노인환자에게 제공하는 개국약국 약료서비스의 경제적 가치

손현순,신현택,Sohn, Hyun-Soon,Shin, Hyun-Taek 대한약학회 2007 약학회지 Vol.51 No.5

This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.

우리나라 보건의료계열 대학의 인문사회 교육과정 분석

손현순(Hyun Soon Sohn),구정선(Jung seon Koo),백드보라(Deborah Baik),김현진(Hyun Jin Kim),강혜영(Hye-Young Kang) 대한약학회 2021 약학회지 Vol.65 No.3

Medical humanities are important disciplines in the education of healthcare professionals to achieve the goal of training healthcare professionals with a deep understanding of human beings and society. In this study, we investigated the scope of humanities and social science education proposed by the accreditation criteria of healthcare professional colleges, including medical, dentistry, oriental medicine, and nursing schools in Korea. Specific curricula related to humanities education were investigated from 19 medical schools, nine dentistry schools, 12 oriental medical schools, and 18 nursing schools. The most frequently offered liberal arts courses were English and writing, while major courses included ethics, regulations, communication, psychology, history, and management. Humanities courses tend to be placed in lower grades and social sciences in higher grades, but overall, education in humanities and social studies is spread throughout the entire school grades. This result would be an important reference in designing humanities and social medicine curricula integrated with six-year pharmacy school educational programs. Subjects such as pharmacy ethics, professionalism, pharmacy communication, history of pharmacy, healthcare policies and health insurance, regional public health and health promotion, management, and evidence-based pharmacy are suggested. Further discussions on the best selection of subjects and teaching methods should be continued.

정신신경용계 의약품의 치료군 중복처방 평가기준(안) 개발

손현순(Hyun Soon Sohn),최윤영(Yoon Young Choi),이영숙(Young Sook Lee),최경업(Kyung Eob Choi),신현택(Hyun Taek Shin) 대한약학회 2011 약학회지 Vol.55 No.3

Therapeutic duplication (TD) is frequently reported inappropriate drug use in healthcare settings in Korea. This study was aimed to develop TD criteria for psycho-nervous system drugs (KFDA classification 117 and 119). ATC classification was used to determine therapeutic and/or chemical similarities among the 93 ingredients reviewed. Clinical practice guidelines, textbooks and product labels were referenced for principles and evidences of possible drug combination usage. 16 groups that listed ingredients to be considered as TD were established and the criteria would be helpful to prevent TDs.

우리나라 폐동맥고혈압환자에 대한 Bosentan과 Iloprost의 비용-효용 분석

손현순(Hyun Soon Sohn),이태진(Tae-Jin Lee) 대한약학회 2010 약학회지 Vol.54 No.2

This study was conducted to analyze cost-utility of bosentan versus iloprost indicated for pulmonary arterial hypertension (PAH) in a Korean healthcare setting from a payer’s perspective. We constructed a Markov model to estimate total costs and outcomes for 1-year time horizon in a hypothetical cohort of 50-year-old patients with PAH. Base analysis showed that bosentan resulted in KW 5.5 billions saving and 18 quality-adjusted life year (QALY) gains per 100 patients compared to iloprost. Bosentan as a dominant strategy was found to be robust through various sensitivity analyses.

