• 제목/요약/키워드: prescription rate

검색결과 324건 처리시간 0.024초

서방형제제 분할처방에 대한 건강보험심사제도의 효과와 장애요인 (Impact and Barriers of the Health Insurance Review on Splitting Extended-Release Formulation Drugs)

  • 장혜민;이의경
    • 한국임상약학회지
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    • 제21권4호
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    • pp.347-352
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    • 2011
  • Health insurance review & Assessment service (HIRA) has enforced cutting the drug costs when physicians prescribe split extended release drugs, starting from December, 2010. The objective of this study is to analyze extended release and enteric coated drugs on pharmaceutical reimbursement list in Korea, and to investigate the impact and barriers of the health insurance review on splitting extended-release formulation drugs. By using the ingredient code, extended release and enteric coated formulations make up 7.8% of all drugs in April, 2011. The most frequently used drugs are agent affecting circulatory and digestive system. From the extended release and enteric coated formulations (n=112), 34.8% (n=39) were not available in other dosage forms. According to questionnaire survey for 169 pharmacists (response rate: 73.8%), the rate of splitting and crushing of extended release and enteric coated drugs decreased. When pharmacists correct physician's prescription errors, the biggest problem was lack of other dosage forms. So it is necessary to develop variety of other dosage forms, and computerized checking system for splitting extended-release drugs. It is also important to inform physicians and patients in regard to the problems of split prescription of extended release and enteric coated drugs.

치(齒)에 대(對)한 문헌적(文獻的) 고찰(考察) (A Literature Study of the Teeth)

  • 곽익훈;윤철호;정지천
    • 대한한방내과학회지
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    • 제16권2호
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    • pp.146-177
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    • 1995
  • The purpose of this study was to investigate the relationship between the teeth and Zhang-Fu(臟腑), dental diseases, and the hygiene of the mouth through the literature of oriental medicine. First, the relatonship between the teeth and Zhang-Fu is reviewed as follows: The teeth are influenced by Shen(腎) because they are the end of bone and Biao(標) of Shen. Gingiva is related to Wei(胃) and Da-Chang(大腸) because it is passed by Yangming-Channel(陽明經). The growth and nutrition of teeth depends on Shen. The pathological condition of Shen causes the gingival atrophy, the loose of teeth, dedentition due to aging, withering of teeth, and tartar: whereas the pathological condition of Wei and Da-Chang causes toothache, gingivitis, inflamed gums, bad breath, and gingival hemorrhage. Second, the causes and therapies of dental diseases through the literature can be summarized as follows: The major causes of toothache are the pathogenic condition of wind-heat and wind-cold, the heat syndrome of Wei, the damp-heat of intestine, flaring-up of fire of deficiency type, rotten tooth, etc... The principal causes of dedentition and the shaking and loose of teeth are the deficiency of Shen, and the rest of causes are the damp-heat of Yangming. Gingival atrophy is caused by the deficiency of Shen, whereas the gingival hemorrhage comes from the factors in the pathogenic factor of wind-heat of Yangming-Channel, the heat syndrome of stomach, and the deficiency of Shen. The causes of grinding of teeth during sleeping are stomach-heat, and the delayed dentition and the withering result from the deficiency of Shen-Jing.(腎精) The principal therapies of toothache are removing wind and heat, clearing away heat and prompting diuresis, clearing away the stomach-heat, replenishing vital essence to tonify the Shen, relieving superficial syndrome by wind-cold, and alleviating pain by destroying parasites. For the prescription of the principal therapies, there are Xijio Dihuang Tang, Jiajian Ganlu Yin, Qufeng Wan, Qingwei San, Tiaowei Chenggi Tang Shengong Wan, Liangge San Qingwei Tang Yunu Jian, Liuwei Dihuang Wan Zuogui Yin Bawei Wan Wanshao Dan, Xixin San Badou Wan Gianghuo Fuzi Tang, Jiuzi Tang Badou Wan, etc... The therapies of dedentition and the shaking and loose of teeth are replenishing vital essence to tonify the Shen, and warming and recuperating the Shen-Yang: as the prescription, there are Liuwei Dihuang Wana Zuogui Yin, and Bawei Wan Anshen Wan Wanshao Dan Yougui Wan etc... The therapies of gingival hemorrhage are clearing away the stomach-heat, replenishing vital essence to tonify the Shen, warming and recuperating the Shen-Yang(腎陽), and moisturing and purging intence heat with the prescription of Tiaowei Chenggi Tang Xijiao Dihuang Tang, Liuwei Dihuang Wan Zuogui Yin, Bawei Wan Anshen Wan, and Yunu Jian. The therapy of gingival atrophy is replenishing vital essence to tonify the Shen in the prescription of Liuwei Wan Bawei Wan Ziyin Dabu Wan. The therapies of grinding of teeth during sleeping are clearing away the stomach-heat and purging intense heat, and invigorating the spleen through eliminating dampness in the prescription of Qingwei San, Wumei Wan, etc... The therapy of delaed dentition is replenishing vital essence to tonify the Shen with the prescription of Liuwei Wan Buyin Jian, etc... Third, clinical treatment reports of dental diseases are reviewed as follows: The toothache due to stomach-heat was treated by medical herbs like Gypsum, Natrir Sulfas, Rehmanniae, Schizonepetal Herba, Menthae Folium, Cimicifugae Rhizoma, and Scrophulariae Radix. The therapies of toothache due to flaring-up of fire in deficiency type from deficiency of Shen provided with replenishment of vital essence to tonify the Shen and clean ministerial fire, and the prescription was the kind of Liuwei Wan, which worked very well. The therapy of dedentition and loose of teeth due to deficiency of Shen was done to stablize the teeth as tonifing the Shen with the prescription of Guchi Wan. The rate of imrovement was over 90%. The destruction of periodontal tissue due to periodonititis was cured of dispelling wind, reducing heat, and alleviating pain, It was improved by taking Zizhi Xingiong Tang, Guchi Xiaotong San, Yunii Jian, and Qingwei San about 3-7 days, and the rate of improvement was over 80%. Fourth, the prevention and regimens are reviewed as follows: As a physical and breathing exercise of the teeth, tapping teeth which stimulates the circulation of Qi(氣) and Xue(血) had been used. The tapping time of 14, 17, 36, etc... has been reported, and it should be applied based on the body condition. The medical herbs for gargling and brushing teeth have been used. Specifically, Cimicifugae Rhizoma, Gypsum, Gypsum Fibrosum, and Indigo pulrelrata Lereis have been used to reduce heat, Coptidis Rhizama and Yang Jinggu to eliminate damp-heat, Amomi Semen, Cyperi Rhizoma, Flos Caryophylli, Asari Radix, Piperis Longi Fructus, Santali Albae Lignum, Meliae Fructus, Moschus, Aquillaiae Lignum, and Borneol to promote the circulation of Qi and to relieve pain, Ligustici Radix, Angelice Radix, Rhizoma Nardostachydis, Tribuli Semen to relieve superficial syndrome by means of diaphiresis, and Cnidii Rhizoma, Angelicae sinensis Radix, and Olibanum to promote blood circulation to stop pain.

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고혈압 환자의 투약순응도와 영향 요인 분석 (Analysis of the medication compliance of hypertensives and its influential factors)

