• 한국임상약학회지
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• 제30권3호
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• pp.196-205
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• 2020

Background: The indication of denosumab for osteoporosis was expanded from second-line to first-line therapy in 2019. The aim of this study was to evaluate the efficacy of denosumab as both first- and second-line therapy in postmenopausal women with osteoporosis and osteopenia with risk factors by using the Fracture Risk Assessment Tool (FRAX). Methods: We conducted a medication use evaluation of denosumab in 98 patients who had been treated three or more times for osteoporosis or osteopenia at Chungnam National University Hospital from July 1^st, 2017 to January 31^st, 2020. Risk factors were identified using quantitative N-gram analyses of FRAX estimations. Patient information, including menopause status and results of bone mineral density tests (T-score), was obtained from electronic medical records. Results: Age, body mass index (BMI), prior medication use, and T-score were identified as risk factors and were included as variables in the evaluation of denosumab use. Since no significant differences were detected between groups, denosumab is likely effective regardless of age or BMI. In addition, no significant difference was detected in T-scores following denosumab treatment, between groups who took bisphosphonates and selective estrogen receptor modulators (SERMs) with denosumab as first-line therapy for postmenopausal osteoporosis. Denosumab may, therefore, be effective as second-line therapy. Conclusion: Efficacy of denosumab was evaluated in postmenopausal women with osteoporosis. Denosumab may be used as first- and second-line therapy regardless of age, BMI, and prior use of bisphosphonates and SERMs.

• 한국임상약학회지
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• 제31권4호
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• pp.311-323
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• 2021

Objective: The disabled are in a blind spot for obtaining information on drugs, and the pharmacies' counseling on drug use is centered on non-disabled people. Few studies have investigated the current statuses of drug use by type of disability. The purpose of this study is to understand the drug use by type of disability and by life cycle of visually impaired and hearing impaired in Korea. Methods: The study participants consisted of 16 people with visually impairments, 12 people with hearing impairments. One in-depth interview was conducted per participant, and each interview was recorded and documented. Results: Common barriers against safe medication and medical service uses across disability types are 'lack of consideration and service for the disabled, limited access to medical facilities due to disability, limited access to information regarding medication use, psychological anxiety about drug use and side effects, and inconvenience regarding COVID-19 epidemic. The specific factors were 'difficulties in identifying proper medicines and following prescribed dosages' in the case of visually impaired, and 'problems with sign language interpretation system' for the hearing impaired. Conclusion: Disabled people are hindered from using medicines properly due to various factors. Based on the content derived from this study, it is necessary to eliminate the inhibition factors and devise specific measures for the safety of each type of disorder such as developing a method for medication counseling considering disabilities and establishing communication support systems.

• 한국임상약학회지
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• 제32권4호
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• pp.321-327
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• 2022

Background: To implement medication management service in Korean nursing home (NH), medication review tool for residents in Korean long-term care facilities was developed. This prospective pilot study aimed to verify the applicability of this newly developed tool and to evaluate the drug related problems (DRPs) identified by pharmacists' medication review in NH setting. Methods: This study was carried out in two NHs in Korea. The elderly residents (65 or older) using 5 or more medications were eligible. Pharmacists conducted medication review and identified the DRPs and potentially inappropriate medications (PIMs) based on the newly developed tool. Results: Among 43 NH residents, 27 residents agreed to participate. The median age was 87 and about 55.6% of them were taking 10 or more medications. Pharmacists identified a total of 37 PIMs in 18 NH residents (66.7%) and 54 DRPs in 22 residents (81.5%). The most frequent PIM was general-PIM (26 cases) followed by PIM under specific diseases or conditions (7 cases). Out of 77 items contained in the tool, 15 items were detected in study participants. 'Continued use or regular daily use of hypnotics' was the most highly detected item (9 cases) followed by 'multiple prescriptions within each class of hypnotics/sedatives' (5 cases). Among 54 DRPs identified, pharmacist intervened 39 cases (72.2%) and interventions were accepted in 18 cases (46.1%). Conclusion: This pilot study demonstrated that newly developed tool is feasible for the nursing home residents. However, further studies with larger population are warranted.

