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Original

Prescribing patterns in breast cancer survivors: A Korean National Health Insurance Service cohort study 

Hyun Sook Oh, Alexandre Chan, and Hwa Jeong Seo

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Volume 59 (2021) p. 358 - 365

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 59 – No. 5/2021 (358-365)

Prescribing patterns in breast cancer survivors: A Korean National Health Insurance Service cohort study 

Hyun Sook Oh¹, Alexandre Chan², and Hwa Jeong Seo³

¹Department of Applied Statistics, Gachon University, Sengnam, Korea, ²Department of Clinical Pharmacy Practice, Susan & Henry Samueli College of Health Sciences, University of California, Irvine, CA, USA, and ³Medical Informatics and Health Technology (MIT), Department of Health Care Management, Gachon University, Seongnam, Korea
Purpose: Breast cancer survivors often manifest comorbidities that require medication management. This study aimed to investigate the prescription patterns of drugs prescribed frequently among breast cancer survivors and to provide data to monitor adverse effects using other covariates in these patients.
Materials and methods: We analyzed a Korean national sample cohort database. The diagnosis of breast cancer, survival, survival duration, and frequency of drug prescription were first defined and extracted. We then analyzed the frequency of drug prescription in breast cancer by survival duration. Factors associated with drug prescribing patterns were analyzed using logistic regression analysis.
Results: Among 2,410 breast cancer survivors, anti-hormonal agents, gastrointestinal drugs, calcium, and anxiolytics were most frequently prescribed. Gastrointestinal disturbance and depression are most commonly observed among breast cancer survivors. Survivors who were 3 to < 5 years post treatment were frequently prescribed calcium. In addition to gastrointestinal drugs, anxiolytics were frequently prescribed among survivors manifesting comorbidities. In addition to anti-hormone agents, which were frequently prescribed to breast cancer patients, gastrointestinal drugs were the second most frequently prescribed, and anxiolytics were often co-prescribed. Calcium was also frequently co-prescribed in patients requiring anti-depressants.
Conclusion: In the Korean National Cohort, gastrointestinal drugs, calcium, and anxiolytics were frequently prescribed to older patients, suggesting that older patients diagnosed with cancer experience a wide array of toxicities requiring supportive care.Correspondence to:
Hwa Jeong Seo, PhD 
Medical Informatics and Health Technology (MIT)
Department of Health Care Management
Gachon University
1342 Seongnamdaero, Sujeong-gu,
Seongnam-si, Gyeinggi-do, 13120, Korea
Email: [email protected]

Original

Association between first-step analgesic use and cancer in patients with diabetes 

Ie Byung Park and Hwa Jeong Seo

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Volume 61 (2023) p. 67 - 73

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 61 – No. 2/2023 (67-73)

Association between first-step analgesic use and cancer in patients with diabetes 

Ie Byung Park¹ and Hwa Jeong Seo²

¹Department of Endocrinology and Metabolism, Gachon University Gil Medical Center, Incheon, and ²Medical Informatics and Health Technology (MIT), Department of Health Care Management, College of Social Science, Gachon University, Sengnam, South Korea
Objectives: This study aimed to determine the effectiveness of analgesics in inhibiting cancer development in patients with diabetes based on a sample cohort supplied by the Korean National Health Insurance Service.
Materials and methods: Regular users of analgesics included those using prescription analgesics ≥ 15 days per month at least 6 times over 2 years after the diagnosis of diabetes mellitus (baseline). The effectiveness of analgesics in patients with diabetes was evaluated using metformin adherence and three models: model 1 was adjusted for age and sex; model 2 was further adjusted for body mass index (BMI), exercise, cholesterol, hypertension, and Charlson comorbidity index (CCI); and model 3 was further adjusted for analgesics.
Results: Based on stringent extraction criteria, the sample had a cancer incidence of 4.6%. The hazard ratios of models 1 and 2 were 0.830 and 0.865, respectively. The adjusted hazard ratio for all variables, including acetaminophen and nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen, was 0.871 (model 3).
Conclusion: Regular use of analgesics by patients with diabetes decreased their risk of subsequent cancer development in this large national cohort. Compared with participants who did not develop cancer, those with cancer were older and more likely to be male, did not exercise, have more comorbidities (as assessed by CCI), and did not use analgesics regularly.Correspondence to:
Hwa Jeong Seo, PhD
1342 Seongnamdaero, Sujeong-gu,
Seongnam-si, Gyeonggi-do, Korea
Email: [email protected]

Original

Effect of inhaled corticosteroid with oral montelukast and levocetirizine in asthma: A population-based study 

Myunghee Park, Seong-Dae Woo, Minae Park, Yujin Lee, and Hwa Jeong Seo

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Volume 64 (2026) p. 210 - 218

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 64 – No. 4/2026 (210-218)

Effect of inhaled corticosteroid with oral montelukast and levocetirizine in asthma: A population-based study 

