• 제목/요약/키워드: prescription pattern

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소아 호흡기감염 외래환자에 대한 항생제 처방양상 (Outpatient Antibiotic Prescription Patterns for Respiratory Tract Infections of Infants)

  • 김예지;이수형;박실비아;나현오;최병호
    • 보건행정학회지
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    • 제25권4호
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    • pp.323-332
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    • 2015
  • Background: Antibiotic resistance has been becoming serious challenge to human beings. Overuse of antibiotics, especially, for infants is concerned, but studies are very few for the prescribing pattern of antibiotic use for infants. This study analyzes prescribing patterns of antibiotics in outpatients of preschool children with acute respiratory tract infections in South Korea. Methods: Data are used from 2011 Health Insurance Review & Assessment Services-pediatric patients sample. Inclusion criteria is outpatient children (0 to 5 years) with top five frequent diseases. Prescription rates are analyzed by types of disease, provider, specialty, region, and ages. Binary or multinomial logit models are used to analyze determinants of providers' prescription pattern. Results: The main findings are as follows. First, distributions of prescription rates are shown as L-shape or M-shape depending on the types of disease. Second, the prescription variation is so large among providers, where providers are polarized as a group with low prescription rates and the other group with high prescription rates, though the shapes are shown diversified across types of disease. Third, prescription rates appear to be lower in pediatrics and higher in ENT (ear-nose-throat). Fourth, broad spectrum antibiotics are widely used among children. Finally, the logit analysis shows similar results with descriptive statistics, but partly different results across types of disease. Conclusion: Antibiotics for respiratory tract infections of infants are used excessively with a large variation among providers, and especially broad spectrum antibiotics are used. The prescription guideline for antibiotics should be provided for each specific disease to reduce antibiotic resistance in the future.

울산 지역 소아청소년과 및 이비인후과에서의 항염증제 처방 형태 분석 (Outpatient Prescription Pattern of Anti-inflammatory Drugs by Pediatricians and ENT Physicians in Ulsan City)

  • 김성철;김영록;황재윤;장현욱;남두현
    • 한국임상약학회지
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    • 제20권3호
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    • pp.205-212
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    • 2010
  • The prescription sheets for outpatients from July 2008 to June 2009 from 7 community pharmacies in Ulsan City were surveyed for the anti-inflammatory drug (AID) prescription pattern. The AID prescription rate of pediatricians and ENT physicians were 30.0% and 34.8%, respectively. The oral steroidal anti-inflammatory drugs (SAIDs) were prescribed as much as 3.9% by pediatricians and 10.3% by ENT physicians. The chiefly prescribed oral SAID was prednisolone in pediatric clinics and methylprednisolone in ENT clinics. Meanwhile the prescription rate of oral non-steroidal anti-inflammatory drug (NSAID) was 22.5% by pediatricians and 21.4% in ENT physicians. The most favorable NSAIDs were propionate derivatives in both clinics. In case of externally-applied SAIDs, the prescription rate of pediatricians was 3.6% and that of ENT physicians was 2.8%. Among them, nasal spray, inhalant and gargle formulations for upper respiratory infection (URI) treatment occupied 35.8% of externally-applied SAIDs in pediatric clinics and 59.7% in ENT clinics. Further, it was observed that ENT physicians favored much stronger SAIDs in Group III of ATC classification (75.4% of externally-applied SAIDs) than pediatricians (49.2%). In the survey of AID combination rate, pediatric clinics showed much lower rate (1.4% of total AID prescriptions) than ENT clinics (7.5%). Among them, the combination rate of oral SAID and oral NSAID by ENT physicians (52.2% of total AID combinations) was much higher than pediatricians (36.6%), which might be over-prescription of AID agents. In conclusion, the AID prescription rate as well as AID combination rate, especially in SAID prescriptions, was much higher in ENT than pediatric clinics, which implies the higher confidency on AID drugs of ENT physicians even though the severity of patient's symptom could be considered.

