Original
Higher systemic antibiotic consumption in a population of South Korea (2008 – 2009)
Hyun Soon Sohn, Ock Hee Oh, Jin-Won Kwon and Young Sook Lee
Price
42.00 $
Volume 51 p. 585 - 592
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 51 – No. 7/2013 (585-592)
Higher systemic antibiotic consumption in a population of South Korea (2008 – 2009)
Hyun Soon Sohn1, Ock Hee Oh2, Jin-Won Kwon3 and Young Sook Lee4
1College of Pharmacy, Sookmyung Women’s University, 2FirstDis Korea, Seoul, 3College of Pharmacy, Kyungpook National University, Daegu, and 4College of Pharmacy, Keimyung University, Daegu, Republic of Korea
This study was conducted to investigate overall systemic antibiotic consumption levels and specific patterns using standardized Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology. National Health Insurance claims data during 2008 and 2009 was used. Antibiotic prescription data was classified using the ATC system and converted into DDD. Consumption figures were presented as the number of DDD per 1,000 inhabitants per day (DID). Detailed information on indications and seasonal variations, age and institutional determinants on antibiotic consumption were also explored. Total consumption was slightly increased from 24.3 to 25.2 DID in 2009 compared to 2008. The most frequently prescribed antibiotic was amoxicillin/clavulanic acid (5.1 and 5.2 DID, in 2008 and 2009, respectively), followed by cefaclor (3.0 and 3.3 DID) and amoxicillin (3.3 and 3.2 DID). Respiratory system diseases were the main causes of antimicrobial prescription (47.3%) and acute forms of bronchitis, tonsillitis and sinusitis were the most common diseases. There were typical seasonal fluctuations with heightened winter peaks. Consumption figures under 5 years of age (41.6 and 43.3 DID) were even higher than figures in aged 65 – 80 (36.2 and 39.1 DID). Antibiotic consumption in South Korea remained high compared with other OECD countries. Efforts to increase prudent antibiotic use, especially for upper respiratory system infections and for younger children, should be made to decrease antibiotic use.Correspondence to:
Young Sook Lee, PharmD
College of Pharmacy, Keimyung University
1095 Dalgubeol-daero
Daegu, 704-710, Republic of Korea
Email: [email protected]
Original
In-depth investigation for prescribing trends of benzodiazepines in South Korea
Sung-Hee Oh, Kang Seob Oh, Kyoung-Uk Lee, Jong-Min Woo, Boung-Chul Lee, Jin Seub Hwang, EunJeong Park, Su Jin Kwak, and Jin-Won Kwon
Price
42.00 $
Volume 52 p. 460 - 470
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 52 – No. 6/2014 (460-470)
In-depth investigation for prescribing trends of benzodiazepines in South Korea
Sung-Hee Oh1, Kang Seob Oh2, Kyoung-Uk Lee3, Jong-Min Woo4, Boung-Chul Lee5, Jin Seub Hwang1, EunJeong Park1, Su Jin Kwak1, and Jin-Won Kwon1,6
1National Evidence-based Healthcare Collaborating Agency, Seoul, 2Department of Psychiatry, School of Medicine, Sungkyunkwan University, Seoul, 3Department of Psychiatry, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, College of Medicine, Seoul, 4Department of Psychiatry and Stress Research Institute, Inje University Seoul Paik Hospital, Seoul, 5Department of Psychiatry, Hangang Sacred Heart Hospital, Hallym University, Seoul, and 6College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, South Korea
