• Title/Summary/Keyword: pharmacy claims

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Antipyretic and Diuretic Activity of Ammania baccifera

  • Joanofarc, J.;Sangeeta, J.;Jayakumari, S.;Kumar, S. Sadish;Gopinadh, B.;Sam, S. Kishore Gnana
    • Natural Product Sciences
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    • v.9 no.3
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    • pp.180-182
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    • 2003
  • In the present study the whole plant of Ammania baccifera Linn was extracted with petroleum ether, chloroform, ethyl acetate and ethanol. The extracts were vacuum dried to yield the respective petroleum ether (PEE), chloroform (CE), ethyl acetate (EAE) and ethanol extracts (EE). PEE, CE, EAE and EE were evaluated for their antipyretic and diuretic activity at 200 mg/kg dose level. Significant antipyretic activity was associated with PEE, CE, EAE and EE. CE was found to exhibit higher antipyretic activity as paracetamol at 100 mg/kg dose level. Significant diuretic activity was exhibited by EAE, EE and PEE. The present study supports the claims of Ammania baccifera mentioned in the Indian system of medicine.

Trends and Appropriateness of Outpatient Prescription Drug Use in Veterans (보훈의료지원 대상자의 외래 처방의약품 사용경향과 적정성 평가)

  • Lee, Iyn-Hyang;Shim, Da-Young
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.2
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    • pp.107-116
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    • 2018
  • Objective: This study analyzed the national claims data of veterans to generate scientific evidence of the trends and appropriateness of their drug utilization in an outpatient setting. Methods: The claims data were provided by the Health Insurance Review & Assessment (HIRA). Through sampling and matching data, we selected two comparable groups; Veterans vs. National Health Insurance (NHI) patients and Veterans vs. Medical Aid (MAID) patients. Drug use and costs were compared between groups by using multivariate gamma regression models to account for the skewed distribution, and therapeutic duplication was analyzed by using multivariate logistic regression models. Results: In equivalent conditions, veteran patients made fewer visits to medical institutions (0.88 vs. 1), had 1.86 times more drug use, and paid 1.4 times more drug costs than NHI patients (p<0.05); similarly, veteran patients made fewer visits to medical institutions (0.96 vs. 1), had 1.11 times more drug use, and paid 0.95 times less drug costs than MAID patients (p<0.05). The risk of therapeutic duplication was 1.7 times higher (OR=1.657) in veteran patients than in NHI patients and 1.3 times higher (OR=1.311) than in MAID patients (p<0.0001). Conclusion: Similar patterns of drug use were found in veteran patients and MAID patients. There were greater concerns about the drug use behavior in veteran patients, with longer prescribing days and a higher rate of therapeutic duplication, than in MAID patients. Efforts should be made to measure if any inefficiency exists in veterans' drug use behavior.

Treatment Costs and Factors Associated with Glycemic Control among Patients with Diabetes in the United Arab Emirates

  • Lee, Seung-Mi;Song, Inmyung;Suh, David;Chang, Chongwon;Suh, Dong-Churl
    • Journal of Obesity & Metabolic Syndrome
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    • v.27 no.4
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    • pp.238-247
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    • 2018
  • Background: We aimed to estimate the proportion of patients with diabetes who achieved target glycemic control, to estimate diabetes-related costs attributable to poor control, and to identify factors associated with them in the United Arab Emirates. Methods: This retrospective cohort study used administrative claims data handled by Abu Dhabi Health Authority (January 2010 to June 2012) to determine glycemic control and diabetes-related treatment costs. A total of 4,058 patients were matched using propensity scores to eliminate selection bias between patients with glycosylated hemoglobin (HbA1c) <7% and HbA1c ${\geq}7%$. Diabetes-related costs attributable to poor control were estimated using a recycled prediction method. Factors associated with glycemic control were investigated using logistic regression and factors associated with these costs were identified using a generalized linear model. Results: During the 1-year follow-up period, 46.6% of the patients achieved HbA1c <7%. Older age, female sex, better insurance coverage, non-use of insulin in the index diagnosis month, and non-use of antidiabetic medications during the follow-up period were significantly associated with improved glycemic control. The mean diabetes-related annual costs were $2,282 and $2,667 for patients with and without glycemic control, respectively, and the cost attributable to poor glycemic control was $172 (95% confidence interval [CI], $164-180). The diabetes-related costs were lower with mean HbA1c levels <7% (cost ratio, 0.94; 95% CI, 0.88-0.99). The costs were significantly higher in patients aged ${\geq}65$ years than those aged ${\leq}44$ years (cost ratio, 1.45; 95% CI, 1.25-1.70). Conclusion: More than 50% of patients with diabetes had poorly controlled HbA1c. Poor glycemic control may increase diabetes-related costs.

Pharmacological Screening of Dikamali Resin Extract

  • Sridhar, S.K.;Ramachandran, S.;Anbalagan, N.;Leonard, J. Thomas;Joanofarc, J.;Kumar, S. Sadish
    • Natural Product Sciences
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    • v.9 no.1
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    • pp.10-12
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    • 2003
  • In the present study, dikamali resin (obtained from the leaf buds and the young shoots of Gardenia gummifera Linn.) was extracted with diethyl ether and the extract was vacuum dried. Qualitative tests confirmed the presence of flavonoids and free phenolic compounds in the extract. The antioxidant property (qualitative) of the extract was performed by TLC method $({\beta}-carotene-linoleate method)$. The $LD_{50}$ of the extract was found to be 2227 mg/kg by Karber's arithmetic method. The extract was screened for analgesic, anti-inflammatory, antipyretic (100, 200 and 400 mg/kg) and anthelmintic (0.1,0.2 and 0.5%w/v) activities by standard methods. The extract exhibited antioxidant property and prevented oxidation of ${\beta}-carotene$. The extract exhibited significant graded dose response for analgesic, anti-inflammatory, antipyretic and anthelmintic activities. The extract caused the death of earthworms in all experimental concentration whereas the standard drug (piperazine) only effected paralysis. The present study proved the claims of dikamali resin mentioned in the Indian system of medicine.

Current Prescription Status of Contraindicated Drug Combinations Causing Serotonin Syndrome: Analysis of HIRA-NPS Data

  • Jae Gon Ryu;So Young Kim;Susin Park;Nam Kyung Je
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.4
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    • pp.313-320
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    • 2022
  • Background: Serotonin syndrome is a life-threatening disease if not appropriately treated. This study aimed to investigate the prescription status of contraindicated drug combinations that cause serotonin syndrome and identify the related factors. Methods: A cross-sectional study was conducted using nationwide claims data. Adult patients taking serotonergic drugs with Parkinson's disease or mental disorders were selected. Based on international medical databases (MDBs) and the Korean Drug Utilization Review (DUR), the status of prescribing contraindicated drug combinations that induce serotonin syndrome, the related factors, and the difference between international MDBs and the Korean DUR were analyzed. Results: Of the 49,773 study subjects, 163 (0.3%) were prescribed contraindicated serotonergic drug combinations based on international MDBs, and among them, only 105 (64.4%) were contraindicated by the Korean DUR. Positive influencing factors for prescribing contraindicated drug combinations include patient age between 65 and 74 and physician's specialties (neurologists, and orthopedists). Negative influencing factors were physician's specialty (internists) and medical institution (primary institutions). Conclusion: Despite the implementation of DUR, 3 out of 1,000 study subjects received contraindicated drug combinations that caused serotonin syndrome. Hence, it is necessary to comply with the DUR and improve it in accordance with international MDBs.

The Effect of Public Report on Antibiotics Prescribing Rate (급성상기도감염 항생제 처방률 공개 효과 분석)

  • Kim, Su-Kyeong;Kim, Hee-Eun;Back, Mi-Sook;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.3
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    • pp.242-247
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    • 2010
  • Controlling inappropriate antibiotics prescribing for acute upper respiratory infections(URI) is a very important for prudent use of antibiotics and resistance control. Health Insurance Review and Assessment Service (HIRA) introduced Prescribing Evaluation Program and publicly reported antibiotics prescribing rate for URI of each health institution. We performed segmented regression analysis of interrupted time series to estimate the effect of public report on antibiotics prescribing rate using national health insurance claims data. The results indicate that just before the public report period, clinics' monthly antibiotics prescribing rate for URI was 66.7%. Right after the public report, the estimated antibiotics prescribing rate dropped abruptly by 12.3%p. There was no significant changes in month-to-month trend in the prescribing rate before and after the intervention.

Lepidium sativum (Garden cress): a review of contemporary literature and medicinal properties

  • Mali, Ravindra G;Mahajan, Shailaja G;Mehta, Anita A
    • Advances in Traditional Medicine
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    • v.7 no.4
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    • pp.331-335
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    • 2007
  • The utility of Lepidium sativum Linn (Garden cress) as a medicinal plant has increased many fold over a period of time. A survey of literature relating to the medicinal uses of L.sativum reveals it to be one of the widely used medicinal plants. It finds place in folklore medicine, Ayurveda, Unani and other indigenous systems of medicine. Following a large number of claims on the wide range of traditional medicinal properties of the plant, considerable efforts have been made to verify its efficacy as a curative agent through pharmacological investigations and clinical trials. In this article, a comprehensive account of the traditional uses, phytochemical investigation and therapeutic potential of Lepidium sativum is presented.