  • 손경애;김윤신;홍민희;정미애
    • 한국산학기술학회논문지
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    • 제11권5호
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    • pp.1897-1904
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    • 2010
  • 본 연구는 행정자료인 건강보험 및 의료급여비용 청구자료를 이용하였으며, 일개지역(2개도, 남 북)에 개설되어있는 전체 의료기관을 대상으로 진료일 기준 '08.7월~'08.12월(184일)동안 외래 방문이 1회 이상인 30세 이상의 수진자 432,915명을 대상으로 하였다. 투약순응도와 영향 요인을 분석한 결과 아래와 같다. 연구대상자의 투약순응도 평균은 61.5%로 나타났으며, 이는 분석대상기간 6개월(184일)동안 약 113일 정도 처방 받았음을 의미하며, 투약순응군 비율은 13.0%에 불과하였다. 고혈압상병(주 부상병)으로 외래를 방문한 평균 횟수는 4.3일, 방문한 기관수는 평균 1.1곳이었고, 한곳의 의료기관만을 이용한 환자가 전체의 94.9%로 나타났다. 당뇨병을 동반상병으로 가지고 있는 환자가 11.6%로 가장 많았고 고혈압 환자의 23.3%가 동반상병을 가지고 있었다. 투약순응도는 남성, 건강보험 가입자, 종합전문을 주이용기관으로 이용하는 환자, 동반상병을 가지고 있는 환자에서 높게 나타났으며, 65-74세까지 투약 순응도가 증가하다가 그 후 감소하는 경향을 보였다. 투약순응도에 영향을 미치는 요인으로는 남성, 55-64세, 건강보험 가입자가, 종합전문, 종합병원, 보건기관을 주 이용기관으로 방문하는 환자와 심장질환, 당뇨병을 동반상병으로 가지고 있는 환자에서 투약순응도가 높았다. 이상의 연구결과 투약 순응도가 낮은 환자에 대한 다양한 요인분석이 필요하며, 투약 순응도를 높이기 위한 고혈압관리사업의 정책적 검토 및 대안이 필요할 것이다. 또한 고혈압 환자의 경우 당뇨 등 동반상병 비율이 높아 저염식, 금연 등 올바른 생활습관 관리를 위한 체계적 보건교육과 홍보 프로그램을 개발할 필요성이 요구된다.

자궁경부암 고선량율 강내조사치료시 A, B점 선량과 Curie-minutes 단위의 비교 (Intracavitary Dosimetry: A Comparison of Doses at Point A and B to Curie-minutes in Cervical Cancer)

  • 허승재
    • Radiation Oncology Journal
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    • 제7권1호
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    • pp.81-83
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    • 1989
  • This study, involving thirty-two patients with carcinoma of uterine cervix treated by high dose rate intracavitary irradiation using a remotely controlled afterloading system, compares the doss at point A and 8 with the Curie-minutes prescription. A linear least-square regression analysis was used to compare the two sets of date. Correlation coefficients between doses at points A and B and the Ci-min prescription are 0.92 (p<0.001) and 0.90 (p<0.001), respectively, and linear relationship is observed between these two system. The limitation and significance of the comparison of the two approaches to intracavitary dosimetry is discussed.

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H. pylori에 감염된 소화성궤양 치료에 관한 문헌고찰 -근래(近來) 중의잡지(中醫雜誌)를 중심(中心)으로- (A literature study on the treatment of H. pylori infected gastric ulceration. -Chinese medicine journal put first in importance-)

  • 서영철;임성우;이원철
    • 동국한의학연구소논문집
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    • 제7권1호
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    • pp.53-64
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    • 1998
  • 소화기 질환중 다수를 차지하고 있는 소화성궤양의 발병원인이 H. pylori로 많이 발생한다고 보고되는 현재, 부작용을 최소화 하고 치료율을 높이기 위한 변증치료를 최근 보고된 문헌을 통해 고찰하고 향후 H. pylori 감염에 의한 소화성궤양 치료의 연구 방향을 제시해 본다.

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Sca-1+골수조혈세포에서 JAK2/STAT5/GATA-1 신호전달 경로를 통한 다채, 도두 그리고 두 조합물에 의한 조혈증진 조절에 관한 연구 (Studies on the regulation of Hematopoietic enhancement of Brassica campestris var narinosa., Canavalia gladiata DC semen and their combinational prescription via Jak2/STAT5/GATA1 Pathway in Sca-1+ hematopoietic stem cells)

