약학대학 학생들의 학습 포트폴리오에 대한 경험과 인식

제남경 ( Nam Kyung Je ),이인향 ( Iyn Hyang Lee ) 영남대학교 약품개발연구소 2014 영남대학교 약품개발연구소 연구업적집 Vol.24 No.0

Background: Learning portfolio is a collection of evidence that learning has taken place. It has gained its reputation asa useful assessment tool in the education of health professionals. The purpose of this study is to describe the pharmacystudents` experiences and perceptions upon the introduction of a learning portfolio into the Introductory Pharmacy PracticeExperience course. Methods: Fifty five students from one pharmacy school who used a learning portfolio to documenttheir progress in the IPPE course participated in 16-item questionnaire exploring opinions and experiences oflearning portfolio preparation, assessment, and personal and professional development and reflection. Results: Most studentsagree that a learning portfolio is a valuable tool in promoting self-directed and reflective learning. However mostof them (46/55) also feel developing a portfolio is time-consuming, and when compared to their effort, an appropriatereward has not been given. Conclusion: To make the use of learning portfolios successful students should receive clearguidelines on their purpose, content and structure. Also the assessment criteria should be provided before the introductionof learning portfolio and their effort in developing learning portfolio should be rewarded.

Patterns and Persistence of Pharmacotherapy for Children and Adolescents with Attention Deficit Hyperactivity Disorder in South Korea

이경은,제남경,Lee, Kyeong Eun,Je, Nam Kyung Korean College Of Clinical Pharmacy 2018 한국임상약학회지 Vol.28 No.3

Objective: This study aimed to assess treatment persistence in Korean children and adolescents with attention deficit hyperactivity disorder (ADHD) and the factors influencing their adherence to ADHD pharmacotherapy. Methods: The study included patients between 6 and 18 years of age with ADHD who were taking various formulations of methylphenidate and atomoxetine on June 1, 2014. Patients were dichotomized as "persistent" or "non-persistent", depending on whether they continued ADHD therapy for 6 months (therapy persistence). We also investigated if the patients were taking the same medication(s) as before and also classified the patients as "medication persistent" or "non-persistent". Patient' characteristics were correlated with therapy persistence and medication persistence. Multiple logistic regression analyses were performed to assess potential risk factors for treatment persistence. Results: Overall, 3,317 patients were included in the analysis. A majority of patients were taking stimulants (82.0%), 16.2% were taking non-stimulants and 1.8% were taking a combination therapy of stimulants and non-stimulants. After 6 months, 2,290 patients (69.0%) continued to take medication for ADHD with 1,953 patients taking the same medication(s) as 6 months previously. Common positive factors for therapy persistence and medication persistence were identified as younger age, retardation, and developmental delay, and long-acting formulations of methylphenidate as either monotherapy or in a combination therapy may be used. Conclusion: ADHD medications were proven to improve academic performance and social skills of children. Collaboration between patients, parents, school staffs, and prescribers is required to improve the persistent use of ADHD medications.

SGLT2 저해제/metformin 고정용량복합제의 국내 사용 현황

최하은,이지원,제남경,정경혜,Choi, Ha Eun,Lee, Ji Won,Je, Nam Kyung,Jeong, Kyeong Hye 한국임상약학회 2022 한국임상약학회지 Vol.32 No.1

Background: The use of combination therapy and fixed-dose combination therapy is increasing for the treatment of type 2 diabetes. Sodium glucose cotransporter-2 inhibitor (SGLT2i) is a drug class used in combination with metformin. Methods: Type 2 diabetes patients on SGLT2i/metformin combination therapy were extracted from the 2019 Health Insurance Review & Assessment Service-National Patients Sample. On July 1, 2019, SGLT2i and metformin fixed-dose combination (SGLT2i/metformin FDC) and two-pill combination (TPC) groups were identified, and a chi-square test and multiple logistic regression were performed. Results: Of total 2,992 patients, 1,077 (36%) were prescribed SGLT2i/metformin FDC and 1,915 (64%) were prescribed TPC. We found that the most common comorbidities were in the order of dyslipidemia, gastrointestinal disease, and hypertension. Multiple logistic regression analysis showed that the use of SGLT2i/metformin FDC was lower than TPC in patients with diabetic neuropathy (OR=0.76, p=0.008). Clinic (OR=2.09, p<0.001) and general hospital (OR=1.40, p=0.019) showed higher tendency to prescribe SGLT2i/metformin FDC compared to tertiary hospital. The tendency of prescribing SGLT2i/metformin FDC was lower in Kyeonggi (OR=0.79, p=0.037), Gyeongsang (OR=0.77, p=0.025) and Chungcheong (OR=0.68, p=0.007) than Seoul. Conclusion: Factors related to the use of SGLT2i/metformin FDC in patients with type 2 diabetes were complication, medical institution and region. The tendency to prescribe SGLT2i/metformin FDC was relatively higher in clinics than in tertiary general hospitals and in Seoul than in other regions.

