• Title, Summary, Keyword: Retrospective review

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Review of the Retrospective Drug Utilization Review Program from Foreign Countries' Experience (외국의 후향적 DUR 제도 현황과 정책적 함의)

  • Kim, Dong-Sook;Kim, Su-Kyeong;Jang, Sun-Mee
    • YAKHAK HOEJI
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    • v.55 no.3
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    • pp.173-184
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    • 2011
  • The purpose of this study was to review foreign retrospective Drug Utilization Review(DUR), and so to suggest a development plan suitable for use with domestic situation. Literature review of foreign retrospective DUR program and domestic project such as DUR and prescribing analysis project were reviewed. To improve prescribing quality, developed countries such as US, Canada, UK, France, and Australia have implemented various forms of policy. Based on the review of foreign retrospective DUR program, we suggested to apply practical implementation of retrospective DUR program.

Retrospective Drugs Utilization Review Study for Chronic Kidney Disease Using National Health Insurance Database (건강보험 자료를 이용한 만성신부전 환자의 신독성 약물사용 현황)

  • Kim, Dong-Sook;Lee, Hyun-Jeong;Son, In-Ja;Kim, Gui-Sook;Shin, Joo-Young;Lee, Kun-Sei
    • YAKHAK HOEJI
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    • v.53 no.3
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    • pp.138-144
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    • 2009
  • The purpose was to implement drug utilization review (DUR) for whom were diagnosed with chronic kidney disease (CKD) population using health insurance claim data. This study constructed drug utilization database using Health Insurance Review and Assessment Service (HIRA) database and selected contraindicated drugs with kidney based on previously developed drug utilization guide and reviewing other countries' examples. Main outcome measures were the proportion of prescription for 1 or more drugs of concern. The cohort included 115,948 subjects, who were diagnosed with chronic kidney disease. Inappropriate drugs with CKD patients was some used, and the most commonly prescribed classes were aluminum drugs. However it is difficult to find problems with inappropriate drug because claims data doesn't have laboratory data. Based on the result of retrospective drug utilization review study, more studies should be analysed drug utilization patterns and monitoring system should be developed.

Retrospective Drug Utilization Review of Antibiotics for Respiratory Tract Infection(RTI) in Ambulatory Outpatient Care (외래 호흡기계 질환에서 항생제 사용에 대한 후향적 평가방안)

  • Kim, Dong-Sook;Bae, Green;Kim, Su-Kyeong;Lee, Hak-Seon;Kim, Yoon Jin;Lee, SukHyang
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.291-303
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    • 2012
  • As respiratory tract infections (RTI) account for about 60% of all antibiotic prescriptions in outpatient care setting, there are significant concerns about emerging resistance that are largely due to the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study was aimed to develop retrospective drug utilization review (DUR) program of antibiotics for RTIs using Delphi methods. Retrospective DUR criteria of antibiotics for RTIs were identified based on clinical practice guidelines and opinion of experts. Expert panel members were clinical doctors and pharmacists and Delphi method was applied by survey on 16 members of panels. The claim data from Korean Health Insurance Review & Assessment (HIRA) were used to examine trends in outpatient antibiotic prescription between Janunary to December of 2008. As results, Quality index for RTI was assessed for the claim type, antibiotics use of quantity, duration, number and cost. Antibiotic prescription rate for RTIs, Defined Daily Dose (DDD), and duration of antibiotics use were more recognized as significant quality index by experts' opinion. Use of first line agents suggested by guidelines was low and duration of antibiotics use was shorter compared to the recommendations. Antibiotics were over prescribed for RITs. However, dose and duration of antibiotics were under-used.

