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Major Depressive Disorder 질환성 노인 환자들의 치료제 평가
임옥정,이옥상,윤혜설,최경식,임성실 대한약학회 2013 약학회지 Vol.57 No.2
Depressive disorders are the most common psychiatric problem in the elderly. Most depression treatment guidelines emphasize treatment with antidepressant medication and recommend that benzodiazepine use be minimized for limited period, particularly to elderly patients. In order to evaluate appropriate use of antidepressants and benzodiazepine, retrospective review of prescriptions was performed. The study population are older than 65 years who had been newly diagnosed with major depressive disorder in specialty mental health at a community general hospital from January 1 st , 2007 to October 31 th , 2012 (N=373). Initial antidepressant accounted for 89.5% with SSRI, and escitalopram accounted for 60.9% of SSRI group. 79% or more of the patients were prescribed the recommended dosage. The maintenance rate for 4 weeks of initial antidepressant was 48% and 6 weeks was 39%. Treatment-discontinuation rate was 68% at 3 month. Alprazolam (short acting benzodiazepine) was prescribed the most, followed by clonazepam (long acting benzodiazepine) and then diaz- epam. 55% of patients received a duplicated prescription for short acting plus long acting benzodiazepine. 61% of patients used long acting benzodiazepines. Prescribed dosages of benzodiazepines were commonly within a recommended range, while no one was prescribed a appropriate period (up to 2 weeks) except for the early discontinued patients. Appropriate use of zolpidem was only 16.2%. The depressed elderly treated in specialty mental health mostly received long-term treat- ment with benzodiazepines in combination with antidepressants, guideline recommendations was not followed. Multi- disciplinary interventions like audit and feedback of benzodiazepine use are needed and education for the elderly is needed to properly maintain antidepressant treatment.
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김미경,정현희,최지혜,임옥정,이영아,주정흔,이지선,윤혜설 한국병원약사회 2005 병원약사회지 Vol.22 No.4
To enhancing availability and satisfaction of medical staffs about drug information, it were conducted quality improvement(QI) program. We improved the quality or quantity of drug information by increasing OCS drug information's quantity, standardizing of drug identification consultation sheet form, and increasing the number of newsletter's page. It were evaluated 'satisfaction increase' and 'dissatisfaction decrease' as indicator of quality measurement through questionnaire filled out by doctors and nurses. After QI program, in the question concerning satisfaction about OCS drug information, 'very enough' or 'enough' were 49.3%, and 'not enough' or 'very not enough' were 5.8%(satisfaction increase 6.4% point, dissatisfaction decrease 13.2% point). In addition, after increasing OCS drug information's quantity, the number of use times were increased. In the question concerning newsletter, respondents' perception ratio were increased, especially in doctor respondents. And also standardization of drug identification consultation sheet form caused of decreasing dissatisfaction. In the question concerning the drug formulary publishment, because arguments for and against were similar to each other, drug formulary were published in summary information for request of users and cost-effective issue. In conclusion, after QI program, overall availability and satisfaction about drug information were improved.
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