대장암에 대한 항암화학요법 사용평가

방은미,박윤희,김원규,임금숙 한국병원약사회 2010 병원약사회지 Vol.27 No.2

Colorectal cancer is the third most frequently diagnosed cancer in Korea (2007). It is the third leading cause of cancer death in men and the forth leading cause of cancer death in women. The mortality from colorectal cancer has increased slightly over the past 10 years for the westernization of Korean diet. But the survival rate is increasing with endoscopic surgery and chemotherapy regimens including a VEGF(Vascular Endotherial Growth Factor) inhibitor or an EGFR(Epidermal Growth Factor Receptor) inhibitor. The objective of the study is to review and evaluate the adjuvant chemotherapy after surgery and the chemotherapy of advanced or metastatic disease by NCCN(National Comprehensive Cancer Network) guideline in oncology (for colon cancer) V.2.2010. We reviewed retrospectively the EMR of 29 patients who had received adjuvant chemotherapy after surgery from January 2007 to December 2009. The use of adjuvant chemotherapy for patients with stage II colon cancer is controversal. The adjuvant therapy with FOLFOX, 5-FU/LV or capecitabine is recommended for patients with stage III disease, and as an option for patients with high-risk stage II disease by NCCN guideline. And irinotecan-containing regimens should not be used as adjuvant therapy in colon cancer. All of the patients with stage II lesions were received LF regimen regardless of risk-based stage in NPH(National Police Hospital). The use of irinotecan-containing regimens(IFL or FOLFIRI) as adjuvant therapy in 3 cases of 21 cases is not appropriated(14.3%). Recommended initial therapy options for advanced or metastatic disease depend on whether or not the patient is appropriate for intensive therapy. And chemotherapy options for patients with progressive disease are dependent on the choice of initial therapy. The use of IFL regimen for advanced disease is no longer recommended for its toxicity and is removed from the guideline. However we found that 5 cases of 9 patients in advanced or metastatic disease were received IFL regimen. Therefore, it is recommended that the use of IFL regimen for advanced disease should be limited.

초등학생이 지각하는 무용수업 재미요인이 몰입과 참여지속 의도에 미치는 영향

방은미,김정원,전진욱 한국발육발달학회 2022 한국발육발달학회지 Vol.30 No.2

The purpose of this study is to investigate the effect of the fun factors in dance classes perceived by elementary school students on immersion and participation intention. We were selected for the final 265 people in the study sample. In addition, we conduct a frequency analysis to determine the demographic characteristics and the reliability tests were conducted and exploratory factor analysis to analyze the validity and reliability of the questionnaire. If the demographic characteristics and for fun Learn the difference between factors by conducting a t-test and one-way ANOVA, correlation analysis, and multiple regression analysis the results were as follows. First, regarding demographic characteristics, there is partially significant difference found in fun factors. Second, among the sub factors of fun factors, when they perceive their interest, stress, social life, teacher’s charm, or recognition more highly, their commitment becomes higher, too. Third, among the sub factors of fun factors, when they perceive their interest, stress, or social life more highly, their sustained involvement in participation gets higher, too. Fourth, when their dance commitment is higher, their sustained involvement in participation also becomes higher.