울산 지역 소아청소년과 및 이비인후과에서의 항생제 처방 형태 (Outpatient Antibiotic Prescription by Pediatric and ENT Physicians in Ulsan City)

  • 김성철;박용철;김보금;남두현
    • 한국임상약학회지
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    • 제20권2호
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    • pp.145-150
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    • 2010
  • In order to investigate the antibiotic prescription pattern for upper respiratory infections (URI), the prescription sheets for outpatients from July 2008 to June 2009 were collected from 7 community pharmacies in Ulsan City, and the prescription pattern of Pediatric and ENT physicians was analyzed. The antibiotic prescription rates of Pediatric and ENT physicians were 63.8% and 61.7%, respectively. It was also observed that the oral antibiotic prescription was 95.6% in Pediatrics and 97.6% in ENT. The most favorable antibiotics by Pediatric physicians were penicillins (21.5%) penicillin-clavulanate (36.4%) and cephalosporins (16.5%), macrolides (11.6%), quinolones (3.5%), and nifuroxazide (3.5%). In case of ENT, the commonly prescribed antibiotics were also penicillin-clavulanate (47.6%), cephalosporins (31.6%), macrolides (11.9%) and sulfonamide (1.3%). The antibiotic combination rate was 7.6% in Peditrics and 1.9% in ENT, among antibiotic prescriptions. The combination of more than two oral antibiotics was examined as 66.8% in Pediatrics and 44.2% in ENT. The common oral antibiotic combination in Pediatrics was prescriptions of two ${\beta}$-lactam antibiotics (54.3%). Among them 83% was the combination of amoxicillin-clavulanate (7:1) and amoxicillin, which could be judged as antibiotic overuse. The next highly prescribed oral antibiotic combination was ${\beta}$-lactam/macrolide antibiotic combination probably for URI (11.3%) and ${\beta}$-lactam/nifuroxazide combination (10.0%) presumably for acute diarrhea. Comparatively the oral antibiotic combination prescribed by ENT physicians was negligible except one physician. In conclusion, the antibiotic over-prescription rate by antibiotic combination was much higher in Pediatrics than ENT, even though both clinical departments showed nealy the similar antibiotic prescription rates.

골프 퍼팅 시 오류동작 교정을 위한 진단과 처방 (The Diagnosis and Prescription for Correcting Errors of Putting in Golf Skill : A Case Study)

  • 하종규
    • 한국운동역학회지
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    • 제16권2호
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    • pp.21-24
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    • 2006
  • The purpose of this paper is to diagnose the errors by comparing putting motion with the single pendulum pattern applicable to putting in golf skill and order prescription that correct errors of putting. In the modern-day game of golf, putting remains the key to shooting low scores, and the ability to hole putts can turn a good round into a great round A semi-golfer, subject(sex female, age 20yrs, mass 94.3kg, height 1.65m) who has troubles to do putting is chosen. Six cameras, ProReflex MCU240(240Hz) made by Qualisys company is used to capture putting motion and data is processed by QTM(Qualisys Track Manager) and Mathematica 5.0. The result that differentiates the putting and the single pendulum pattern is acquired To make the pattern of subject's putting to the single pendulum pattern quasi-equal, one tries to lower center of mass gradually. As a result of it, one has a similar pattern like the single pendulum Conclusively, to lower C.O.M one orders prescriptions that increase the weight and length of a putter and lower C.O.M subject's segment. Further improvements to the study could be to train a subject according to prescriptions and to monitor putting again. It will probably be necessary to simulate putting motions and to research relations for body shapes and putting patterns in order to establish suitable putting-motions.

갱년기장애 사용처방과 변증분류에 관한 전문가 합의 연구 (A Study on the Experts' Agreement on the Patterns Classification of the Prescription for the Use of Menopausal Disorder)

