• 동의신경정신과학회지
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• 제20권4호
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• pp.1-13
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• 2009

Objectives : As depression falls into the category of Wuljeung, Gamiguibi-Tang(Jiaweiguipitang) is the standard prescription to cure Wuljeung. This study develops a questionnaire for building the guidelines to administer Gamiguibi-Tang to depression and evaluates reliability and validity of questionnaire. Methods : With extracting the text related to depression and Gamiguibi-Tang through total 9 Korean medicine books and consulting the experts, the study selected 80 items and converted them into a questionnaire. It surveyed the neuropsychiatry professors and the medical specialists three times by Delphi method, and lastly selected 21 final items of a questionnaire. On the basis of the questionnaire, it collected total 216 samples and tested their reliability and validity. Results : 21 items all didn't reduce total Cronbach alpha coefficient and satisfied test-retest reliability. As a result of factor analysis, totally 5 factors were extracted such as mental state, sleep, accompaniment, fatigue and weakness. Finally, in comparing a depression group with a normal control group, two groups all showed meaningful difference in each 21 items' point, the sum of factor 1 to 5 items' points, and the sum of 21 items' points. Conclusions : The questionnaire on the updated depression prescription guideline of Gamiguibi-Tang satisfied both of reliability and validity. Later it can help objectifying to apply Gamiguibi-Tang to depression cure.

• 한국임상약학회지
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• 제15권2호
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• pp.149-159
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• 2005

Purpose: To determine the extent and rate of prescription drug therapy, especially polypharmacy and the prevalence of potentially inappropriate medication use in Korean elderly ambulatory patients based on an explicit criterion. Methods: Performed a retrospective study of 65 years or older ambulatory patients visiting a university hospital based clinic from January 2002 to April 2004. Study determined the patterns of drug prescription per Anatomical Therapeutic Chemical Classification and the potentially inappropriate medication usage based on explicit Beers criteria. Results: Of the 4,042 elderly patients the mean number of prescription was $2.2{\pm}2.0$, which was similar between genders and all age groups within the elderly. 10.7% of patients were prescribed with more than 5 medications concurrently. The most frequently prescribed medication was the drugs used for treating nervous system diseases (44.3%), followed by alimentary tract/metabolism disorders (27.6%), cardiovascular disease (10.7%), blood/blood forming disorders (4.3%), respiratory disorders (6.5%), and musculoskeletal diseases (3.2%). A total of 511 elderly (13%) was prescribed with medication that met the criteria for=1 potentially inappropriate drugs for the elderly. This proportion was similar between genders and all age groups within the elderly. Among these 511 elderly patients the mean number of potentially inappropriate drugs prescribed was $5.1{\pm}3.3$ drugs. Potentially inappropriately prescribed drugs included amitriptyline (76 cases), diazepam (69 cases), ketorolac (57 cases), short acting nifedipine (44 cases), triazolam (38 cases), and hydroxyzine (38 cases). Conclusion: Potentially inappropriate drug prescribing in Korean ambulatory elderly patients are common. Education programs and interventions aimed at optimizing the prescribing and dispensing of the most appropriate drugs are needed.

• 보건의료산업학회지
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• 제13권3호
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• pp.115-125
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• 2019

Objectives: Korea has been practicing the separation of dispensary from medical practice since 2000 as a national policy to prevent misuse or overuse of medicines. This study aimed to investigate prescription patterns from except pharmacies in order to determine the appropriateness of drug usage among those patients. Methods: Thirty-two pharmacies in the Yeongdong area of Gangwon Province were examined in this study. The same simulated patient complaining of cold symptoms for 3 days visited each pharmacy to obtain a prescription for medication. Results: At pharmacies prescribing medicine, steroids (53.1%) and antibiotics (50.0%) were used to treat the common cold. Duplicate prescriptions of drugs, such as antihistamines (47.0%) and decongestants (31.3%) were common. The average number of drug prescriptions was 6.59, and 53.2% of pharmacies had prescribed more than seven drugs. The average total cost of the prescriptions was 6,093 won, and the daily cost was 2,544 won. Conclusions: Steroids and antibiotics were frequently abused among patients whose medications had been prescribed by pharmacies. Also, there were a considerable number of drugs and duplicate prescriptions. The prices of the drugs were somewhat high.

