Original
What are the patient factors affecting repetitive use of injectable pain relievers in outpatient care settings?
Juyeun Lee, Sunmee Jang, Euna Han, Eun-Ju Lee, Yun Jung Choi, and Hyun Soon Sohn
Price
42.00 $
Volume 52 p. 202 - 208
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 52 – No. 3/2014 (202-208)
What are the patient factors affecting repetitive use of injectable pain relievers in outpatient care settings?
Juyeun Lee1, Sunmee Jang2, Euna Han3, Eun-Ju Lee4, Yun Jung Choi1, and Hyun Soon Sohn5
1College of Pharmacy, Hanyang University, Ansan, 2College of Pharmacy, Inje University, Gimhae, 3College of Pharmacy, Yonsei University, Incheon, 4Graduate School of Public Health, Seoul National University, Seoul, and 5College of Pharmacy, Ajou University, Suwon, South Korea
Targeting repeated injection users with education interventions aimed at highlighting the extent of their current use and increasing awareness of the oral preparation options may reduce unnecessary injection use. The aim of this retrospective observational study was to investigate the patient factors related to repeated use of injection formulation analgesics in patients with musculoskeletal disorders who were frequent users of ambulatory healthcare services. Population-based national health insurance claims data for the time period July 2011 – December 2011 were analyzed. Patients aged 18 – 80 years with a musculoskeletal disorder, attended ambulatory healthcare settings > 25 times, and were prescribed pain relievers such as non-steroidal anti-inflammatory drugs and narcotic analgesics in an oral formulation for ≥ 14 days or in an injection formulation ≥ 3 times during the study period were included in the study. There were 742,675 repeated systemic analgesic users, and 64.1% (n = 476,021) of these patients were injection users. The average use of injections per patient during the 6-month period was 8.3. Tramadol was the most frequently prescribed medication for injection, followed by diclofenac, piroxicam, and ketorolac. Statistical analyses showed significant correlations between prevalent injection formulation use and patient factors such as gender, age, area of residence, days of healthcare utilization, number of healthcare centers visited, type of healthcare center visited, total medical expenditure, and total out-of-pocket expenditure. These factors could possibly be used to determine the target population for educational interventions aimed at changing behavior relating to the preference for injectable formulations.Correspondence to:
Hyun Soon Sohn, PhD
College of Pharmacy, Ajou University
206 Worldcup-ro, Yeongtong-gu,
Suwon-si, Gyeonggi-do, 443-749, South Korea
Email: [email protected]
Original
Association between non-adherence to statin and hospitalization for cardiovascular disease and all-cause mortality in a national cohort
Sukyoun Shin, Sunmee Jang, Tae-Jin Lee, and Ho Kim
Price
42.00 $
Volume 52 p. 948 - 956
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 52 – No. 11/2014 (948-956)
Association between non-adherence to statin and hospitalization for cardiovascular disease and all-cause mortality in a national cohort
Sukyoun Shin1, Sunmee Jang2, Tae-Jin Lee3, and Ho Kim3
1Review and Assessment Research Institute, Health Insurance Review and Assessment Services, Seoul, 2College of Pharmacy, Gachon University, Incheon, and 3Graduate School of Public Health & Institute of Health and Environment, Seoul National University, Seoul, South Korea
Objectives: This study evaluates the effect of adherence to stain on hospitalization for cardiovascular disease and all-cause mortality in South Korea. Methods: We performed a national cohort study on 423,786 individuals using the Korean National Health Insurance Claims Database. The cohort was composed of individuals who were aged between 18 and 84 years, were newly treated with statin, and were followed from 2005 to 2009. Adherence to statin was calculated using medication possession ratio (MPR) and associations between adherence to statin and health outcomes were evaluated using Cox’s proportional hazards regression analysis. Results: Of the study subjects, 41.9% were male, 7.4% were beneficiaries of a tax-financed medical aid program (MAP), 1.5% had prior cardiovascular disease (CVD), 13.0% had diabetes, and 27.5% had hypertension. Non-adherence to statin was found to be associated with an increased risk of cardiovascular hospitalization (HR 2.18, 95% CI: 2.02 – 2.35) and all-cause mortality (HR = 1.75, CI: 1.66 – 1.84). As the age of the study group increased, non-adherence was more strongly associated with the risk of hospitalization for CVD. In addition, the risk of hospitalization for CVD was relatively high in patients who were male, older or MAP beneficiaries, and who had hypertension, diabetes, and high Charlson’s comorbidity index. Conclusions: This study supports that non-adherence to statin is associated with an elevated risk of hospitalization for cardiovascular disease and all-cause mortality.Correspondence to:
Ho Kim, PhD
Graduate School of Public Health &
Institute of Health and Environment
Seoul National University
Gwanak-ro, Gwanak-gu, Seoul 151-742, South Korea
Email: [email protected]
Original
Patient response to insurer-led intervention for medication adherence – a pilot study based on claims data in Korea
Hyun Soon Sohn, Sunmee Jang, Ju-Yeun Lee, and Euna Han
Price
42.00 $
Volume 54 p. 28 - 35
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 54 – No. 1/2016 (28-35)
Patient response to insurer-led intervention for medication adherence – a pilot study based on claims data in Korea
Hyun Soon Sohn1, Sunmee Jang2, Ju-Yeun Lee3, and Euna Han4
1Graduate School of Clinical Pharmacy, CHA University, Gyeonggi-do, 2College of Pharmacy, Gachon University, Incheon, 3College of Pharmacy, Hanyang University, Ansan, Gyeonggi-do, and 4College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, South Korea