  • 전수형;박영희;김종원;지규용;이지연;이인선
    • 대한한방부인과학회지
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    • 제35권2호
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    • pp.70-86
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    • 2022
  • Objectives: This study attempted to provide prescriptions that can be used according to the classification of menopausal disorders in order to increase the clinical utilization of CaPSPI (Diagnostic System for Climacteric and Postmenopausal Syndrome Pattern Identification). Methods: Delphi method survey was conducted for expert consensus on the Pattern Identification that could be used for each prescription by selecting frequent prescriptions based on the literature researched on the prescription of Korean medicine used for women with menopausal disorders. 11 experts participated in the questionnaire for posterity and 7 experts for sasang constitution. The survey was divided into the main prescription that can be mainly used for the patterns and the minor prescription that can be used although the suitability is somewhat low. Expert consensus was obtained through the second survey, and the pattern classification of prescriptions that were not confirmed here was confirmed through a face-to-face meeting. Results: There were 56 prescriptions mainly used for treatment for menopause, 45 for posterity and 11 for Sasang constitution. There were 69 identifications of 45 posterity prescriptions and 17 classifications of 11 Sasang constitutional prescriptions including major and minor patterns. By pattern identifications, the number of major/minor prescriptions was as follows. 肝鬱 14/5, 腎陰虛 8/2, 腎陽虛 4/1, 肝腎陰虛 2/7, 腎陰陽兩虛 3/1, 心腎不交 6/3, 心脾兩虛 15/2, 心火 7/6. Conclusions: In the future, by accumulating and analyzing the data on the diagnosis and treatment using CaPSPI, the clinical status of Korean medicine for menopausal disorders can be reviewed, and it can be used as the basis for the clinical practice guidelines for menopausal disorders. In addition, it is thought that analyzing the results of the diagnosis of pattern identifications and the prescription of Sasang constitution can be helpful in research on the posterity and Sasang constitution.

우리나라 성인의 의약품 사용 양상 : 외래처방의약품과 라이프스타일 의약품을 중심으로 (Medication use among adults in Korea: focusing on prescription drugs and lifestyle drugs)

  • 변진옥;정연;정혜주
    • 보건행정학회지
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    • 제22권4호
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    • pp.579-596
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    • 2012
  • The purpose of the study is to examine the use of medication among adults by comparing the pattern of outpatient prescription drug use with the pattern of long term taking lifestyle drug use. Furthermore, the study investigates factors associated with the use of medication, particularity focusing on socioeconomic factors. Korea Health Panel data of 2008 was used to conduct the study analysis. By performing four different logistic regression models, the study noticed different patterns of the medication use between prescription drugs and lifestyle drugs. More specifically, the study showed that adults with lower education level tend to more frequently receive prescriptions while adults with higher education as well as income level tend to more use lifestyle drugs than their counterparts. Furthermore, other control factors such as age and gender were statistically significant for the use of both prescription and lifestyle drugs in different patterns. The study findings expect that reimbursement structure of drugs may be significantly associated with the different patterns and accordingly the accessability of medicine in particularly vulnerable population. Therefore, these policy factors should be considered in future study to more comprehensively understand about the diverse patterns in the medication use.

『온병조변(溫病條辨)』 처방의 기원과 처방 변화의 병리학적 고찰 (The Pathologic Study on Difference between Prescriptions of 『Wenbingtiaobian』 and their Sources)

  • 박미선;김영목
    • 대한한의학방제학회지
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    • 제25권2호
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    • pp.253-270
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    • 2017
  • Ojectives : To indicate source of prescriptions in "Wenbingtiaobian" and draw pathologic consideration for differences between prescription and source. Methods : Analysed cause and mechanism of disease, pattern identification, treatment, prescriptions and medicinal herbs based on "Translation of Wenbingtiaobian", "Modern Shanhanlun", "Jinkuiyaolueyishi", "Medical collection of Yetianshi" and "Herbal Formula Science". Results : 64.5% of prescriptions in "Wenbingtiaobian" are derived from "Linzhengzhinanyian", "shanghanlun" or "Jinkuiyaolue". Prescriptions from "shanghanlun" or "Jinkuiyaolue" have been modified to fit for heat pattern differentiations, to expand or reduce their medicinal scope, to build up efficacy by adding cold herbs, herbs of nourishing yin, engendering fluid or outthrusting through the exterior, to diffuse water-dampness or warm yang by adding warm herbs. Prescriptions from "Linzhengzhinanyian" have been modified to eliminate cold-dampness, disperse and outthrust with lightness, tonify yin. Conclusions : Wenbingtiaobian" inherited "Linzhengzhinanyian", "shanghanlun" nd "Jinkuiyaolue" andchanged and developed them to cure the febrile disease in the aspect of prescription, mechanism of disease, pattern differentiation and treatment.