Myunghee Park¹#², Seong-Dae Woo³, Minae Park¹, Yujin Lee¹, and Hwa Jeong Seo²

¹Department of Data Science, Hanmi Pharm Co Ltd, Seoul, Republic of Korea, ²Medical informatics and health Technology (MiT), Department of Medical Industry Management, College of Business, Gachon University, Seongnam, and ³Department of Pulmonary, Allergy, and Critical Care Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
Introduction: Asthma is a chronic disease that requires careful management, and its exacerbations can be life-threatening. The aim of this study was to ascertain whether inhaled corticosteroids (ICS)-containing inhaler in combination with oral montelukast and levocetirizine could lessen the exacerbation of asthma in comparison to inhaler alone.
Materials and methods: Among 437,915 asthma patients receiving ICS-containing inhaler, 91,122 participants were included. Treatment groups were categorized as (1) ICS-containing inhalers (ICS with or without long-acting β-2 agonist (LABA)), and (2) ICS-containing inhalers used in combination with both oral montelukast and levocetirizine, and (3) severe exacerbation of asthma (visit of emergency room or hospitalization). After 1 : 1 propensity score matching of treatment groups, survival analysis utilizing Cox regression was conducted for estimating the effect of treatment on asthma exacerbation.
Results: We found that the inhaler plus montelukast and levocetirizine group exhibited a lower crude incidence rate and was associated with a lower risk of all-cause death and moderate to severe exacerbation. Specifically, the adjusted hazard ratios (HRs) were 0.71 (p = 0.006) for all-cause death, 0.57 (p < 0.001) for moderate exacerbation. For severe exacerbations, the adjusted HRs were 0.59 for emergency room visits and 0.66 for hospitalizations (p = 0.018 and 0.011, respectively), compared to the ICS-only group, demonstrating a statistically significant reduction.
Conclusion: Treatment with ICS-containing inhaler plus oral montelukast and levocetirizine was significantly associated with a lower risk of exacerbations in asthma patients. Alongside the growing burden of healthcare utilization and costs in South Korea, consideration of the treatment of ICS with montelukast and levocetirizine may serve as an effective treatment option for patients with severe, uncontrolled asthma, potentially improving disease management and reducing healthcare costs.Correspondence to:
Hwa Jeong Seo, PhD
Medical informatics and health Technology (MiT)
Department of Medical Industry Management
Gachon University
1342 Seongnamdaero, Sujeong-gu,
Seongnam 13120, Gyeinggi-do, South Korea
Email: [email protected]

Original

Development of a pain intensity estimation model in breast cancer survivors using quantile regression: A nationwide claims-based cohort study 

Jin Lee, Alexsandre Chan, Juhee Cho, and Hwa Jeong Seo

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Volume 64 (2026) p. 391 - 397

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 64 – No. 8/2026 (391-397)

Development of a pain intensity estimation model in breast cancer survivors using quantile regression: A nationwide claims-based cohort study 

Jin Lee¹#², Alexsandre Chan³, Juhee Cho¹#²#⁴#⁵*, and Hwa Jeong Seo⁶#⁷*

¹Department of Clinical Research Design and Evaluation, SAIHST, ²Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea, ³Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, CA, USA, ⁴Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, ⁵Department of Digital Health, Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, ⁶Medical Informatics and Health Technology (MiT), Department of Healthcare Industry Management, and ⁷Global Healthcare Research Institute, Gachon University, Seongnam, South Korea
Objective: In patients in whom pain cannot be objectively evaluated, achieving high compliance with symptom management is challenging. This study aimed to estimate pain-related factors and pain intensity in patients with breast cancer according to prescription history of analgesics.
Materials and methods: Pain intensity was rated according to low, moderate, and high cumulative analgesic consumption score (CACS). CACS-based quantile regression analysis was performed considering sociodemographic (age, income, and disease duration), index-related (body mass index (BMI) and Charlson Comorbidity Index (CCI)), and surgery- and treatment-related variables.
Results: In the mild pain group (Q1), age (≥ 50 years; β_Q1 = 0.5803) and BMI (≥ 25; β_Q1 = 0.7062) -affected the pain estimate. In the moderate-pain group (Q2), age (≥ 50 years; β_Q2 = 1.0380), BMI (≥ 25; β_Q2 = 0.9011), CCI (≥ 3; β<sub>Q2</sub> = 0.6106) and radiation therapy (yes; β_Q2 = 0.5652) affected pain intensity. In the severe-pain group (Q4), age (≥ 50 years; β_Q4 = 7.002), BMI (≥ 25; β_Q4 = 6.2800), CCI (≥ 3; β_Q4 = 3.4480), lymph node dissection (yes; β_Q4 = 2.4420), and lymphedema (yes; β_Q4 = 4.6580) affected pain estimate.
Conclusion: Among patients with breast cancer, older age, longer disease duration, higher BMI and CCI, prior lymph node dissection, and lymphedema presence may contribute to more severe pain symptoms. These findings may pave the way for the development of preemptive pain intervention for patients with breast cancer.Correspondence to:
Juhee Cho or Hwa Jeong Seo
Medical informatics and health Technology (MiT)
Department of Healthcare Industry Management
Gachon University
1342 Seongnamdaero, Sujeong-gu,
Seongnam 13120, Gyeinggi-do, South Korea
Email: [email protected]; [email protected]

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