  • 김근회;김승형;조인식;김한영;김동선;이영철
    • 대한본초학회지
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    • 제28권4호
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    • pp.7-16
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    • 2013
  • Objectives : Brassica campestris var narinosa (BCN), Canavalia gladiata DC semen (CGD) and their combinational prescription (BCN+CGD) have been use to demonstrate to regulate hematopoiesis. In the current study, we investigated whether Brassica campestris var narinosa, Canavalia gladiata DC semen and their combinational prescription is related to hemato-potentiating function using Sca-$1^+$ hematopoietic stem cells (Sca-$1^+HSCs$) as a testing system. Methods : Sca-$1^+HSCs$ isolated from femur in C57bl/6 mice with leukopenia and thrombocytopenia induced by cyclophosphamide (CTX). Then, Real-time PCR was performed to measure the mRNA expression, ELISA and haematopoiesis-related gene (EPO, TPO, IL-3, SCF, c-kit, GM-CSF), the phosphorylation of JAK2, GATA-1 and STAT-5a/b were observed by western blot, and the numbers of $CD117^+/Sca-1^+$ cell and the number of granulocyte erythrocyte monocyte macrophage colony-forming units (CFU-GEMM) and erythroid burst forming units (BFU-E), semisolid clonogenic assay was performed. Result : When Sca-$1^+HSCs$ were treated with Brassica campestris var narinosa, Canavalia gladiata DC semen and their combinational prescription with rIL-3/rSCF, the expression of haematopoiesis-related (EPO, TPO, IL-3, SCF, c-kit, and GM-CSF) were significantly increased at the levels of mRNA as well as production in Sca-$1^+HSCs$. Additionally, CGS enhanced phosphorylation of JAK2, GATA-1, and signal transducer and activator of transcription-5a/b (STAT-5a/b) in Sca-$1^+HSCs$. Furthermore, their combinational prescription (BCN+CGD) significantly enhanced the growth rate of granulocyte erythrocyte monocyte macrophage colony-forming units (CFU-GEMM) and erythroid burst forming units (BFU-E) in vitro. Conclusion : These result suggest that Brassica campestris var narinosa (BCN) and Canavalia gladiata DC have hematopoietic enhancement via hematopoietic cytokine-mediated JAK2/GATA-1/STAT-5a/b pathway, and their combinational prescription (BCN+CGD) has superior hematopoietic enhancement to those of individual extracts.

주의력결핍과잉행동장애 치료 약물 Methylphenidate IR의 순응도 연구 (COMPLIANCE STUDY OF METHYLPHENIDATE IR IN THE TREATMENT OF ADHD)

  • 황준원;조수철;김붕년
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제15권2호
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    • pp.160-167
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    • 2004
  • 목 적:주의력결핍과잉행동장애(Attention Deficit Hyperactivity Disorder:ADHD) 치료를 위해 가장 흔하게 사용되는 속방형 메틸페니데이트(methylphenidate-immediate releasing form:MPH-IR)에 대한 약물 순응도 연구는 매우 제한적이었다. 이에 본 연구에서는 외래를 통한 평균 1년 기간의 약물치료 과정에서의 약물 순응도를 평가하고, 관련 요인을 분석하였다. 방 법:2002년 9월부터 2002년 12월까지 외래를 처음 방문하여, DSM-Ⅳ에 근거한 ADHD 진단을 받고 MPHIR로 약물치료를 시작한 환아들 중 선별기준에 합당하고, 배제기준에 해당되지 않는 환아를 무작위 선발을 하여 100명의 대상 환아를 모집하였다. 상기 환아들을 대상으로 2003년 3월부터 4월까지 약물순응도에 대한 설문조사를 실시하였고, 설문조사 후 6개월이 경과한 시점인 2003년 10월, 동일 100명의 환아에 대한 인구사회학적 정보, 발달력, 가족력, 공존장애, 약물치료력, 약물 반응, 약물순응도를 평가하였고, 심리학적 평가로서, 지능검사, 기초학습검사, 주의력장애진단 검사결과를 조사하였다. 이를 통해 평균 치료기간 1년 동안의 약물치료 순응도를 평가하였고, 순응도에 관련된 다양한 변인들을 조사하였다. 결 과:1) 평균 약물치료기간 6개월이 되는 시점인, 2003년 3월에 실시한 약물순응도 설문조사에서, 치료효과 만족도는 60%였고, 오전처방 순응율은 81%, 오후처방 순응율은 43%로 큰 차이를 보였다. 2) 평균 약물치료 기간 1년이 되는 시점인 2003년 10월의 조사에서는, 외래 약물치료를 지속적으로 받는 아동이 62%였고, 38%는 약물치료를 자의로 중단하였다. 3) 약물치료 탈락군(비순응군)과 지속적인 치료를 받고 있는 군(순응군) 사이에 임상적 특성을 비교하였을 때, 부모학력, 사회경제상태, 아동 나이 및 성별 등 인구사회학적 변인들에서 차이는 발견되지 않았고, 아동의 발달력, 출산 및 주산기 문제, 의학적 문제, ADHD 외 공존병리 등에서도 차이는 발견되지 않았다. 심리학적 변인에서는 지능에서 유의한 차이가 있었다. 순응군이 전체지능지수, 언어 및 동작성 지능 지수가 유의하게 높았고, 상식, 산수, 토막짜기 점수도 유의하게 높았다. 약물치료력에 있어서는 임상가가 평가한 약물 반응이 순응군에서 유의하게 높았고, 약물 용량도 순응군이 유의하게 높았으며, 오후 약물 순응율(2003년 3월 평가)도 유의하게 순응군이 높았다. 또한 주치의의 지휘에 따라서도 순응율에 차이를 보였다. 결 론:국내에서는 최초로, 외래 치료를 받고 있는 ADHD 아동에 대한 MPH-IR 순응도를 조사하였다. 평균 1년 치료기간동안의 순응도는 62%로 외국에서의 연구결과와 유사하였으며, 지능이 높을 때, 약물반응이 우수하고, 약물용량이 높으며, 오후약물에 대한 순응이 초기에 높을 때 약물 순응률이 보다 높았다. 결국 약물치료 효과에 대한 만족도가 순응률 결정에 가장 중요한 요인이라고 생각되며, 약물치료효과를 높이기 위한 다양한 전략을 사용하여, 약물 순응도를 향상 시킬 필요가 있다고 생각된다.

