• 대한간호학회지
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• 제41권6호
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• pp.795-804
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• 2011

Purpose: The purpose of this study was to examine the effects of interactive pictorial education on community dwelling older Korean adults' self-efficacy and knowledge for safe medication. Methods: A quasi-experimental, three-group pre- and post-intervention design was used in this study. The interactive pictorial education was designed to suit the learning patterns and psychomotor skills of older adults. The education content, dealing with safe medication, was delivered over three sessions. A total of 136 older adults from local senior centers were assigned to one of the three groups: a) interactive pictorial education plus information booklet (experimental); b) education only with information booklet (conventional); or c) no intervention (control). Results: Participants receiving interactive pictorial education had significantly higher self-efficacy (F=24.32, p<.001) and knowledge (F=24.26, p<.001) scores than the information booklet or control group at post intervention. Post-hoc analyses indicated that both the interactive pictorial and the information booklet groups had significantly higher self-efficacy and knowledge scores than the control group at the post-test point (p<.05). Furthermore, the interactive pictorial group had higher self-efficacy and knowledge scores than the information booklet group at the post-test point (p<.05). Conclusion: These results suggest that the interactive pictorial education is an innovative approach that provides a means for older adults to learn appropriate medication use to improve their own health. It empowers older adults with different literacy levels to enhance their self-efficacy and knowledge for the safe use of medication.

• 한국임상약학회지
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• 제30권3호
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• pp.143-148
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• 2020

Objective: This study aimed to investigate pharmaceutical care for critically ill neonates and suggest targeted strategies compatible with the Korean health-system pharmacy. Methods: Articles that reported pharmacy practices for critically ill neonates were reviewed. Pharmaceutical care practices and roles of neonatal pharmacists were identified, and criteria were developed for neonates in need of specialized care by clinical pharmacists. Results: Neonatal pharmacists play many roles in the overall medication management pathway. For clinical decision support, multidisciplinary ward rounds, clinical pharmacokinetic services, and consultation for pharmacotherapy and nutrition support were conducted. Prevention and resolution of drug-related problems through review of medication charts contributed to medication safety. Pharmaceutical optimization of intravenous medication played an important role in safe and effective therapy. Information on the use of off-label medicine, recommended dosage and dosing schedules, and stability of intravenous medicine was provided to other health professionals. Most clinical practices for neonates in Korea included therapeutic drug monitoring and nutrition support services. Reduction in medication errors and adverse drug reactions, shortening the duration of weaning medicines, decreasing the use and cost of antimicrobials, and improvement in nutrition status were reported as the outcomes of pharmacist-led interventions. The essential criteria of pharmaceutical care, including for patients with potential high-risk factors for drug-related problems, was developed. Conclusion: Pharmaceutical care for critically ill neonates varies widely. Development and provision of standardized pharmaceutical care for Korean neonates and a stepwise strategy for the expansion of clinical pharmacy services are required.

• 한국임상약학회지
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• 제9권2호
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• pp.97-102
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• 1999

The effects of pharmacist's intervention for asthma patients using self-monitoring of peak expiratory flow rate in medication teaching model was evaluated for 3 months in improving clinical outcomes including emergency visits, hospitalizations, antibiotics use, symptoms and sleep disturbance. Twenty seven patients were enrolled in study and twenty three patients completed the follow-up schedules. The selected patients were given the pre-designed instruction for medication including appropriate use of medication, metered-dose inhaler(MDI) technique, identifying and controling asthma triggers and recognizing early signs of deterioration. There were significant improvements in clinical outcomes, in terms of emergency visits, hopitalizations, antibiotics use, symptoms and sleep disturbance. There were also significant improvements in the MDI use, environmental control, and medication knowledges. There was a progressive increase in peak expiratory flow rate during the three-month intervention. In conclusion, pharmacist's intervention using self-monitoring of peak expiratory flow rate has a significant impact on improving clinical outcomes in asthma patients.

• 한국임상약학회지
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• 제31권1호
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• pp.61-78
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• 2021

Background and Objective: The use of potentially inappropriate medications (PIMs) increases the risk of negative health outcomes, including drug-related admissions. Tools for structured medication review have been developed to ensure optimal medication use and safety. Here, we aimed to evaluate medication use review (MUR) tools for community-dwelling older patients. Methods: We performed a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). We searched PubMed, Embase, and the Cochrane Library from 1991 to 2020, excluding tools that are specifically applied to hospitalized patients or nursing home residents. We identified the most common inappropriate medications, drug-disease interactions, drug-drug interactions and prescribing omissions presented among tools. Results: From among 9,788 identified reports screened, 60 met our inclusion criteria; finally, 27 were eligible for data analysis considering originality and up-to-dateness. Most tools presented explicit criteria (93%), and only one was specific to community-dwelling elderly. The most common PIM was tricyclic antidepressants. Use of diltiazem and verapamil in patients with heart failure and the combination of nonsteroidal anti-inflammatory analgesics and warfarin were the most frequent disease-specific PIM and drug-interaction, respectively. Conclusions: Although several medication review tools have been developed for older adults, specific guidelines for community-dwelling populations remain limited. Furthermore, the list of PIMs differed among available tools. In future, specific but integrating MUR tools need to be developed for clinical practice considering this population.