The Retrospective Review of 410 Shoulder Pain Inpatients in Korean Medicine Hospital (어깨 통증으로 한방병원에 입원한 환자 410명을 대상으로 한 후향적 연구)

  • Lee, Jae-Eun;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.2
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    • pp.155-173
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    • 2015
  • Objectives The purpose of this study is to investigate the characteristics of inpatients who were admitted to Korean medicine hospital due to shoulder pain. Methods Characteristics of four hundred ten shoulder pain inpatients of single institution from 2011 to 2013 were retrospectively reviewed through medical charts. Results Patients showed different characteristics in sex, age, motives, interval between onset and admission day, first occurrence or not, related medical history before admission, usage of west medication, admission days, treatment results, radiological examinations by shoulder pain disease groups. Accordingly, Korean medical treatment such as acupuncture, moxibustion, external treatment, cupping therapy, physiotherapy, herb-medication varied with the characteristics of shoulder pain disease groups. Conclusions Through retrospective medical charts review, characteristics of 410 single institution shoulder pain inpatients showed distinctive features and versatile Korean medicine treatments by disease groups. It is expected that this study would accelerate multi-institutional and large scale characteristic review of shoulder pain patients, which would raise reconsideration and expand boundary of Korean medicine.

Review for Retrospective Exposure Assessment Methods Used in Epidemiologic Cancer Risk Studies of Semiconductor Workers: Limitations and Recommendations

  • Park, Donguk
    • Safety and Health at Work
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    • v.9 no.3
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    • pp.249-256
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    • 2018
  • This article aims to provide a systematic review of the exposure assessment methods used to assign wafer fabrication (fab) workers in epidemiologic cohort studies of mortality from all causes and various cancers. Epidemiologic and exposure-assessment studies of silicon wafer fab operations in the semiconductor industry were collected through an extensive literature review of articles reported until 2017. The studies found various outcomes possibly linked to fab operations, but a clear association with the chemicals in the process was not found, possibly because of exposure assessment methodology. No study used a tiered assessment approach to identify similar exposure groups that incorporated manufacturing era, facility, fab environment, operation, job and level of exposure to individual hazardous agents. Further epidemiologic studies of fab workers are warranted with more refined exposure assessment methods incorporating both operation and job title and hazardous agents to examine the associations with cancer risk or mortality.

Retrospective Exposure Assessment of Wafer Fabrication Workers in the Semiconductor Industry (반도체 웨이퍼 가공 공정 역학 조사에서 과거 노출 평가 방법 고찰)

  • Park, Dong-Uk
    • Journal of Environmental Health Sciences
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    • v.37 no.1
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    • pp.12-21
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    • 2011
  • The objective of this study is to review retrospective exposure assessment methods used in wafer fabrication operations to determine whether adverse health effects including mortality or cancer incidence are related to employment in particular work activities and to recommend an appropriate approach for retrospective exposure assessment methods for epidemiological study. The goal of retrospective exposure assessment for such studies is to assign each study subject to a workgroup in such a way that differences in exposure within the workgroups are minimized, as well as to maximize the contrasts in exposure between workgroups. To reduce the misclassification of exposure and to determine if adverse health effects including mortality or cancer incidence are related to particular work activities of wafer fabrication workers, a minimum requirement of work history information on the wafer manufacturing eras, job and department at which they were exposed should be assessed. Retrospective assessment of the task that semiconductor workers performed should be conducted to determine not only the effect of a particular job on the development of adverse health effects including mortality or cancer incidence, but also to adjust for the healthy worker effect. In order to identify specific hazardous agents that may cause adverse health effects, past exposure to a specific agent or agent matrices should also be assessed.

Estimating Benzene Exposure Level over Time and by Industry Type through a Review of Literature on Korea