Objective: This study was designed to investigate patient responses to a medication counseling intervention program piloted by the National Health Insurance Service (NHIS), the national health insurer in Korea, to improve medication management in patients with hypertension, hyperlipidemia, or diabetes. Methods and materials: Interventions were conducted from July to September 2013 through direct mailing followed by two telephone-initiated counseling sessions for the medication discontinuation group (< 80% medication possession ratio (MPR) and ≥ 2 months of discontinuation) and the medication over-possession group (≥ 150% MPR). The telephone intervention was applied through two models: model 1 (counseling by NHIS staff only) and model 2 (counseling by NHIS staff with contract-based working pharmacists in community pharmacies). Multivariate logistic regression analysis was performed to identify factors affecting favorable responses of patients to the telephone-initiated intervention. Patient responses to the telephone-initiated intervention were evaluated by a counselor. Results: In all, 891 patients were counseled via telephone. Patient responses to the telephone-initiated intervention were favorable in 57.6%, neutral in 17.4% and not favorable in 24.9% overall. Counseling by NHIS staff together with pharmacists (model 2) produced more favorable responses from patients than counseling by NHIS staff alone (model 1) (OR 2.73, 95% CI 1.97 – 3.77). Conclusion: Our findings of favorable responses to interventions support a personalized approach by the NHIS to improve patient behavior for medication adherence.Correspondence to:
Euna Han, PhD, Associate Professor
College of Pharmacy & Yonsei Institute of
Pharmaceutical Research, Yonsei University
162-1 Songdo-Dong, Yeonsu-Gu, Incheon, South Korea
Email: [email protected]
Original Research
Geographic variations in antibiotic prescription for pediatric acute upper respiratory tract infections in South Korea
Youn Jung, Hyemin Cho, Eunhee Ji, Eun-ji Park, and Sunmee Jang
Price
42.00 $
Volume 56 (2018) p. 177 - 183
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 56 – No. 4/2018 (177-183)
Geographic variations in antibiotic prescription for pediatric acute upper respiratory tract infections in South Korea
Youn Jung1, Hyemin Cho2, Eunhee Ji2, Eun-ji Park3, and Sunmee Jang2
1Korea Institute for Health & Social Affairs, Sejong-si, 2College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, and 3Big Data Steering Department, National Health Insurance Service, Wonju, South Korea
Objective: This study aimed to investigate the factors affecting the geographic differences in antibiotic prescription rates in pediatric upper respiratory tract infections (URI) patients in South Korea. Materials and methods: We performed a nationwide cross-sectional study using 228 administrative districts of Korea, which are the unit of analysis. Prescription rate of antibiotics, the outcome variable, was measured as the proportion of antibiotic prescription days out of total visit days for the treatment of acute URIs using National Health Insurance Service (NHIS) claims data for 2012. Multivariate regression analysis was performed to identify factors affecting geographic variation in antibiotic prescription rates. Results: The socioeconomic status of the district, as measured by the amount of local property tax payable and the proportion of individuals with higher level of education, were negatively correlated with prescription rate. The degree of competition in the hospital market within a district was positively associated with it. Patients living in areas with better access to family medicine physicians and those living in rural areas were less likely to use antibiotics to treat URIs. Conclusion: Our findings indicate the importance of considering demand factors as well as supply factors when developing intervention strategies for antibiotic overuse.
Correspondence to:
Sunmee Jang, PhD
College of Pharmacy and Gachon Institute of Pharmaceutical Sciences
Gachon University
191,Hambangmoe-ro, Yeonsu-gu,
Incheon, 21936, Republic of Korea
Email: [email protected]
Original Research
Association between use of antiemetics, antipsychotics, or antidepressants and the risk of Parkinson’s disease
Ju-Young Shin, Ha-Lim Jeon, Han Eol Jeong, Hyeo-Il Ma, and Sunmee Jang
Price
42.00 $
Volume 57 (2019) p. 73 - 81
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 57 – No. 2/2019 (73-81)
Association between use of antiemetics, antipsychotics, or antidepressants and the risk of Parkinson’s disease
Ju-Young Shin1, Ha-Lim Jeon1, Han Eol Jeong1, Hyeo-Il Ma2, and Sunmee Jang3
1School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, 2Department of Neurology, College of Medicine, Hallym University, Anyang, Gyeonggi-do, and 3College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, South Korea
Objective: Antipsychotics, antidepressants, and antiemetics are well-known causative agents of parkinsonism. However, it is not certain that the use of these medications increases the risk of Parkinson’s disease (PD). We aim to define the risk of PD associated with use of antipsychotic, antidepressant, or antiemetic therapy. Materials and methods: We conducted a population-based nested case-control study using data from the South Korean health insurance database. For each PD case, we randomly selected sex, age group, cohort entry date, duration of follow-up, and Charlson comorbidity score-matched controls (up to 3). Exposure was categorized into six groups based on treatments received 1 – 90 days before the index date (separate use of either: antiemetics; antipsychotics; or antidepressants; combined use of antiemetics with either: antipsychotics; or antidepressants; and combined use of all three). We used conditional logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for PD. Results: Final subjects included 31,428 cases and 94,284 matched controls. We observed an increased risk of PD with the separate use of antiemetics (adjusted OR, 1.08; 95% CI, 1.05 – 1.11) and that of antipsychotics (1.31; 1.12 – 1.52), and the combined use of antiemetics and antipsychotics (1.42; 1.15 – 1.75). Both antidepressants alone and with antipsychotics were not associated with higher risk of PD. Conclusions: Separate or concurrent use of antiemetics and antipsychotics showed increased risks of PD. Although statistical significance was observed, when taking into account that there still lie unmeasured, unconsidered confounders, there may be no clinical association present. