Unused medication disposal is a problem due to the cost of disposing as well as potential risk of inadvertent dosing. Investigating medication returns is expected to suggest areas for targeting interventions to reduce medication waste. Therefore, the aim of this study was to examine types of medications and identify the expiration date of the medications returned to the community pharmacies through "Drug-Take Back" program. Method: From October 10, 2012 to November 14, 2012, the medications returned to the 58 community pharmacies in Korea were examined. Results: A total of 22,160 g of pill medications were collected; 52.8% for prescription drugs and 47.2% for non-prescription drugs, respectively. The weight of the expired pill medications was more than 5 times that of the non-expired pill medications. On the other hand, 6,168 ml of liquid medications were returned; 80.0% for prescription medication and 20.0% for non-prescription medications, respectively. Of the total oral liquid medications, the volume of the expired medications was more than 5 times that of the non-expired medications. Conclusion: The majority of medications returned to the community pharmacies were prescription drugs rather than non-prescription drugs. In addition, most of the drugs were expired when they returned.
Background: The number of elderly people with comorbidities who experience dysphagia associated with geriatric disorders, such as stroke, Parkinson's disease, and Alzheimer's dementia, is increasing. Consequently, the demand for long-term prescriptions of powdered medications is expected to rise. Most patients procure repackaged prescription medications from pharmacies; however, the guidelines regarding their expiration dates are unclear. Objectives: The aim of this study was to assess awareness among adults regarding the expiration dates and drug stability issues associated with repackaged prescription medications, including powdered medications. Methods: A questionnaire with 16 components was designed and distributed online (August 1-September 1, 2019) to adults aged 19 years or older. Statistical analyses, including descriptive analysis and chi-square test, were conducted on the obtained data. A p-value <0.05 was considered significant. Results: Data from 254 respondents were analyzed; 191 (75.20%) respondents worked in non-healthcare-related fields. A significant number of healthcare workers recognized the stability issues associated with powdered medications (p<0.001). However, a large proportion of healthcare workers were not aware of the expiration dates (p>0.05). Conclusions: More than half of the total respondents, including healthcare workers, were not familiar with the appropriate expiration dates of repackaged prescription medications. The establishment of evidence-based guidelines regarding drug expiration dates and the dissemination of awareness among patients are required. Furthermore, clinical practices including repackaging or pulverizing medications for long-term prescriptions should be avoided owing to the associated drug stability issues.
Unused medication disposal is a burden due to the cost of disposing as well as the cost of the drugs. Investigating medication returns is expected to suggest areas of intervention to reduce unused medications. Purpose: The aim of this study was to examine types, quantity, costs, active pharmaceutical ingredients, and therapeutic category of the medications returned to community pharmacies. Method: From January 15, 2014 to February 28, 2014, the medications returned to the 17 community pharmacies in Gimhae, Jinju, and Incheon, Korea were examined. The pharmacists and student volunteers worked cooperatively to identify the medications and analyze drug cost of prescription pill medications returned to the pharmacies. Results: A total of 2,720 pills of prescription medication were analyzed and 91 active pharmaceutical ingredients were identified. According to the Anatomical Therapeutic Chemical (ATC) classification, the most predominant group was A (alimentary tract and metabolism) with 33.3%, followed by N (nervous system) with 15.0%. With regard to the drug cost of groups, group A was the highest with 26.6%, followed by J01 (antibacterials for systemic use) with 20.2% and N (nervous system) with 18.3%. The total cost of the oral pill prescription medications was 468,477 won. Conclusion: The result from this study implies that unused drugs impose a significant cost to the health care system in Korea. In this study, medicines used to treat gastrointestinal conditions were returned most frequently with the highest drug cost. Further research in nationwide level is necessary to establish strategies to reduce the wastage of unused medicines.
1. Purpose This Study is intended to catch the expasion of theory of Sasang Constitutional Medicine through comparision DongyiSooseBowon Chopanbon with DongyiSooseBowon Chobonguen and DongyiSooseBowon Gabobon. 2. Method I compared the Soeumin's prescriptions and medications of DongyiSooseBowon Chopanbon with those of DongyiSooseBowon Chobonguen and DongyiSooseBowon Gabobon. 3. Result and conclusion 1. The Soeumin's meducations used in the prescriptions of chobonguen are 44 and those of Gabobon are 47, those of chopanbon are 46 2. Soeumin;s Medications of the same kind in Chobonguen's precriptions and Gabobon's and Chopanbon's are twenty-five;like Daejo(大棗), Jinpi(陳皮), Gamcho(甘草), etc. and these medications are the princople in soeumin's disease. 3. Soeumin's Prescriptions of the same name in Chobonguen's prescriptions and Gabobon's and Chopanbon's are two;Gwakhanggeunggisan(藿香精氣散) and Bogungikgitang(補中益氣湯). These two prescriptions are correspond to the prescriptions those were recorded in Song-won-myuong Soeumin's princple prescription of experience(宋元明 少陰人經驗行用要藥). 4. Soeumin's Prescriptions of the same name in Chobonguen's precriptions and Gabobon's are two;Gwakhanggeunggisan(藿香精氣散) and Bogungikgitang(補中益氣湯). Chobonguen's precriptions were composed of Old prescriptions(古方) except the medications those were considered of wrong Sang Constitutional medications. 5. Soeumin's Prescriptions of the same name in Gabobon's prescriptions and Chopanbon's are nine and except Padudan(巴豆丹) have differences in the kind of medications and quantites. This fact shows that Dongmu(東武) roform the Sasnag Constitutional prescriptions continuously. 6. As this, Dongmu(東武) selected Sasang Constitutional prescription and medication in detail as he has the more experince of treatment.