• 한국임상약학회지
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• 제33권1호
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• pp.8-21
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• 2023

Background: Gastrointestinal (GI) drugs are often co-prescribed with other medications to prevent GI complications. This study aimed to evaluate the prescribing pattern of potentially unnecessary GI drugs in patients with acute cystitis who were prescribed oral antibiotics and investigate the influencing factors affecting this. Methods: We identified female patients ≥20 years with acute cystitis who visited the outpatient clinic and were prescribed oral antibiotics between July and December by analyzing Health Insurance Review and Assessment Service (HIRA)-National Patients Sample (NPS)-2019 data. Patients with no prior history of GI disorders within 180 days prior to acute cystitis, excluding or including the date of diagnosis of acute cystitis, were selected (Group A and B). Multiple logistic regression analysis was performed to estimate the factors affecting the prescription of potentially unnecessary GI drugs. Results: A total of 1,544 in Group A and 552 patients in Group B were included for the final analysis. Potentially unnecessary GI drugs were prescribed in 1,176 patients in Group A (76.2%) and 231 patients in Group B (41.8%). Third generation cephalosporines and sulfonamides showed the lower odds ratio for prescribing GI drugs than penicillins. Prescribers from Urology clinics showed more than twice odds ratio for the prescription of GI drugs compared to prescribers from internal medicine clinics. Conclusion: The results of this study showed that potentially unnecessary GI drug prescriptions for patients with acute cystitis were high in South Korea. The positive risk factors affecting the prescription of unnecessary GIs were not patient-related factor but healthcare facility and prescriber-related factors.

• 보건교육건강증진학회지
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• 제29권2호
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• pp.1-12
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• 2012

Objectives: Several practice guidelines recommended both medication and behavior modification to control hypertension. The objective of this study was to analyze ambulatory care utilization pattern and related factors. Methods: A retrospective cohort study was conducted among 45,267 new users who initiated treatment with hypertensive drugs in 2003. Korean National Health Insurance Claims Data was used to study the medical care utilization behavior and related factors after treatment initiation for up to four years. Taking prescription was considered as medical care utilization. Results: More than 20% of patients discontinued visiting physicians for prescription after initiating antihypertensive drug therapy. The average number of institutions visited by patients was about 1.3 annually. Clinic was the most frequently visited institution by patients. In GEE analysis, probability of continuous visit one institution after initiating antihypertensive drug treatment increased in patients who were women, old, have comorbidity, visited clinic or hospital mainly in previous year. Conclusions: Young hypertensive male patients who have no major comorbidity showed high possibility to discontinue medical service utilization. It is necessary to educate these targeted patients about importance of hypertension management in early stage after treatment initiation.

• 보건행정학회지
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• 제11권4호
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• pp.88-108
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• 2001

Separation of prescribing and dispensing practice in Korea has changed the service pattern of the pharmacy. The prescription dispensing activities, however, are concentrated excessively on the pharmacies near hospitals or clinics. Thus this study was conducted to estimate the number of optimal dispensing cases for the community pharmacy. Forty-six pharmacies were selected using systematic stratified random sampling method, and ninety-five pharmacists were interviewed on their workload of dispensing and other activities at pharmacies. One hundred and seventy prescriptions were chosen based on the length of drug administration and drug dosage form, and the dispensing time was measured by time-watch method. Also pharmacy benefit claims data were analyzed to identify the characteristics of the pharmacies which performed more than optimal dispensing cases. According to the study results, the average work time per pharmacist per day was found to be 10hours 32minutes and the dispensing activities occupied 7hours 36minutes. It took 5.72minutes on average for each dispensing case. The optimal dispensing case was estimated as 75 cases under the condition of 10hours 32minutes work time and 6% allowance rate. Even though the pharmacies near hospitals or clinics participated dispensing services actively, only pharmacies near clinics dealt with more than optimal dispensing cases. For the pharmacies near hospitals they dealt with less than optimal cases, but drug administration period per prescription was almost 3 times longer than that of pharmacies near clinics. Thus the intensity of dispensing activities such as drug administration period is to be considered to estimate optimal dispensing cases more accurately.

• 한국의사학회지
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• 제34권2호
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• pp.25-43
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• 2021

Among the ancient ideas of East Asia, there is a myth about the symbol of the Four Gods who commands all directions in the east, south, west, and north, and this is also reflected in the medical field. However, although there is discussion about Qinglong Decoction (青龍湯), Baihu Decoction (白虎湯) and Xuanwu Decoction (玄武湯) in the 『Shanghan Lun (傷寒論)』, there is no content focusing on Zhuniao decoction (朱鳥湯). Considering the consistent perspective of 『Shanghan Lun』, which recognizes the disease-syndrome and seeks prescriptions based on yin and yang thinking, this is very unusual. Therefore, in this study, it was revealed that the concept of 'Sishen Decoction (四神湯)' itself was a concept that emerged when the authors of 『Shanghan Lun』 established the 'eight-principles syndrome differentiation (八綱辨證)' system in their recognition and response to diseases-syndromes. Based on this, I considered the following possibilities: They were able to present Qinglong decoction, Baihu Decoction and Xuanwu decoction, as appropriate prescriptions for 'exterior cold excess syndrome (表寒實證)', 'interior heat deficiency syndrome (裏熱虛證)', and 'interior cold deficiency syndrome (裏熱實證)'. However, it is possible that the name of the prescription 'Zhuniao decoction' was not intentionally used, because it was not possible to provide an appropriate prescription for 'exterior cold excess syndrome (表熱實證)'.