• 한국콘텐츠학회논문지
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• 제19권12호
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• pp.398-406
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• 2019

본 연구는 약물 이행 모델을 기반으로 다제약제 복용 노인의 약물 불이행과 관련 요인을 파악하기 위해 수행되었다. 연구 대상은 서울과 경기도에 거주하는 다제약제 복용 노인 190명이었다. 연구 결과, 대상자의 43.2%가 임의로 처방된 약의 복용을 중단하는 의도적인 약물 불이행을 보였다. 의도적인 약물 불이행의 이유는 '증상이 조절된다고 느낄 때', '약을 복용하는 것이 귀찮고 불편해서', 그리고 '약을 복용하였을 때 더 나빠지는 것 같아' 순으로 나타났다. 또한, 다제약제 복용 노인은 능동적으로 약 정보의 내용 및 경로를 탐색하는 정도가 매우 낮았다. 의도적인 약물 불이행군과 의도적인 약물 불이행이 아닌 군 사이에 성별, 복용 약의 종류, 그리고 약물 부작용 경험에 따라 유의한 차이가 있었지만, 약 정보의 탐색 내용 및 경로에는 통계적으로 유의한 차이가 없었다. 본 연구를 통해, 다제약제 복용 노인의 의도적인 약물 불이행을 줄이기 위해서는 성별을 고려하고 복용 약의 종류를 확인하며, 약물 부작용 경험 여부를 사정하는 것이 중요하다. 그리고 능동적으로 약 정보의 내용 및 경로를 탐색하여 찾는 정도가 낮으므로 노인이 선호하는 경로를 통해 약 정보의 내용을 제공하여 다제약제 복용 노인의 약물 이행 의사결정 과정을 돕는 것이 필요하다.

• 생물정신의학
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• 제2권1호
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• pp.38-43
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• 1995

The application of neuroimaging techniques in psychiatry started in 1970s with the use of CT(computerized tomography). Neuroimaging methods can be categorized as anatomical and functional. Recently, attentions are focused on the functional neuroimaging methods those could give us various important informations. But results regarding to psychotropic medication effect on neuroimaging are not sufficient. Here, the study results of the medication effect with the functional imaging methods are mainly revieued.

• 한국산학기술학회논문지
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• 제15권3호
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• pp.1650-1662
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• 2014

본 연구는 고위험약물의 투약조정을 위한 스마트 폰 어플리케이션의 내용을 구축하고 개발된 어플리케이션의 만족도를 평가하기 위해 수행되었다. xcode 4.5와 ios 6.1 SDK(software development kit)을 이용하여 시스템을 구축하였다. 4주간의 중재 후 35명의 중환자실 간호사들에게 기능적, 내용적, 화용적 측면의 만족도를 물었다. 또한 하루의 사용횟수와 사용의 빈도에 따른 만족도의 차이를 평가하였다. 이를 위해서는 SPSS WIN 18.0을 활용하여 서술적 분석, ANOVA를 적용하였다. 약물계산 식을 개발하고 과다 혹은 과소 용량에 대한 알람을 주는 과정을 개발하였고, 고위험 약물에 대한 정보를 구축하였다. 만족도와 관련된 문항 중 이 어플리케이션은 약물계산을 수행하는데 도움이 된다는 문항이 3.14점이었으나 이 어플리케이션에 만족한다는 문항은 2.94에 그쳤다. 하루의 사용횟수와 사용빈도와 관련해서 만족도의 차이는 없었다. 이 연구의 결과에 근거할 때 추후 더욱 진보된 고위험약물을 위한 투약조정용 스마트폰 어플리케이션은 환자안전을 위한 중요한 기반을 제공해 줄 수 있을 것이다.

• The Korean Journal of Pain
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• 제26권1호
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• pp.89-93
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• 2013

Compensatory hyperhidrosis or reflex hyperhidrosis is the increase in sweating in the postoperative stage of thoracic sympathectomy or lumbar sympathectomy. It shares several features with anxiety disorders and has a negative impact on a patient's quality of life. Oralglycopyrrolate is one of the treatment options available. This study reviewed case notes in a series of 19 patients with compensatory hyperhidrosis. We made a comparison between the Milanez de Campos score of a pre-glycopyrrolate medication group and the Milanez de Campos score of a post-glycopyrrolate medication group. The Beck Depression Inventory (BDI) score, Beck Anxiety Inventory (BAI) score, and autonomic nervous system (ANS) scale score were also compared between the pre-medication and post-medication groups. In the post-glycopyrrolate medication group, there was decrease in the Milanez de Campos score, BAI score, and BDI score (P < 0.05). But no meaningful change was seen in the ANS score in the post-glycopyrrolate medication group (P > 0.05). Glycopyrrolate is an effective medication in the treatment of compensatory hyperhidrosis that, can alleviate anxiety and improve patients' quality of life.