This study aimed to investigate national prescription trends of benzodiazepines (BZD) for adults between 2007 and 2011 using Health Insurance Review and Assessment Service (HIRA) database in South Korea. Data analysis was performed by claim unit or patient unit. For the analysis of patient unit, each claim was merged by the same patient. Defined daily dose (DDD) was used to analyze the data in terms of dose and periods of BZD prescription. We identified a total of 22,361,449 adult patients who had BZD prescription at least once in 1,989,263 claims during 5 years. The average national BZD prescription prevalence for 1 year was 23.7%, 7.9%, 4.7%, and 3.2% of ≥ 1 day supply, ≥ 30 days supply, ≥ 90 days supply, and ≥ 180 days supply, respectively. The trends for 5 years were very similar. Among study population, 87.7% visited only non-psychiatric departments and the most frequent indication was gastrointestinal related diseases. BZD consumption expressed as DDDs per 1,000 inhabitants per day was 109.2. BZD consumption tended to be ~ 4 × higher in elderly than that of non-elderly (268.6 vs. 60.0 in male and 367.7 vs. 90.9 in female). Our study indicated the possibilities for inappropriate prescription of BZD, and the limitation policy on continuous prescription over 30 days supply did not seem to be effective. The effective interventions including an educational program for appropriate prescription of BZD should be considered.Correspondence to:
Jin-Won Kwon, MPH, PhD
College of Pharmacy and Research Institute of Pharmaceutical Sciences
Kyungpook National University
80 Daehak-ro, Buk-gu, Daegu 702-701, South Korea
Email: [email protected]
Original
Association of fracture risk with benzodiazepine among adults in South Korea
Jin Seub Hwang, Sung-Hee Oh, Kang Seob Oh2, Kyoung-Uk Lee, Jong-Min Woo, Boung-Chul Lee, EunJeong Park, Su Jin Kwak, and Jin-Won Kwon
Price
42.00 $
Volume 53 p. 163 - 171
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 53 – No. 2/2015 (163-171)
Association of fracture risk with benzodiazepine among adults in South Korea
Jin Seub Hwang1*, Sung-Hee Oh1*, Kang Seob Oh2, Kyoung-Uk Lee3, Jong-Min Woo4, Boung-Chul Lee5, EunJeong Park1, Su Jin Kwak1, and Jin-Won Kwon1,6
1National Evidence-based Healthcare Collaborating Agency, Seoul, 2Department of Psychiatry, School of Medicine, Sungkyunkwan University, Seoul, 3Department of Psychiatry, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, College of Medicine, Seoul, 4Department of Psychiatry, Inje University Seoul Paik Hospital, Seoul, 5Department of Psychiatry, Hangang Sacred Heart Hospital, Hallym University, Seoul, and 6College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, South Korea
This study examined the association between fracture and benzodiazepine (BZD) prescription in Korean adults using case-crossover (CCO) and self-controlled case-series (SCCS) designs, which have the advantage to control confounding bias, such as individual characteristics. Patients with fracture were defined as patients who visited the emergency room and orthopedics department with the ICD-10 diagnosis code for fracture. Fractures due to motor vehicle accidents and stroke were excluded. Whereas the CCO design presented odds ratio (OR) using a conditional logistic regression model, SCCS design showed incidence rate ratio (IRR) using a conditional Poisson regression model. The concomitant drugs that can affect the fracture were adjusted. Sensitivity analysis and subgroup analysis by age (elderly vs. nonelderly), action mechanism (short-acting vs. long-acting), and prescription duration (short-term user vs. long-term user) were conducted. The adjusted OR (AOR) for control period I (prior to 90 days from case) was 1.39 (95% CI = 1.25 – 1.54) for all BZD prescriptions. The adjusted ORs for other control periods showed similar trends. The adjusted IRRs (AIRR) during the first 4 weeks, 4 – 8 weeks, 8 – 12 weeks, and 12 – 16 weeks from new BZD use were 1.46 (95% CI = 1.28 – 1.66), 1.23 (95% CI = 1.01 – 1.49), 1.09 (95% CI = 0.86 – 1.37), and 1.38 (95% CI = 1.07 – 1.77), respectively. Regardless of age group, action mechanism, or prescription duration, fracture risk was higher during case period than control. The risk for fracture was higher in both elderly and non-elderly people with BZD prescription than in those without BZD prescription. Careful monitoring for people who start BZD treatment and further research in the non-elderly is required.