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2020 Year of the nurse and the midwife: a call for strengthening midwifery in response to South Korea's ultra-low birth rate

  • Kim, Yun Mi
    • 여성건강간호학회지
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    • 제26권4호
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    • pp.255-259
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    • 2020
  • Along with the low birth rate in Korea, the aging of mothers is progressing very rapidly. Recent studies have reported that the obstetric infrastructure is crumbling due to the accelerating closures of obstetric medical institutions resulting from the low birth rate and low reimbursement rates for obstetric procedures. The number of birth centers has also decreased, but women's interest in natural birth has actually increased, such that deliveries at birth centers now account for 11.8% of deliveries in obstetric clinics. In the Netherlands, Japan, and the United Kingdom, initiatives to promote natural birth through care provided by midwives increased the rate of natural births, decreased the number of cesarean sections, and lowered the rate of postpartum complications. In light of these examples, South Korea should also encourage natural delivery by midwives. A national support system for midwife applicants is necessary, and the requirements for institutions that train midwives should be revised. Independent birth centers should have emergency prescription privileges, and women should be given the choice to have a natural delivery by creating birth centers within hospitals.

걷기의 생리학적 분석 - 체력 증진을 위한 운동 - (Physiological Analysis of Walking - Physical Exercise for the Promotion of National Health -)