  • Park, Donguk;Choi, Sangjun;Ha, Kwonchul;Jung, Hyejung;Yoon, Chungsik;Koh, Dong-Hee;Ryu, Seunghun;Kim, Soogeun;Kang, Dongmug;Yoo, Kyemook
    • Safety and Health at Work
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    • v.6 no.3
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    • pp.174-183
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    • 2015
  • The major purpose of this study is to construct a retrospective exposure assessment for benzene through a review of literature on Korea. Airborne benzene measurements reported in 34 articles were reviewed. A total of 15,729 individual measurements were compiled. Weighted arithmetic means [AM(w)] and their variance calculated across studies were summarized according to 5-year period intervals (prior to the 1970s through the 2010s) and industry type. Industries were classified according to Korea Standard Industrial Classification (KSIC) using information provided in the literature. We estimated quantitative retrospective exposure to benzene for each cell in the matrix through a combination of time and KSIC. Analysis of the AM(w) indicated reductions in exposure levels over time, regardless of industry, with mean levels prior to the 1980-1984 period of 50.4 ppm (n = 2,289), which dropped to 2.8 ppm (n = 305) in the 1990-1994 period, and to 0.1 ppm (n = 294) in the 1995-1999 period. There has been no improvement since the 2000s, when the AM(w) of 4.3 ppm (n = 6,211) for the 2005-2009 period and 4.5 ppm (n = 3,358) for the 2010-2013 period were estimated. A comparison by industry found no consistent patterns in the measurement results. Our estimated benzene measurements can be used to determine not only the possibility of retrospective exposure to benzene, but also to estimate the level of quantitative or semiquantitative retrospective exposure to benzene.

Retrospective Drug Utilization Review of Drug-Drug Interaction Criteria Based on Real World Data: Analysis in Terms of Dispensing Types (건강보험심사청구 자료에 근거한 병용금기 약물의 후향적 약물사용평가 : 처방전 조제 형태별 분석)

  • Lee, Young-Sook;Shin, Hyun-Taek
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.3
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    • pp.249-255
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    • 2011
  • Objective: To examine the drug use (prescribing) pattern of serious drug-drug interactions (DDIs, contraindicated drug interactions) using real world data. Prescription patterns were examined in terms of dispensing types. Method: Retrospective drug utilization review (DUR) study was performed. One hundred and six datasets of serious DDIs (DDI pairs) were determined among DDI datasets that Ministry of Health & Welfare announced for the DUR system from 2004 to 2005. Electronically transacted ambulatory patients' prescription database to Health Insurance Assessment and Review Services (HIRA) from July, 2005 to June, 2006 was collected with personal information deidentified and analyzed in terms of types of dispensing as a contributing factor. Results: After prescription data analysis per each patient, total number of DDI cases using 95 DDI pairs was 5,511, which accounted for 2.6 cases per patients. DDI cases between two drugs from each of community pharmacy dispensing- type prescription were considerable (63% vs. 24% in those from each of in-institutional dispensing-type prescription and vs. 13% in those from a community pharmacy dispensing-type prescription and an in-institutional dispensingtype prescription). Conclusions: DDI cases from different prescribers were found to be significant. Thus, the concurrent DUR process between prescriptions from different physicians and institutions should be implemented for the safe drug use.

Hypothesis Proposal about Predictive Factors and Optimal Age for Response to Herbal Medicine Treatment for Height Gain in Children: a Retrospective Review

  • Leem, Jungtae;Kim, Jeeyeun;Suh, Kyeungsuk;Lim, Youngkwern;Lee, Junhee
    • The Journal of Korean Medicine
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    • v.39 no.4
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    • pp.16-29
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    • 2018
  • Introduction: We aimed to investigate the predictive factors and optimal age for response to herbal medicine treatment for height gain in children. Methods: This retrospective chart review included 61 children (age range, 5-16 years) treated for height gain between 2011 and 2015. A predictive model was established by multiple linear regression analysis. Dependent variables were defined by the differences in percentile before and after herbal medicine treatment. The optimal cutoff value of patient age was determined by receiver operating curve analysis. Results : The age of initiation of herbal medicine therapy (p = 0.012) and administration of Forsythiae fructus (p = 0.002) were significant variables for treatment response. The adjusted R2 value was 0.231. The mean ages of the responder and non-responder groups were significantly different (p = 0.023). The optimal cutoff value of age for predicting treatment response was 9.75 years. Treatment response was better among children below 9.75 years of age. Conclusions: Patient age and administration of Forsythiae fructus were identified as determinants of response to herbal medicine treatment. Treatment of rhinitis and initiation of height gain treatment at an early age are critical for better response. These findings will provide fundamental data for further research.