병용금기, 연령금기 경고 등급화 방안과 DUR 처방변경률 분석

이수옥(Soo Ok Lee),제남경(Nam Kyung Je),김동숙(Dong-Sook Kim),천방옥(Bang Ok Cheun),황인옥(In Ok Hwang) 대한약학회 2015 약학회지 Vol.59 No.6

Abstract—The computerized prospective Drug Utilization Review (DUR) program supported by the Korean government has provided alerts to physicians and pharmacists since December 2010. This study aims to propose and apply the tiering system in “drug combinations to avoid (DCA)” and “age-precaution” alerts based on severity to improve the compliance of users. To propose the severity and clinical importance of 647 DCA alerts and 140 age precautions, a Delphi evaluation survey was conducted. An expert panel comprising 5 clinical pharmacists and 5 physicians were participated in mail surveys. Based on the results of Delphi survey, DCA pairs were classified into 3 groups; group 1 (70.6%), 2 (26.9%), and 3 (2.8%). Drug-age precaution ingredients were also classified into three groups; group 1 (53.6%), group 2 (40.7%), and group 3 (5.7%). When this grouping was applied to claim data from 2011 to 2013, the majority of alerts had occurred in the groups of high severity. Presenting DUR alerts with severity level is expected to improve the compliance of clinicians. The implementation of tiering system in DUR criteria should be considered.

약물사용검토 서비스에 대한 개국약사들의 인식을 탐구한 질적 연구

이인향 ( Iyn Hyang Lee ),제남경 ( Nam Kyung Je ),경은정 ( Eun Jung Kyung ),김종윤 ( Jong Yoon Kim ),이숙향 ( Su Khyang Lee ) 한국보건경제정책학회(구 한국보건경제학회) 2011 보건경제와 정책연구 Vol.17 No.3

‘의약품 처방조제지원서비스’의 전국 확대의 즈음에 개국약사들의 인식을 고찰하고 이들의 시각에서 해당 제도의 효율성을 높이고 효과를 향상시킬 수 있는 방안을 모색하고자 하였다. 질적 연구. 유의추출법(purposive sampling)과 눈덩이모집법(snowballing sampling)을 이용하여 모집된 지역약국 약사를 전화 또는 대면 심층인터뷰를 하였고 수집된 자료를 프레임분석기법을 이용하여 분석하였다. 개국약사 31명이 연구에 참여하였으며, 이들 중 2인 미만 소형약국의 개설약사가 과반수이상으로 우리나라 개국약국가의 전형적 특성을 보였다. 지금까지 약사들은 지식정보의 한계, 시간적 제약, 처방의사와의 관계, 환자들의 부정적 반응 등의 현실적 어려움 때문에 자발적 약물사용검토를 습관적, 수동적, 소극적으로 제공하는 경향을 보였다. 정보기술 기반 네트워크를 이용한 의무적 약물사용검토 제도는 상존하던 어려움들 중 일부(환자의 약물복용 정보의 실시간 제공, 의/약사 최소한의 소통을 하도록 할 것)에는 긍정적인 영향을 미칠 수 있을 것으로 생각되었다. 다른 한편, 새로운 제도가 약사 업무를 가중시키거나, 의사나 환자와의 관계를 악화시킬 것이라는 등 부정적인 전망도 상당하였고, 불합리하다고 느낀 사항을 구조적으로 개선하고 발전시키고자 노력하기 보다는 손쉬운 개별적 우회로를 찾아 어려움을 해결하려고 할 가능성이 있어보였다. ‘처방조제지원서비스’가 ‘환자의 안전한 약물 사용’이라는 궁극적 목적을 달성할 수 있기 위해서 거시적, 미시적 측면의 정책적 함의가 도출되었다. 전자는 관련 정책전반에 대한 공감대 형성, 관련전문가 간 신뢰제고, 수요자를 고려한 쌍방형 정보의 제공 등을, 후자는 ‘처방조제지원서비스’이 제공하는 정보의 질과 양에 대한 지속적 모니터링과 향상, 융통성 있는 제도운영 등이 포함되었다. 주치약사제도가 ‘처방조제지원서비스’만으로 극복할 수 없는 현실적 문제점을 해결해 줄 수 있는 정책적 대안으로 제시되었다. 약학대학 및 관련 전문가단체는 약사가 사회가 요구하는 전문직능인으로서의 역량을 발전시킬 수 있도록 교육적 뒷받침을 제공할 필요성이 컸다. The study aimed to investigate community pharmacists`` perceptions on drug utilization review (DUR) in South Korea. The concrete situation of this newly launched system at practices as well as challenges and prospects were explored. A qualitative study. We performed indepth interviews with 31 community pharmacists who were recruited through a purposive sampling or a snowballing sampling. Data were analyzed using the framework approach. Community pharmacists have provided DUR services only to the limited degree due to the shortage of available information and time. Poor communication with prescribers and negative response from patients have also discouraged the pharmacists from being actively engaged. A newly launched, computerized DUR system has being expected to reduce some of the difficulties and contribute to the rational utilization of medicines by giving relevant information in a timely manner and putting legal responsibility on prescribers and dispensers. In the other hand, participants concerned heavier work load and increasing tensions with doctors or patients. Additionally, there were some signs indicating that the system could be operated far from the purpose if service givers sought an individual "bypass" against possible disadvantages. To achieve the aims of the DUR system in South Korea, dual policy efforts should be made at a macro level (e.g. making social consensus, giving appropriate professional training) and a micro level (e.g. monitoring the quality of DUR information, settling down the system technically).

