition to that, we searched 29 papers in Chinese from www.cnki.net. Results are as follows. Results and Conclusions : There are not completely new treatments for childhood obesity. Instead of that, many studies aimed for prevention through family education, nutrition education, and exercises education. Specially, because some diseases including hypertension, diabetes and heart disease are connected with obese children, medication can be prescribed optionally. In that case, their mental health must be laid emphasis. And in China, TCM(Traditional Chinese Medicine) is very common treatment for childhood obesity. Acupuncture, herb medication and manual therapy could be used usefully. It is suggested that above latest treatments can be combined with Korean traditional treatments method in treating obese children.

• Journal of Trauma and Injury
• /
• v.30 no.1
• /
• pp.1-5
• /
• 2017

Purpose: Nefopam is a centrally acting non-narcotic analgesic that has mostly been used for postoperative pain. We examined the efficacy of nefopam analgesia (alone and in combination with ketorolac) for trauma patients in the emergency department. Methods: We performed a retrospective chart review to select trauma patients who received nefopam at the emergency department of Korea University Medical Center Guro Hospital between January 2012 and December 2012. Patients younger than 15 years were excluded. The primary outcome measure was change of pain score (numeric rating scale) from baseline (before medication) to 30 min after medication. The secondary outcome measure was requirement for additional analgesia (pethidine). Results: Records of 1465 trauma patients who received analgesics in the emergency department from January 2012 to December 2012 were examined. Patients were classified into five groups according to initial analgesic: nefopam (n=112), ketorolac (n=867), pethidine (n=365), nefopam+ketorolac (92), and nefopam+pethidine (22). There were no significant differences in pain score reductions among the five groups. Twenty-two patients in the nefopam group, 141 in the ketorolac group, and 29 in the nefopam+ketorolac group required rescue analgesia with pethidine; these rates were not significantly different. Conclusion: The efficacy of nefopam analgesia for trauma patients in the emergency department is comparable to that of more commonly used agents, including ketorolac and pethidine.

• Korean Journal of Adult Nursing
• /
• v.12 no.4
• /
• pp.727-740
• /
• 2000

It is well recognized that case management is required to survive in the rapidly changing medical environment. One of the case management is the critical pathway(CP) which is assumed to increase the quality of care and at the same time to decrease the length of stay in hospital. The purpose of the study was to develop a CP for the management of patients with postero-lateral fusion for lumbar spinal stenosis. Through review of literature and medical records of patients with spinal stenosis, a pilot CP was designed, including 8 different care components such as medication, laboratory tests, assessment etc., from one day before surgery to 6 days of postoperative care. Every item of the pilot CP was evaluated by a panel of experts to test the content validity. The items not agreed on by more than 4 out of 6 experts were deleted or modified to be integrated in the CP. To apply the modified CP to a clinical environment, the items reflecting treatment, medication and lab work were entered into an order communication system(OCS), and doctors and nurses were taught to use the CP. Finally, the development of CP for the patients with posterolateral lumbar fusion was completed after the application and variance analysis of the CP.

• The Journal of Korean Medicine
• /
• v.32 no.4
• /
• pp.75-82
• /
• 2011

Objectives: This case report aimed to evaluate whether oriental medical treatment was effective on ADHD through a records review of a local oriental medical clinic. Methods: We reviewed clinical charts of a local oriental medical clinic between December 2007 and September 2010 to select ADHD patients. Among those patients, for comparison before and after treatment, we selected cases which had at least twice Stroop test results and 2 months of treatment. Baseline, 3-month and 6-month Stroop test results were compared. Oriental medical treatment consisted of 2 months' herbal medicine, periodic acupuncture and exercise. Results: 1. 3-month data showed that subjects were 12 and improved word score and word-color score of Stroop test. 2. 6-month data showed that subjects were 20 and improved word score, color score, and word-color score of Stroop test. Conclusions: 1. Relatively short term herbal medication and exercise are effective on the word score and word-color score of the Stroop test. 2. After short term herbal medication, continuous exercise maintained the effects of short term oriental medical treatment. 3. We need to consider the balance of left and right as an important point of exercise, but further study is needed.