국립병원의 고령 환자에 대한 약사의 중재역할과 노인의료 활성화에 대한 제언

박윤희,방은미 한국병원약사회 2016 병원약사회지 Vol.33 No.1

Background : The elderly population is rapidly increasing in Korea. The issue of polypharmacy has become one of the main problems in geriatric care due to the high prevalence of chronic disease in older persons. In this study, we investigated the current status of inappropriate multiple drug prescriptions in retired police officers aged ≥ 65 years, who were scheduled from March to April in 2015. This was a retrospective study to survey the prevalence of potentially inappropriate medications (PIMs) used for elderly patients. Selection of PIMs was based on the Beers/STOPP criteria and additional proposal. We researched the medication profiles of a total of 358 geriatric patients, who were scheduled in outpatient department at National Police Hospital during the period of the 1st of March to the 30st of April of 2015. The objective of this study was to confirm the intervention role of pharmacists in elderly patients, and determine further usefulness of the Comprehensive Geriatric Assessment in the extension of the role of pharmacists in the alteration of prescription. Methods : We included 358 elderly patients older than 65 years who visited the outpatients' clinic from March 1st 2015 to April 30th 2015. Comprehensive geriatric assessments, drug-drug interaction, creatinine clearance, overlapping prescription of similar efficacy, including medication review by the pharmacists were performed. Beers/STOPP criteria and additional proposal were used to determine PIMs. Statistical analysis was performed using the Pearson’s Chi-square test version 11.0(SPSS). A p-value of <0.05 was considered statistically significant. Results : A total of 179 cases (50%) by Beers criteria and 80 cases (22.3%) by additional proposal were prescribed with PIMs. After the intervention of pharmacists, the percentage of the patients who received inappropriate medication by Beers criteria decreased by 28.4% (102 cases). According to increasing numbers of diagnoses, increases were observed for a total number of medicines per patient (<0.003), the risk of inappropriate prescription by Beers/STOPP criteria (<0.001), the risk of adverse drug reaction (<0.001) and a total number of medicines to be considered for renal function (p<0.001). Increasing the total number of medicines per patient was correlated with the risk of inappropriate prescription by Beers/STOPP criteria (<0.001), the risk of adverse drug reaction (<0.003), a total number of medicines to be considered for renal function (p<0.001) and prescription of anticoagulant, antithrombotic and antiplatelet agents (<0.001). Conclusion : A considerable number of cases of prescriptions likely to cause adverse events in older patients were identified. Our study raised the alert for harmful effects of polypharmacy and the necessity of well-structured drug monitoring system for older persons. The intervention of pharmacists in this study was associated with significant reductions in inappropriate prescribing. Our results demonstrated that the medication assessment of pharmacists leads to safer and more appropriate pharmacotherapy for elderly patients. Therefore, the intervention of pharmacists in older patients should be considered to reduce incidences that are related to the pharmacotherapy and the extension of the role of pharmacists for the prescription process.

MIS(Management Information system)에 의한 효율적 재고관리 방안 - 의료소모품을 중심으로 -

박윤희,방은미,김원규,임금숙 한국병원약사회 2010 病院藥師會誌 Vol.27 No.4

Background : Recently, increasing of the use of medical supplies, expensive medical equipments and related accessories led to decrease in hospital earnings, caused increasing amount of the total stock. Therefore, most of large hospitals tried to cut costs and minimize their stock through effective stock management. Adapting to the environmental change, we came to build MIS to do effective stock management. Through this study, I tried to suggest for effective stock management by using Management Information System. Methods : Previously being mentioned , for this background, National Police Hospital came to build a MIS(Management Information System) in 2007. Pharmacy department in this hospital handles about 3,648 kinds of products like medical supplies, chemical reagents, dental materials and so on. We categorized 3,648 kinds of products as 11 items and made systematized cords on each of them. Also, we have changed methods on demand and supply to reduce stocks and keep the balance of inventories. We introduced the process of making a payment after using on specific and high priced materials. Results : First, we can reduce making mistakes and omission of prescribing by categorizing of products and systematized cords. Secondly, we can keep the optimal stock management by decreasing inventory of each department. The manager in pharmacy can find the current state of using department stocks through MIS. Thirdly, we can make the best use of budget by adapting new payment method about specific and high priced materials. Finally, we made a new type written request about equipment supplies. As a result, we can manage them effectively by fully getting the information of equipment supplies. Conclusion : We can check the current state of stocks by using MIS in real time. Changing method of demand and supply led to decreasing of making mistakes and omission of prescribing about specific and high priced materials. It contributed to increasing of hospital funds and protecting against loss. However, bar-code system is not yet being done. If we adapt bar-code system to stock management, we can rather manage the term of validity of medical supplies than before.

항생제 전산관리시스템의 도입에 따른 항생제 사용의 평가

노은숙,박윤희,방은미,김원규,임금숙 한국병원약사회 2009 病院藥師會誌 Vol.26 No.4

The purpose of antibiotic treatment is the eradication of microorganism from infection sites. To achieve the desired therapeutic effect, choosing the right amount of the proper antimicrobial agent and using it at the precise time is important. The National Police Hospital tried to manage the use of antimicrobial agent by creating a guideline for the antimicrobial remedy. The National Police Hospital has developed the CPOE system(computerized physician order entry system) which links the medicine master and introduced the program for restricted antimicrobial agents in July, 2008. This study was designed to evaluate the new system for antimicrobial agent of analyzing the total amount of antimicrobial administered, the proportion of the general antibiotics and the reserved antibiotics and the restricted antibiotics, the data of the permission program for application of the restricted antibiotics for 2 years (August, 2007-July, 2009). The results shows that the total amount of antimicrobial usage for 1 year decreased 7.3% compared with the year before appling the new system. In addition, the proportion of the restricted antibiotics decreased from 6.9% to 4.9%.

입원환자의 경구용 levofloxacin 약물 사용 평가

임금숙,노은숙,박윤희,방은미,김원규 한국임상약학회 2009 한국임상약학회지 Vol.19 No.2