Application of Australian Pharmaceutical Benefits Scheme data to the drug utilization studies: A case analysis on atorvastatin (호주의 급여의약품 청구데이터의 활용에 대한 고찰: Atorvastatin의 사용량과 청구액 분석 사례를 중심으로)

  • Lee, Hye-Jae;Yu, Su-Yeon
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.2
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    • pp.73-80
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    • 2020
  • Objective: The Australian Pharmaceutical Benefits Scheme (PBS) is a national drug subsidy program. Given the similarity and comprehensiveness of the Australian PBS and the Korean National Health Insurance (NHI) data, these data are increasingly used for pharmacoepidemiological investigations, as well as international comparative studies. This study aims to introduce the various sources of publicly available PBS data and provide a practical guide to researchers conducting drug utilization studies. Methods: We searched literature and websites to detail and compare the collection, structure, components, and characteristics of each PBS data format. We identified different characteristics of the PBS data from the Korean NHI claims data which are mainly owing to their unique co-payment policies and data collection processes. In addition, the utilization and expenditure of atorvastatin, a widely used treatment for hyperlipidemia, were analyzed using two different sources of PBS data and the different results were interpreted. Results: There exist differences in when data were collected or non-subsidized uses of medicine were included among sources of PBS data. Additionally, two countries have different cost sharing methods inmedicine subsidy scheme; co-payment in Australia and co-insurance in Korea. Therefore, it should be noted that prescriptions under co-payment are not included in some data sources in Australia. Conclusion: Despite several analytical challenges, open access and easy data management are the strengths of the PBS data sources. A detailed knowledge of the PBS data can ensure robust methodology and interpretation of pharmacoepidemiological investigations or international comparative studies.

Association of Arrhythmia in the Elderly Patients on Combination Therapy of CYP3A4 Substrates and Inhibitors with the Korean Claims Data (CYP3A4 기질과 억제제 약물의 병용 고령환자에서 부정맥 부작용 연관성)

  • Tae Woo Kim;Junhyuk Chang;Eunjung Choo;Rae Woong Park;Sukhyang Lee
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.4
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    • pp.242-253
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    • 2023
  • Background: Arrhythmia due to QT prolongation is one of the most serious adverse events with drug interactions in the elderly. This study aimed to examine the incidence of arrhythmia in Korean elderly patients who administered both cytochrome P450 3A4 (CYP3A4) substrates and inhibitors. Methods: Patients using CYP3A4 substrate and inhibitor were selected from the 2017 elderly patient dataset (the Korean Health Insurance Review and Assessment Service - Aged Population Sample). Selection criteria were patients with a medication possession ratio over 80%, medication duration of at least 7 days, and a follow-up period of 3 months or more. The patient's basic information is age, gender, health insurance type, and comorbidities. The top 50 drug pairs and comorbidity with high-incidence arrhythmia were presented. Results: In patients with drug combinations for over 7 days, there were 981 incidences of arrhythmia, and 351 incidences in those with combinations for over 30 days. The comorbidities of congestive heart failure and myocardial infarction had a significant association with incidence of arrhythmia. Among patients with 7 days or longer, the drug pairs [substrates-inhibitors] with significant adjusted odds ratio (aOR) were [propranolol-cimetidine] (aOR, 2.25; 95% confidence interval [CI], 1.66-3.04). Among patients with 30 days or longer, the drug pairs with significant aOR were [tramadol-amiodarone] (aOR, 2.87; 95% CI, 1.97-4.19). Conclusions: In elderly patients, the incidence of arrhythmia was high with drug interactions of CYP3A4 substrates and inhibitors. The comorbidity of congestive heart failure was the risk factor.

Analysis of Frequent Therapeutic Duplication Drug Classes Based on National Health Insurance Claimed Data in Korea (국내 건강보험심사청구자료에 근거한 다빈도 치료중복 의약품 약효군 분석)

  • Sohn, Hyun-Soon;Lee, Young-Sook;Choi, Kyung-Eob;Shin, Hyun-Taek
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.3
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    • pp.262-267
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    • 2010
  • Therapeutic duplication of prescriptions is the most frequently reported inappropriate drug use in Korea. To prevent significant problems during drug prescribing and dispensing, prospectively, development of standard including drug lists considered as therapeutic duplications for the prioritized drug classes first would be necessary. This study was aimed to analyze frequent drug classes of therapeutic duplications by healthcare providers in clinical practice settings. National health claims data for drug review and reimbursement (1,426,065 prescriptions dated March 19, 2008) were analyzed. Therapeutic duplication was defined as the prescription including more than 2 ingredients belonging to the same KFDA drug classification numbers that considered to have therapeutic similarities. The following 3 drug classes were mostly frequent therapeutic duplication classes: 114 anti-pyretics, analgesics and anti-inflammatory drugs; 117 drugs for psycho-nervous system; 141 Antihistamines. About 3.5% of overall prescriptions analyzed showed therapeutic duplications. This result might be starting step to develop DUR therapeutic duplication standard.