1. Purpose This study is intended to catch the expasion of theory of Sasang Constitutional Medicine through comparision DongyiSooseBowon Chopanbon with DongyiSooseBowon Chobonguen and DongyiSooseBowon Gabobon. 2. Method I compared the Soyangin's prescription and medications of DongyiSooseBowon Chopanbon with those of DongyiSooseBowon Chobonguen and Dongyisoosebowon Gabobon. 3. Result and conclusion 1) Soyangin's Medications of the same kind in Chobonguen's prescriptions and Gabobon's and Chopann's are thirty-two; like Bangpoong(防風), Hyeunggye(荊芥), Sangjihwang(生地黃), sukgo(石膏), etc. And these medications are the principle in Soyangin's disease. 2) Soyangin's Prescriptions of the same name in Chobonguen's prescriptions and Gabobon's and Chopanbon's are Yangdokbackhotang(陽毒白虎湯). Chopanbon's Yangdokbackhotang(陽毒白虎湯) is more rational and effective prescription. 3) Soyangin's Prescriptions of the same name in Chobonguen's prescriptions and Gabobon's are eleven; Bangpoongtongseungsan(防風通聖散), chengumdojuksan(千金導赤散), etc. These prescriptions are similar in the structure. 4) Soyangin's Prescriptions of the same name in Gabobon's prescriptions and Chopanbon's are five; Hyungbangpaedoksan(荊防敗毒散), Yangdokbackhotang(陽毒白虎湯). etc. These Prescriptions make a change in the structure from Gabobon's to Chopanbon's. As this we know that Dongmu(東武) selected Sasang Constitutional prescription and medication in detail as he has the more experience of treatment.
Kwak, Min Ji;Kim, Jongoh;Bhise, Viraj;Chung, Tong Han;Petitto, Gabriela Sanchez
Journal of Preventive Medicine and Public Health
/
v.51
no.5
/
pp.257-262
/
2018
Objectives: Smoking cessation decreases morbidity and mortality due to chronic obstructive pulmonary disease (COPD). Pharmacotherapy for smoking cessation is highly effective. However, the optimal prescription rate of smoking cessation medications among smokers with COPD has not been systemically studied. The purpose of this study was to estimate the national prescription rates of smoking cessation medications among smokers with COPD and to examine any disparities therein. Methods: We conducted a retrospective study using National Ambulatory Medical Care Survey data from 2007 to 2012. We estimated the national prescription rate for any smoking cessation medication (varenicline, bupropion, and nicotine replacement therapy) each year. Multiple survey logistic regression was performed to characterize the effects of demographic variables and comorbidities on prescriptions. Results: The average prescription rate of any smoking cessation medication over 5 years was 3.64%. The prescription rate declined each year, except for a slight increase in 2012: 9.91% in 2007, 4.47% in 2008, 2.42% in 2009, 1.88% in 2010, 1.46% in 2011, and 3.67% in 2012. Hispanic race and depression were associated with higher prescription rates (odds ratio [OR], 5.15; 95% confidence interval [CI], 1.59 to 16.67 and OR, 2.64; 95% CI, 1.26 to 5.51, respectively). There were no significant differences according to insurance, location of the physician, or other comorbidities. The high OR among Hispanic population and those with depression was driven by the high prescription rate of bupropion. Conclusions: The prescription rate of smoking cessation medications among smokers with COPD remained low throughout the study period. Further studies are necessary to identify barriers and to develop strategies to overcome them.
Byun, Seonjeong;Kim, Euitae;Yoo, Hee Jeong;Ha, Tae Hyon;Yoon, In-Young;Kim, Ki Woong
Korean Journal of Biological Psychiatry
/
v.22
no.4
/
pp.195-204
/
2015
Objectives This study investigated the patterns of psychotropic medications prescribed to patients admitted to an open psychiatric ward. Methods We reviewed 4282 medical records of patients who were discharged from an open psychiatric ward from May 2003 through April 2014. Data were collected on each patient's age, sex, length of hospital stay, number of past admissions, discharge diagnosis, and kinds and dosages of psychotropic medications at discharge. Results Among the 1384 male and 2898 female patients, 3.56 psychotropic medications were prescribed on average, with the number increasing across years, from 3.30 in 2003-2008 to 3.76 in 2009-2014. Prescription rates of antipsychotics, anxiolytics, and hypnotics significantly increased in patients with depressive disorders, bipolar disorders, anxiety disorders, delirium, dementia, and amnestic and other cognitive disorders. Only lithium prescription rates decreased significantly. Prescriptions for two or more anxiolytics and antipsychotics increased during the survey years, while antidepressant polypharmacy rates decreased. Conclusions Recently, there has been a significant increase in the number of psychotropic medications prescribed, including antipsychotics, anxiolytics, and hypnotics. Caution should be exercised when prescribing medications to avoid cost increases and the risk of side effects, with uncertain gains in the quality of care.