• 한국보건간호학회지
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• 제19권1호
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• pp.117-128
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• 2005

Purpose: The study examines the condition of medication counseling to determine the patient customers' demands, with the purpose of providing a basic data to improve the condition of medication counseling for phamacists and clinical nurses. Method: Questionnaire was completed by 150 nursing students. For data analysis, the SPSS win 10.0 program was used. Result: The contents of medication counseling given by the pharmacists in order of frequency were($100\%$ means 'always'): way of use$(78.7\%)$, period of taking medicine $(63.3\%)$, dosage$(46.7\%)$, effect$(27.3\%)$, drug name$(18.7\%)$, diet$(12.7\%)$, question of taking other drug$(12.7\%)$, giving a notice$(12.0\%)$, way of storage$(7.3\%)$, side effects$(6.0\%)$, drug interaction$(3.3\%)$' The needs and demands desired by the patients in order of frequency were('the most important' is given 10 points, followed by the others in numerically decreasing order until 0): effect(8.68), way of use(7.60), side effect(7.20), giving a notice(6.38), dosage (5.95), drug name(5.67), a period of taking medicine(5.60), drug interaction(4.37), diet(3.63), the way of storage(3.03). Most of the respondents were satisfied with the pharmacists' kindness$(62.7\%)$. Some recognized the medication counseling was quite good$(16.7\%)$, but the majority felt it was modest$(50.8\%)$' Nearly half of them felt the medication counseling time was quiet short$(47.3\%)$' The communication was mostly oral$(83.3\%)$, while others used sticker$(6.0\%)$ or leaflet$(6.0\%)$ additionally. There was a significant correlation between pharmacists' kindness and medication counseling content(p<,01), and also recognition(p<.001). The correlation between the number of medication counseling which gave to the patient customer and the recognition was also significant (p<.001). As the number of medication counseling increased, the patient felt the medication counseling time was adequate(p<.05). The correlation between the medication counseling recognition and the adequate time was also very significant(p<.001). Conclusion: These results revealed the situation of medication counseling to be poor and to be differ from the patient customers' demands. Therefore optimal medication counseling, especially regarding possible side effects and drug interaction should be emphasized. Pharmacists and clinical nurses should give qualitative medication counseling which reflects the patients' demands.

• 대한간호학회지
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• 제24권1호
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• pp.47-57
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• 1994

The purpose of this study was to examine nurses’ perceptions of medication treatment for psychiatric patients and to compare these perceptions with the perceptions held by the patients. The methodology used in this study was a descriptive design with semi-structured and open-ended interviews. This study used a convenience sample of 112 nurses who worked in, and 209 patients who were under psychiatric treatment, in four hospitals attached to a university and one national mental hospital in the city of Seoul. The collected data were analyzed by SAS, using percentages for descriptive purposes, and t-test or x$^2$ for comparing the variables. The results were as follows : 1. There was no significant differences between nurses’ and patients’ perceptions on the extent to which patients complied with their medication treatment. Generally speaking, the mean compliance scores for both nurses and patients was high(nurse : (equation omitted)=3.70, Patient : (equation omitted)=3.76). 2. There was a significant difference in nurses’ and patients’ perceptions on the reasons why patients do not take medication. The nurse group indicated that the patients did not take medication because of the “worry about side effects or habituation(49.53%)”, “boredom from long-term use of medication(26.17%)” and “distrust toward medical staff(12.15% )”, but the patient group indicated that they “did not want to be dependent on medication (25%)”, “forgot to take medication(19.7%) and “worried about side effects or habituation(15.91%). 3. As for the necessity of medication, both groups showed some different responses. Even though both groups were aware of the necessity of taking medication, the patient group(21.53%) showed a more negative response. As (or the effects of medication, both groups (nurses and patients ) showed positive responses. However, the nurse group showed a higher positive response (91.07% ) than the patient group(74.16%), 5. Both the patient and nurse group indicated that the most helpful element for the patient’s life under psychiatric treatment was interviews and conversations with therapists and nurses. However, the nurse group showed a higher response(70.15%) than the patients group(47.15%). According to the patient group, family support for the patient was another important factor for psychiatric treatment and daily struggles. In conclusion, as there were differences between the perception of nurses and patients, the nurse must consider the patients’ subjective perceptions first. They should also revaluate their false belief and prejudice concerning the patients’ perceptions. Such information can provide a base to be applied by the nurses in devloping effective mutual relationships with patients which can in turn help in compliance with medication regimen. As it was confirmed that medication was the most important factor in the patients’ recovery, a thorough education program on the therapeutic effect of medication and the necessity of their continued use after discharge is also needed.