• 대한한의학원전학회지
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• 제32권3호
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• pp.131-146
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• 2019

Objectives : The aim of this paper is to study the methodology for effectively analyzing the "Jinguiyaolue" prescriptions using database, and to explore possibilities of applying the data construction and query produced in the process to comparative research with other texts in the future. Methods : Using "Xinbianzhongjingquanshu(新編仲景全書)" as original script, the contents of "Jinguiyaolue" were entered into the database, in which one verse would be separated according to content for individual usage. Also, data with medicinal construction and disease pattern information of the previously constructed "Shanghanlun" database designed for comparison with other texts was applied for comparative analysis. Results : For input and analysis, 6 tables and 12 queries were made and used. Formulas were accessible by using herbal combinations, and applications of these formulas could be assembled for comparison. Formulas were also accessible by using disease pattern combinations, and combinations of herbs and disease pattern together were also applicable. In comparison with other texts, examples and frequency of usage of herbs could be relatively accurately compared, while disease patterns could not easily be compared. Conclusions : Herbal combinations, disease pattern combinations could yield related texts and herb/disease pattern combinations of the prescriptions in the "Jinguiyaolue", which shortened time needed for research among formulas in texts. However, standardization research for disease pattern is necessary for a more accurate comparative study that includes disease pattern information.

• 동의생리병리학회지
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• 제24권5호
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• pp.790-795
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• 2010

Sasang Constitution Medicine(SCM)'s researches have been developed in many ways, especially Herbal medicine prescriptions and diagnosis. But there are no acceptable acupuncture theory for the Sasang Constitution. So We have tried to find the way for identifying each Sasang Constitution's acupuncture point on more reasonable methods. We studied that SCM acupuncture based on collecting Books of "Shanghanlun(傷寒論)", or Six-meridian pattern identification's acupuncture prescription. Selected books are "The Acupuncture and Moxibustion(침구학)", "Zhonghua Zhenjiuxue(中華鍼灸學)", "Zhenjiuxinchuan(鍼灸心傳)", "Shanghanlun Zhenjiupeixuexuanzhu(傷寒論鍼灸配穴選注)". So-eumin uses Conception Vessel's acupuncture points most frequently. And So-yangin and Tae-eumin use Bladder meridian and Stomach meridian's acupuncture points most. Moxibustion is used many times for So-eumin, especially at three Yin-Symptoms(三陰病). Orders for using frequencies of three Sasang constitutions' acupuncture points are: So-eumin uses ST36 CV12 CV4 most, So-yangin uses PC6 ST36 LI4 most, Tae-eumin uses ST36 LU7 CV12 most. Acupuncture for Sasang constitutions has been developed for many ways, but there are no generally acceptable theory. So we need to hold a committee for SCM and acupuncture specialist to establish acceptable and reasonable SCM acupuncture theory.

• 한국보건간호학회지
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• 제15권2호
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• pp.398-411
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• 2001

The separation system of pharmacy and clinic has begun on the purpose of preventing drug misuse and abuse since July 1st of 2000. The system revealed some conflicts between doctors. pharmacists and consumers. Consequently pharmaceutical law and related policies undergone some change. Now in an early period of the implementation of the system, the necessity to examine relevance of those policies and law enforcement to medical doctors' prescriptions pattern evolves. This study tries to verify the pattern through a field study. For the purpose, 930 prescriptions collected in May of 2001, from a pharmacy located in Gangnam-gu in Seoul, were analysed. The prescriptions were issued from several clinics: 459 prescriptions from otorhinolaryngological clinic(ENT), 177 from internal medicine clinic(IM), 130 from ophthalmic clinic(Opt), 52 from obstetric and gynecologic clinic(OB & GY), and 112 from miscellaneous clinics. ENT, IM, Opt. OB & GY are situated in a clinic building of 40m distance. The general findings are following: 1) $88.8\%$ of the total patients came from 5clinics in nearby single clinic building. 2) Average prescribing days were 6.2 days and the average number of used drugs were 4.0 drugs, i.e. 2-4 times of WHO criteria 1-2 drugs. 3) Use of antibiotics in the oral administration drugs rated $71.8\%(WHO: \;22.7\%)$ 4) Use of injection rated $31.3\%(WHO:\;17.2\%)$ 5) $96.2\%$ of the patients use multiple antibiotics in the injection and oral administration together. 6) The patients had multiple disease : ENT patients 1.7 disease and 1M patients has 2.7 disease in average and several regular prescribing types evolved particularly in the ENT prescription. With this result we found that drugs. especially antibiotics are still abused a lot, and there were significant differences in the number of used drugs and prescrbing days between the clinics. It implies somes differences of the preparation work and time for pharmacists. And preparation can be done in advance by pharmacists' own efforts through noticing regular prescribing types. The study suggests the followings: 1) Patient counseling should be done to minimize the incidence of adverse events. 2) The enforcement of the standardized differential preparation price system should be reconsidered. 3) Preparation of typical regularly appeared prescription in advance. which is regarded as 'a prearranged work between doctors and pharmacists' and has been prohibited should be reconsidered. 4) Drug utilization review program should be established to prevent drugs abuse. especially antibiotics abuse.