*Jin Seub Hwang and Sung-Hee Oh contributed equally as co-first authors.Correspondence to:
Jin- Won Kwon, MPH, PhD
College of Pharmacy and Research
Institute of Pharmaceutical Sciences
Kyungpook National University
80 Daehak-ro, Buk-gu, Daegu 702-701, South Korea
Email: [email protected]
Original
Evidence supporting the need for considering the effects of smoking on drug disposition and effectiveness in medication practices: a systematic narrative review
Hyun Soon Sohn, Hyunah Kim, Im-Sook Song, Eunjeong Lim, Mihwa Kwon, Ji-Hye Ha, and Jin-Won Kwon
Price
42.00 $
Volume 53 p. 621 - 634
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 53 – No. 8/2015 (621-634)
Evidence supporting the need for considering the effects of smoking on drug disposition and effectiveness in medication practices: a systematic narrative review
Hyun Soon Sohn1*, Hyunah Kim2*, Im-Sook Song3, Eunjeong Lim3, Mihwa Kwon3, Ji-Hye Ha4, and Jin-Won Kwon3
1Graduate School of Clinical Pharmacy, CHA University, Gyeonggi-do, 2College of Pharmacy, Sookmyung Women’s University, Seoul, 3College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, and 4Clinical Research Division, National Institute of Food and Drug Safety Evaluation (NIFDS), Chungcheongbuk-do, South Korea
This study was conducted to provide a narrative overview of interactions between smoking and drug effectiveness/ pharmacokinetics. Database searches were performed to identify review articles published prior to March 10, 2013. Eligible articles reporting altered pharmacokinetic profiles, drug response, or adverse drug effects due to drug-smoking interactions were selected. Information on mechanism of action and clinical effects from the selected articles (n = 83) were summarized by therapeutic drug class. For cardiovascular drugs, smoking effects were variable. Smoking reduced aspirin response but increased clopidogrel response by increasing active metabolites. Warfarin, which has a narrow therapeutic range, required dosage adjustment in smokers due to its rapid clearance. Smoking is a risk factor for respiratory disease, leading to a lower response to corticosteroid and requiring increased doses or additional drugs. Higher doses of theophylline and some antipsychotics, which are mainly metabolized by CYP1A2, are required to reach an optimal plasma concentration in smokers. Smoking is also a risk factor for cancer, especially for lung cancer. Erlotinib or gefitinib are epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) for lung cancer and showed lower anticancer effects in smokers. This summary of the interactions between smoking and drug pharmacological properties will aid healthcare professionals in providing patients with appropriate drug therapies, and emphasizes the need for considering smoking status as a patient factor in the clinical setting.
*Sohn HS and Kim H equally contributed as co-first authors.Correspondence to:
Jin-Won Kwon, MPH, PhD
College of Pharmacy and Research Institute of Pharmaceutical Sciences
Kyungpook National University
80 Daehak-ro, Buk-gu, Daegu 702-701, South Korea
Email: [email protected]
Original
Prescribed drugs and polypharmacy in healthcare service users in South Korea: an analysis based on National Health Insurance Claims data
Hae-Young Park, Hyun-Nam Ryu, Mi Kyong Shim, Hyun Soon Sohn, and Jin-Won Kwon
Price
42.00 $
Volume 54 p. 369 - 377
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 54 – No. 5/2016 (369-377)
Prescribed drugs and polypharmacy in healthcare service users in South Korea: an analysis based on National Health Insurance Claims data
Hae-Young Park1, Hyun-Nam Ryu2, Mi Kyong Shim3, Hyun Soon Sohn3, and Jin-Won Kwon1
1College of Pharmacy and Research Institute of Pharmaceutical Sciences, 2College of Natural Science, Kyungpook National University, Daegu, and 3Graduate School of Clinical Pharmacy, CHA University, Gyeonggi, South Korea
Objective: This study was conducted to analyze and compare the exposure to individually prescribed drugs and the prevalence of polypharmacy according to age group and concomitant disease in South Korea. Methods: The use of prescribed drugs was evaluated according to average numbers of prescription drugs used daily during a year or month, using the Korean Health Insurance Claims Database, which is representative of over 90% of citizens, in 2010 and 2011. The use of prescribed drugs was also analyzed according to concomitant diseases and age. Polypharmacy was defined as the use of 5 or more drugs daily during a specific observation period, and proportions of polypharmacy users were calculated according to comorbidity and age group. Results: The annual average numbers of daily used prescription drugs in 2010 and 2011 were 0.3 (SD = 0.5), 0.4 (SD = 0.7), 1.2 (SD = 1.5), and 2.3 (SD = 2.0) for people aged < 20 years, 20 – 49 years, 50 – 64 years, and ≥ 65 years, respectively. Proportions of individuals demonstrating polypharmacy increased with age and were 9.5% and 44.1% for elderly individuals in the year- and month-based analyses, respectively. The annual average number of daily medications used increased by ~ 2 drugs in the concomitant disease group, and the higher mortality group used a higher number of prescribed drugs than the lower mortality group. Conclusions: The results highlight the elevated burden of multi-medication in elderly patients, and the study found that prescribed drug use increased with age and the number of concomitant diseases.Correspondence to:
Jin-Won Kwon, MPH, PhD
College of Pharmacy and Research Institute of Pharmaceutical Sciences
Kyungpook National University
80 Daehak-ro, Buk-gu, Daegu 702-701, South Korea
or
Hyun Soon Sohn, PhD
Graduate School of Clinical Pharmacy
CHA University
335 Pankoro, Bundanggu, Sungnamsi,
Gyeonggi 487-010, South Korea
Email: [email protected] or [email protected]