• 디지털산업정보학회논문지
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• 제9권1호
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• pp.25-31
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• 2013

Medication adherence is a basic and important element in diabetes management, and it has been known the adherence rate should be keep over 80% to get positive result in diabetes management. In order to increase medication adherence, there have been smart phone apps that record medication, exercise, and diet. However, diabetes patients are generally over 50s, and most of them do not use smart phones. Therefore, in this paper, we propose a medication adherence help system that support both smart phone apps and feature phone SMS. Furthermore, we introduce system architecture for the system. Our work will help ICT-based diabetic management system developers to consider some issues for mobile based diabetic management systems..

• 생물정신의학
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• 제23권3호
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• pp.116-121
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• 2016

Objectives Experience of early childhood abuse elevates the risk of developing schizophrenia in later period of life, incidence of psychiatric comorbidity, symptomatic severity and complexity. In this context, we hypothesized that the pattern of psychotropic medication used would reflect this; those with childhood trauma will received more types and higher doses of psychotropic medication. Methods From our database of 102 outpatients diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) schizophrenia, we analyzed experiences of childhood trauma measured by the Childhood Trauma Questionnaire-Short Form and types and dose of prescribed psychotropic medication. Results We found significant positive correlations between child sexual abuse and the number of psychotropic medications (p = 0.029) and between child emotional neglect and the number of psychotropic medications other than antipsychotics (p = 0.045). Conclusions This preliminary study suggests that the pattern of psychotropic use may be affected by types of childhood trauma. Further studies will have to shed light on mediating factors such as symptoms or comorbid conditions that lead to prescription of certain psychotropic class.

• 보건행정학회지
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• 제2권2호
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• pp.131-151
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• 1992

The contents of prescription service were comparatively analysed between health centers(HC) and private clinics(PC). Medical chart review was done for 330 otu-patients diagnosed with upper respiratory tract infection(UR) of 120 adults and 90 children, and gastritis or duodenitis of 120 adults. Emphasis on comparison was the prime cost of medication which used in prescription service. The results were as follows; 1. The prime costs fro the medication per visit of HC group were significantly higher than PC group in all three diseases, and the out of pocket payments of patients per visit were significantly lower in the HC group than PC group. 2. The reason for high prime costs of medication per visit of HC in adult case of URI were due to the idverse use of medication and long prescription period per visit. And high medication costs in children cases of URI in HC group were due to the longer prescription day. In cases of gastritis, the prime cost of medication was also higher because of longer prescription period and the higher prime cost of medication. The proportions of medications for injection in the HC and PC groups showed similar features. 3. In depth analysis of the prescription services showed the differences of the contents of medication. In adults cases of URI, the averaged cost of oral medication was significantly lower in HC group, but that of medication for injection was higher in HC group. In children cases of URI, the averaged cost of oral medication and medication for injection was lower in HC group than in PC group. But in the cases of gastritis it was was higher in HC group than in PC group. The prescription periods were longer in HC group than in PC group in all three diseases. As a conclusion prime medication cost and quality of prescription services of HC group were higher than PC group. In terms of health care the cost containment and quality assurance in physician visit for common disease, public sector utilization is good option for those perspectives. But it should not be generalized unless future study about structure and outcome research for quality assurance.

• 한국간호교육학회지
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• 제29권2호
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• pp.115-123
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• 2023

Purpose: This study aimed to identify the factors affecting the chemotherapy medication errors made by new nurses and to use the results as basic data for the development of a chemotherapy medication nursing education program for new nurses. Methods: This cross-sectional study was conducted with 189 new nurses working at a general hospital and a tertiary general hospital in Korea. The data collection period was from January 11 to February 7, 2021. The data collected during this study were analyzed using the IBM SPSS statistics version 25.0 program. Data analysis included descriptive statistics, independent t-test, ANOVA, and logistic regression analysis. Results: One factor influencing chemotherapy medication errors was new nurses' educational needs (odds ratio=.18, p=.005). As educational needs increased, the probability of making errors in medication was reduced by .18. Conclusion: It is necessary to develop a chemotherapy medication education program tailored to the educational needs of new nurses by considering the education period, method, and content, with a focus on the content with high demand from new nurses.