• 대한한방소아과학회지
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• 제24권3호
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• pp.16-25
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• 2010

Objectives: Compliance of herbal medicine is extremely important in Korean oriental medicine, since herbal medicine is main approach to the most of outpatients in Korean pediatrics. The more compliant to the medication, the more effective care is given to children. Thus, we conducted this research to evaluate the compliance of herbal medicine, and factors associated with compliance in children. Methods: 61 children (men 28, women 33) were participated who visited the Korean Oriental Medicine Department in university hospital for two weeks. We used Morisky's self-reported questionnaire which is consisted of four questions. Also, we checked medical records and researched respondent to acquire more factors. We defined as a "full compliant" if answers were 'No' to all of the questions. We analyzed the compliance and associated factors with Pearson's $x^2$-test and Fisher's exact test, and Spearman correlation coefficient. Compliance and associated factors were analyzed with linear regression. Results: Compliance of herbal medicine was not related to respondent, and 34 children (55.7%) were non-compliant. The best compliant type of herbal medicine was granule medication (p=0.046). However, there was no relationship between compliance and age, sex, sibling, purpose of medication, period of disease, frequency of medication, and medication duration. The age, frequency of medication, medication duration, and purpose of medications(period of disease) had correlation(p<0.01). Also, older children tended to forget to take herbal medicine(p=0.004). Conclusions: Over an half of the total subjects (55.7%) were non-compliant, so we should improve compliance of herbal medicine. Since granule form of medication was shown to have the best compliance, we should try to use granule form of medication instead of liquid medications. Also, we can also improve compliance with giving attention to the patients, especially older children in order to improve their compliance.

• 약학회지
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• 제54권3호
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• pp.205-214
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• 2010

This study aimed to evaluate the patterns of inappropriate medication use and inappropriate dosage in elderly patients in Korea. A retrospective study was performed for the elderly 65 years or older admitted from January 2007 to December 2007 in a medical center, Seoul, Korea. Potentially inappropriate medication (PIM) use in the elderly was evaluated using Beers criteria. Eighteen drugs out of Beers criteria were included in the formulary of the institute. Inappropriate dosage was set using Beers criteria, CMS (the Centers for Medicare& Medicaid Services) guideline, Geriatric Dosage Handbook. As results, the patients with PIM were 2,172 during the study period. The commonly used inappropriate medications were drugs for the nervous system (n=1237, 44.78%), the alimentary System (n=663, 24.54%) and the cardiovascular system (n=494, 18.28%). The elderly patients with prescription of inappropriate dosage were 10% out of patients with PIMs. The commonly inappropriate dosage drugs were digoxin (n=75, 27.27%), diazepam (n=70, 22.55%) and ferrous sulfate (n=66, 24.00%). Logistic regression analysis showed the number of PIM, days of hospital stay as predictors related to inappropriate dosage use. In conclusion, CNS drugs were frequently prescribed as PIM and inappropriate dosages were identified. It is needed to develop a means of decreasing adverse drug events in elderly.

• Integrative Medicine Research
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• 제7권4호
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• pp.333-340
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• 2018

Background: Traditional Korean medicine (TKM) is widely used to treat children with cerebral palsy (CP) in Korea; however, studies investigating factors that influence the use of TKM are scarce. Thus, we investigated the clinical factors that might influence the use of TKM. Methods: A population-based, cross-sectional, multicenter survey was performed from August 2014 to May 2016. The history of TKM use, type and severity of CP, current treatment characteristics, presence of accompanying disabilities or other health problems not directly related to CP, and monthly cost for the treatment of CP were surveyed. Results: In total, 182 children were recruited, and 78 children (42.9%) had used TKM. Among these 78 children, 50 (64.1% of the TKM-use group) had used both acupuncture and herbal medication, 15 (19.2%) had used acupuncture only, and 13 (16.7%) had used herbal medication only. Children with non-typical CP, accompanying disabilities and general health problems tended to use TKM. The monthly cost of treatment for CP was significantly higher in the TKM-use group than that in the no-TKM-use group, suggesting that economically disadvantaged children may have difficulty in accessing TKM. Dietary supplements, conventional pharmacological treatments, and rehabilitation therapies did not affect TKM use. Conclusion: Children with non-typical symptoms or those with poor overall health status are likely to use TKM. Additionally, TKM use leads to increased treatment costs. Studies investigating the motivation for starting or ceasing TKM therapy, socioeconomic factors and the attitude of parents towards complementary and alternative medicine should be performed.