세균성결막염에 대한 안과용 플루오로퀴놀론계 항균제의 효과 : 체계적문헌고찰

손현순(Hyun Soon Sohn) 대한약학회 2011 약학회지 Vol.55 No.1

This systematic review was conducted to assess the clinical effect of ocular fluoroquinolones used for the treatment of bacterial conjunctivitis. A literature search for randomized controlled clinical trials registered up to January 2010 based on PubMed database, using the following search terms: conjunctivitis and fluoroquinolones (besifloxacin, moxifloxacin, gatifloxacin, levofloxacin, lomefloxacin, ciprofloxacin and ofloxacin) were performed. Pooled data on the clinical resolution and bacterial eradication rates derived from selected 16 studies were reported as the relative risk (RR) and 95% confidence interval (95% CI) compared with placebo. Early clinical resolution and microbiological eradication rates in placebo were 28% and 62% respectively. Fluoroquinolones were significantly effective comparing to placebo: early RR 1.94 (95% CI 1.60~2.34) and late RR 1.30 (1.19~1.43) in clinical resolution rates, and early RR 1.75 (1.58~1.94) and late RR 1.28 (1.18~1.39) in microbiological eradication rates. Besifloxacin, ciprofloaxain and moxifloxacin in clinical resolution, and besifloxacin and levofloxacin in microbiological eradication showed higher RRs than pooled overall fluoroquinolones' RRs. New quinolones had higher antibacterial potencies for all pathogens isolated from bacterial conjunctivitis and resistant isolates than old generation quinolones. In conclusion, ocular 7 fluoroquinolones were all effective than placebo for bacterial conjunctivitis and there were differences between quinolones in early and late clinical resolutions and microbiological eradications, and no differences in safety comparing to placebo.

약물유산과 수술유산의 임상 성과 비교 : 체계적 문헌고찰 및 메타분석

김현진(Hyun Jin Kim),박수린(Su Lyn Park),손현순(Hyun Soon Sohn) 대한약학회 2021 약학회지 Vol.65 No.3

According to the recent legal changes concerning abortion in Korea, clinical pharmacists are required to improve their evidence-based knowledge of medical abortion using mifepristone and misoprostol. This systemic review and meta-analysis compared clinical outcomes between medical and surgical abortion methods at the first trimester of pregnancy using acceptability and satisfaction, as well as methods that are currently available worldwide. PubMed, KMbase and KISS databases were utilized for literature searches, and randomized controlled studies reporting complete abortion as a primary endpoint were analyzed. The program Review Manager version 5.4 (Cochrane Collaboration) was employed to estimate the pooled risk ratio (RR) with 95% confidence interval (CI); random effect models were applied for all analyses. A total of 1,093 studies were identified, nine of which were eligible and selected for a meta-analysis. The pooled complete abortion rate was higher for surgical abortion than for medical abortion (RR 1.07, 95% CI 1.04-1.09). As a complication of intervention, bleeding (RR 3.29, 95% CI 2.21-4.91), nausea (RR 2.82, 95% CI 2.26-3.51), vomiting (RR 5.71, 95% CI 3.60-9.06), pain (RR 1.61, 95% CI 1.18-2.20) and fever (RR 2.36, 95% CI 0.97-5.75) all scored higher for medical abortion than for surgical abortion. However, acceptability (RR 1.25, 95% CI 1.12-1.40) and satisfaction (RR 1.60, 95% CI 1.34-1.89) scored higher for medical abortion than for surgical abortion. While medical abortion showed statistically significant weakness compared with surgical abortion with regard to complete abortion and complications, personal preferences could be better for medical abortion due to surgical intervention related fears. This study could significantly help women who prefer abortion in decision making as well as pharmacists in providing professional services regarding miscarriage medicines in clinical settings.

의약품 부작용에 관한 국제 분류체계인 WHO-ART와 MedDRA의 비교분석

임경화,신현택,손현순,전효정,이주현,이유정,이영숙,송인숙,Lim, Kyung-Hwa,Shin, Hyun-Taek,Sohn, Hyun-Soon,Jun, Hyo-Jung,Lee, Joo-Hyun,Lee, Yoo-Jung,Lee, Young-Sook,Song, In-Sook 한국임상약학회 2007 한국임상약학회지 Vol.17 No.1

This study was aimed to provide the controlled terminology for adverse drug reactions by selecting an appropriate internationally standardized classifications (WHO-ART or MedDRA). We collected the relevant information on ADR terminology systems including WHO-ART and MedDRA by online searching and visiting pharmaceutical companies and WHO UMC (Uppsala Monitoring Centre, Uppsala, Sweden). For MedDRA, project leader directly communicated with the officer of MSSO (Maintenance and Support Services Organization). Collecting all the pertinent information, two possible terminology classifications or systems (WHO-ART and MedDRA) were compared in the views of acceptability, cost-effectiveness and international feasibility and reviewed by the consultation committee and finally WHO-ART was selected.