  • 남기용;장신요;신동훈;성낙응;엄륭의
    • The Korean Journal of Physiology
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    • 제4권1호
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    • pp.1-11
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    • 1970
  • Studies on the analysis of walking were performed on 33 male subjects. A prescription of physical exercise (walking at a speed of greater than 6 km/hr for more than one hour daily) for the promotion of individual health is presented on the basis of walking analysis. Presumptions were made that adequate physical exercise does promote health and is beneficial for the healthy life and increases the life span. These presumptions were derived from the numerous experimental literatures. The literatures support indirectly the presumptions. The following results were obtained and prescription of physical exercise is presented. 1. Oxygen uptake in a walking on a treadmill at a speed of 4 km/hr was only 3 times of the resting oxygen uptake. This kind of moderate exercise did not stimulate the cardiopulmonary system adequately. Heart rate at a 4 km/hr walking was 101 beats/min in boys of less than 20 years old and 83 beats/min in adults. Oxygen uptake at a 6 km/hr walking exceeded 4 times of the resting oxygen uptake. It was interpreted that walking at 6 km/hr stimulated the cardiopulmonary system for the promotion of health. Heart rate at this speed was greater than 110 beats/min in boys and greater than 100 beats/min in adults. 2. Heart rates in a walking of 10 km/hr were 172 beats/min in boys, and 143 beats/min in adults, respectively. Maximal heart rates were 185 beats/min in boys, 180 in office clerks, and 168 beats/min in construction site laboreres. 3. The correlation between heart rate and oxygen uptake was high, namely, r>0.95. Subsequently heart rate could be used as a measure of degree of intensity of physical exercise instead of the cumbersome oxygen uptake measurement. 4. The prescription of physical exercise for the promotion of health is: Daily walking for more than one hour at a speed of greater than 6 km/hr. Bodily functions in this daily walking are in boys (body weight, 50 kg): heart rates of 110 beats/min; breathing frequency, 28/min; oxygen uptake, greater than 4 times of the resting uptake; pulmonary ventilation, 351/min; stride, 124 strides/min; cumulative number of strides for one hour, 7,440 strides, and energy expenditure of more than 300 kcal. In adults (body weight, 60 kg) the bodily functions are: heart rates of 100 beats/min, breathing frequency, 28/min; oxygen uptake, greater than 4 times of the resting uptake; Pulmonary ventilation, 301/min; stride, 127 strides/min; cumulative number of strides for one hour, 7,670 strides, and energy expenditure of more than 300 kcal.

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한 농촌지역에서 실시한 소아 급성호흡기감염 관리사업의 평가 -항생제 사용을 중심으로- (Evaluation of Acute Respiratory Infections(ARI) Control Programme in a Korean Rural Community -The Patterns of Antibiotic Prescription-)

  • 이영성;김창엽;김용익;신영수;고재욱
    • 농촌의학ㆍ지역보건
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    • 제18권2호
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    • pp.105-119
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    • 1993
  • The purpose of this study was to evaluate the program for the control of acute respiratory infections(ARI) in children in a Korean rural area(Yonchon county). Evaluating the program, we focused on the pattern of prescription and appropriateness of antibiotics prescribed by the health personnel who had participated in the ARI Control Program. It was implemented at the primary health care setting in rural area, such as district hospital, health subcenters, and health posts. During six-months programme monitoring period, medical records were reviewed and collected data were analysed by the pediatrician, research coordinator of this study. The baseline data were collected from medical records of the same period(six months) of one year before the implementation of the ARI programme. The study results were as follow : 1. Common cold was the most prevalent disease(78.7%. 594 cases) among the all ARI cases (755 cases). The less frequent cases were bronchitis(11.9%), acute pharyngitis(5.2%), and pneumonia(1.8%). 2. Significant reduction in the use of antibiotics was observed after the programme implementation. Ninety three(15.7%) of 594 common cold cases were received antibiotics compared with 282(35.2%) of 802 in the baseline period. In the cases of bronchitis and acute pharyngitis, the reduction rates were 15.1% and 23.2% respectively compared to the baseline period. 3. Mean duration of antibiotics prescription was 1.81-1.75 days, similar to the baseline data. 4. The appropriateness rate of antibiotics prescriptions were 84.3%(common cold), 35.6% (bronchitis) and 28.2%(acute pharyngitis). In the case of pneumonia, the antibiotics prescription was compatible to the criteria developed. 5. Pediatrician prescribed antibiotics more appropriately for all cases than general practitioners in health sub-center, and nurse practitioners in health posts. 6. Antibiotics therapy was shown to be of no effect in the treatment of the all ARI cases. At the 5 and 10 days check-up of common cold cases after visits, proportion of improved patients were 58.3% in the antibiotics-used group and 51.4% in the control group. In the other cases of ARI, the patterns of response were similar to common cold. None of the differences in outcome between the antibiotics-used and control group was statistically significant. This ARI programme may have substantial a substantial impact on antibiotics use at the public health institutions(district hospital, health subcenters, health posts) which are of major domain for primary health care in Korean rural areas.

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