Objective: South Korea made a list of potentially inappropriate medications (PIMs) for elderly patients in 2015 and has prompted medical professionals to prescribe proper medication by using the drug utilization review (DUR) system. It has been three years since the system was introduced, but related studies have rarely been conducted. This study aimed to evaluate the effect of the DUR system on the prescription of PIMs for elderly patients. Methods: The data on the prescription of PIMs for elderly patients (${\geq}65$ years) who received medical treatment between March 1st and May 31st in 2015 (before introduction of the DUR system) and who received medical treatment between March 1st and May 31st in 2018 (after introduction of the DUR system) were retrospectively collected from electronic medical records. Results: The prescriptions of PIMs decreased from 3,716 (7.7%) to 3,857 (6.9%) (p < 0.001). The prescription of escitalopram and paroxetine, among selective serotonin reuptake inhibitors, increased significantly, and that of short-acting benzodiazepines also increased significantly from 454 (0.93%) to 624 (1.2%). Conclusion: Prescription of PIMs for elderly patients significantly decreased (p < 0.001) after the DUR system was introduced. Further expanded studies of PIMs need to be conducted for the safety of elderly patients.
Park, Chan-Hyun;Sohn, Hyun-Soon;Shin, Hyun-Taek;Choi, Kyung-Eob
Korean Journal of Clinical Pharmacy
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v.20
no.1
/
pp.39-49
/
2010
The present study was aimed to examine the occurrence and influencing factors therapeutic duplication (TD) of medications for anxiety disorders by analyzing the relevant prescription data. In this study, the prescription data issued on March 19, 2008 in domestic medical institutes were utilized. TD was defined as more than two medications under the same therapeutic classification per prescription based on the Anatomical Therapeutic Classification (ATC) code. The assessment of TD was performed based on the number of cases and on the ratio determined. To identify the influencing factor of TD, the variables related to the differences in the TD ratio were analyzed based on the results of the Chi-Square test conducted with the variables; patients, medical institutes, diseases, and treatments. The number and ratio of TD were determined to be 1,333 out of the total of 19,219 anxiety disorder cases, and 6.94%, most cases involving benzodiazepine derivatives, respectively. The TD ratio was found to be higher in relation to males than to females. Patients with national health insurance benefits have a higher TD ratio compared to the medical-aid beneficiaries. The TD ratios were highest in clinics, psychiatry divisions, and Gyeongsang district. The TD ratio of the cases with more than two anxiety disorders was found to be higher than that of the cases with only one anxiety disorder. As the number of medications per prescription increased, the TD ratio was shown to have become gradually higher. In conclusion, in order to prevent TD, the concurrent DUR system should be implemented. The prescribers and pharmacists must be educated regarding duplicated medications to promote the safe and effective use of medicines, without unnecessary TD.
Background: This study is to investigate the prescription patterns and factors related to the number of medications treating chronic obstructive pulmonary disease (COPD) in patients under 65 years old according to GOLD guidelines. Methods: We retrospectively analyzed the medical records of patients aged 40-64 years with a diagnosis of COPD from January to March 2016. Patients were classified by combined assessment of COPD (grades A, B, C, D) using spirometry, exacerbation history, mMRC, and/or CAT results. We analyzed prescribed medications, treatment options and factors related to the numbers of COPD medications. Results: The total number of prescriptions were 251. About 35.5% of patients were classified as GOLD A, 34.2% as GOLD B, 17.1% as GOLD C and 13.2% as GOLD D. Inhaled bronchodilator was prescribed for 86.9% of patients and the most frequent COPD medication was long-acting muscarinic antagonist (LAMA) followed by inhaled corticosteroids/long acting beta agonist (ICS/LABA). The majority of low risk patients (GOLD A/B) were prescribed a monotherapy with LAMA or LABA. For high risk patients (GOLD C/D), combination treatment with ICS+LAMA+LABA was mostly prescribed. The 21.2% of patients in GOLD D received systemic corticosteroid. The average number of medications per prescription was 3.7, and this number increased with increasing COPD grade, COPD duration and lung function reduction ($FEV_1$, $FEV_1/FVC$). Conclusion: Generally high adherence to GOLD guideline recommendations was reported. Given the progressive nature of the disease, results suggest that closer attention to respiratory symptoms for early detection, diagnosis, and appropriate treatment of COPD is warranted.
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