단골약국의 필요성과 단골약국에 기대하는 서비스

이주현(Joo Hyun Lee),김혜린(Hye-Lin Kim),한혜성(Hye Sung Han),박일호(Il-Ho Park),손현순(Hyun Soon Sohn) 대한약학회 2023 약학회지 Vol.67 No.1

We wanted to examine people’s demands for a family pharmacy and expected services. We conducted webbased survey and recruited subjects by convenience sampling method. This cross-sectional survey, a 24-item questionnaire, inquired about subjective health problems, pharmacy use, desire to designate one's own family pharmacy, and decision considerations. The Mann-Whitney test, Kruskal-Wallis test, and logistic regression were used to detect these components. 68.8% of the 449 respondents were willing to name their family pharmacy. 89.9, 82.7, 81.3, and 78.6% of respondents agreed that a proximity to home, proximity to the medical institution they usually attend, good setting for counseling, and storage of a wide variety of medications were important pharmacy characteristics when choosing a family pharmacy. 93.3, 93.1, and 88.9% of respondents, respectively, evaluated a conscience, professionalism in pharmaceutical care, and counseling ability as essential pharmacist qualities. Regarding expected service from a family pharmacy, 52.8, 38.8, and 39.4% of respondents highly agreed on a comprehensive medication review, overall health-related counseling, and resolving queries regarding medicines or dietary supplements, respectively. Koreans generally want a family pharmacy, especially women and middle-aged people. To provide services, customers expect answers to various queries concerning medications; therefore, it is vital to be a highly conscientious and professional pharmacist and to create an environment conducive to counseling.

호흡기계 작용 약물의 치료군 중복처방 평가기준 개발

최경업(Kyung Eob Choi),손현순(Hyun Soon Sohn),김남효(Nam Hyo Kim),신현택(Hyun Taek Shin),이영숙(Young Sook Lee) 대한약학회 2012 약학회지 Vol.56 No.2

Purpose: To develop therapeutic duplication criteria for the drugs used for respiratory diseases. Method: Therapeutic duplication was defined as "more than 2 drug ingredient-usage in which each has the same therapeutic effect and combination therapy does not confer additional therapeutic benefit". Respiratory system drugs approved in Korea were examined for the study. The WHO’s Anatomical Therapeutic Chemical Classification System was used for grouping of the corresponding drug ingredients. The principles and recommendations on combination usage or multiple drug regimens were reviewed by using the clinical practice guidelines, textbooks, product labelings, and clinical articles. Clinical expert group consultation was performed and expert opinions were incorporated into the final criteria. Results: Nine hundred sixty two drug products with Korean Food and Drug Administration classification codes of 141, 149, 222, and 229 were evaluated, of which 87 active ingredients were composed. The drug ingredients were classified into 12 groups (antihistamines, oral nasal decongestants, leukotriene receptor antagonists, inhaled anticholinergics, inhaled corticosteroids, oral β2-agonists, long-acting β2-agonists, short-acting β2-agonists, xanthines, antiallergics, mucolytics and cough suppressants). The use of more than 2 drug ingredients including the same group was therapeutic duplication, and thus combination should be recommended not to be used. Conclusion: Twelve drug groups were identified as therapeutic duplication criteria. Combination therapy within each group should not be used otherwise therapeutic benefits outweigh potential risks.

우리나라 노인들의 노인 친화형 의약품 제형 공급의 필요성에 대한 인식

이은주(Eun Joo Lee),손현순(Hyun Soon Sohn) 대한약학회 2023 약학회지 Vol.67 No.4