약학회담(藥學會談) : 일반의약품 설명서의 이해도와 적정 사용가능성 평가

이인향 ( Iyn Hyang Lee ),이형원 ( Hyung Won Lee ),제남경 ( Nam Kyung Je ),이숙향 ( Sukhyang Lee ) 영남대학교 약품개발연구소 2013 영남대학교 약품개발연구소 연구업적집 Vol.23 No.0

A product labelling is one of key tools in ensuring that a patient uses drugs safely and effectively in self-care without professional support. This study aimed to explore the readability and comprehensibility of the information contained on two package inserts of medicines. Two package inserts were tested with first year college students. Fifty-one potential consumers underlined words they could not understand and answered 10 scenario questions. Any differences among groups with different characteristics were statistically tested. Secondly, the readability of two package inserts was assessed with comparison to the level of the 6th grade Korean textbooks. As results, more than 80% of participants properly replied to straightforward questions concerning indication, dosage, duplication, use in pregnancy and contraindication, and 73% about formulation. Less than half answered correctly in multiple choice questions about pediatric use (41%) and side effects (35%). Little discrepancy was observed in the comprehensibility between participants` characteristics. Drug inserts contained about 20% more professional-level words than 6th grade textbooks. In conclusion, Korean consumers may face challenges to understand drug information due to professional terminology and outdated expressions in the current package inserts. To secure safe and effective use of over-the-counter agents, greater efforts should be made to develop more consumer friendly labels. In the other hand, educational supports are required to prepare consumers in a proper level of knowledge for the safe use of drugs.

일반의약품 설명서의 이해도와 적정 사용가능성 평가

이인향(Iyn-Hyang Lee),이형원(Hyung Won Lee),제남경(Nam Kyung Je),이숙향(Sukhyang Lee) 대한약학회 2012 약학회지 Vol.56 No.5

A product labelling is one of key tools in ensuring that a patient uses drugs safely and effectively in self-care without professional support. This study aimed to explore the readability and comprehensibility of the information contained on two package inserts of medicines. Two package inserts were tested with first year college students. Fifty-one potential consumers underlined words they could not understand and answered 10 scenario questions. Any differences among groups with different characteristics were statistically tested. Secondly, the readability of two package inserts was assessed with comparison to the level of the 6th grade Korean textbooks. As results, more than 80% of participants properly replied to straightforward questions concerning indication, dosage, duplication, use in pregnancy and contraindication, and 73% about formulation. Less than half answered correctly in multiple choice questions about pediatric use (41%) and side effects (35%). Little discrepancy was observed in the comprehensibility between participants' characteristics. Drug inserts contained about 20% more professional-level words than 6th grade textbooks. In conclusion, Korean consumers may face challenges to understand drug information due to professional terminology and outdated expressions in the current package inserts. To secure safe and effective use of over-the-counter agents, greater efforts should be made to develop more consumer friendly labels. In the other hand, educational supports are required to prepare consumers in a proper level of knowledge for the safe use of drugs.

의약품의 허가외사용 정보제공과 동의에 대한 일반인 인식

이인향 ( Iyn Hyang Lee ),계승희 ( Seung Hee Kye ),제남경 ( Nam Kyung Je ),이숙향 ( Suk Hyang Lee ) 영남대학교 약품개발연구소 2015 영남대학교 약품개발연구소 연구업적집 Vol.25 No.-

Objective: This study aims to explore the perception of off-label use of medications and the provision of informed consents from the general public’s perspective. Methods: The study subjects (n=291) were recruited from 7 cities in Korea through a convenience sampling method. The self-administered questionnaire with 13 items was issued and collected. The study subjects who have had a pharmaceutical job were excluded. Results: The total of 231 respondents was included. Only 23% of respondents were familiar with the concept of off-label use of medications. Eighty five percent of respondents (n=196) stated that the prescribers should explain the off-label use of a medication to their patients. The preferred method for delivering the message was the oral explanation (n=122, 53%), followed by oral explanation plus a pamphlet (n=94, 41%). The safety issue is the most concerned aspect regarding the off-label drug use, also effectiveness and insurance coverage. The majority of respondents (n=217, 94%) agreed that the prescriber should get a consent from patients before prescribing medications for off-label use. They preferred written consent to oral consent (140 vs. 77). Conclusion: This study demonstrated general publics are infrequently aware of off-label use of medications. It is important to raise public awareness of the off-label use of medications and to openly discuss its pros and cons for safe and effective drug therapy.