건강보험용 한약제제의 처방 패턴에 대한 기술역학적 분석: 건강보험공단 표본코호트 2.0 분석 (2010-2019) (General prescription pattern of insured herbal preparation in South Korea: A nationwide cohort study)

  • 김희경;이만경;김재곤;조주희
    • 대한한의학회지
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    • 제45권3호
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    • pp.14-30
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    • 2024
  • Objectives: Research on the general prescription patterns of insured herbal preparations in Korea has been limited. This study aimed to analyze prescription patterns of insured herbal preparations, utilizing the National Health Insurance Service (NHIS) sample cohort 2.0 data from 2010 to 2019. Methods: NHIS sample cohort 2.0 database, which represents a sample of 2.2% of the Korean population, was analyzed. We analyzed data related to prescriptions recognized as insured herbal preparations. Variables included patient demographics, diagnosis codes, prescription details, and healthcare institution characteristics. We examined trends over the decade, focusing on herbal formulae and single herb extracts. Results: During the study period, 275,358 patients visited Korean traditional medicine clinics and received at least one prescription of herbal preparations, representing 27.5% of the total sample. The number of prescriptions increased by 209%, from 34,621 in 2010 to 72,553 in 2019. Females accounted for 67% of these prescriptions, and 77% were for patients aged 70 and older. The top ten herbal formulae (TTHF), including Ojeok-san and Gungha-tang, constituted 76% of all prescriptions. Herbal formulae were used more frequently than single herb extracts, with certain prescriptions being commonly utilized. There was a notable focus on musculoskeletal disorders, with low back pain being the most common diagnosis. Conclusion: The study demonstrates a significant increase in the use of insured herbal preparations, primarily in small clinics and among the elderly. Prescription patterns showed a preference for specific single herb extracts and herbal formulae, with consistent trends over time. These findings provide valuable insights for future clinical research and policy development, particularly as herbal medicine's role in the national healthcare system continues to expand.

건강보험자료를 이용한 의원의 천식처방 분석 (Analysis of Prescriptions for Asthma at Primary Health Care Using National Health Insurance Database)

  • 이의경;박은자;배은영;이숙향
    • 약학회지
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    • 제47권4호
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    • pp.244-251
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    • 2003
  • Asthma is a chronic inflammatory disease of the airway and the prevalence rate is increasing. As the burden of asthma to the society is significant due to the increasing hospital admissions and emergency visits, National Heart, Lung and Blood Institute (NHLBI, USA) and World Health Organization (WHO) have developed comprehensive guidelines to help clinicians and patients make appropriate decisions about asthma care. The aim of study was to analyze the pattern of asthma prescriptions based on the national asthma guidelines for the patients visiting primary health care providers. Prescription data for asthma were obtained from the Korean National Health Insurance claims database of January 2002. Ten percent of the primary health care providers were sampled based on their specialty areas, and 20% of the claim cases were randomly chosen. Study results showed that prescription rate for oral beta-2 agonists was 44.3%, and that for oral theophylline was 46.9%. Oral steroids were prescribed for the 28.2% of the claims. Utilization of inhalers was low for both bronchodilators (20.3%, beta-2 agonists inhalers), and steroids (8.4% steroids inhalers). Bronchodilators were more preferred to the longterm anti-inflammatory controllers among the primary health care providers. Prescription rate for antibiotics was 46.0% for asthmatic patients. Also gastrointestinal drugs were prescribed for 59.0%, antitussives 65.3%, antihistamines 25.3% and analgesics 29.4%, respectively. This study presented that the prescribing pattern of the primary health care providers for the asthma was quite different from the national and international guidelines. More efforts need to be made to reduce the gap between the present pattern of asthma prescription and the guidelines.

인터넷 기반 한의진단전문가 시스템(KHU-PIPE) 개발 (Development of Web-based Diagnosis Expert System of Traditional Oriental Medicine)

  • 최승훈
    • 동의생리병리학회지
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    • 제16권3호
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    • pp.528-531
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    • 2002
  • In Traditional Oriental Medicine, there has been a growing needs for computerized diagnosis expert system, which can implement pre-diagnosis and correct the errors of practitioners. Therefore, we developed the expert system (KHU-PIPE : Kyung Hee University - Pattern Identification and Prescription Expert) for diagnosis and treatment. It has three characteristics as following. First. this system has the knowledge base which modified the standardized data designed by Chinese government during 1980s. Second, it provides the objective and standardized diagnosis as the results of pattern identification and their appropriate prescriptions for treatment. Third, it is applied to both LAN system and internet. Furthermore, it can be used as an educational methods for the practices of pattern identification and prescription, and provide the objective criteria for clinical studies and promote the Traditional Oriental Medicine as an evidence-based medicine.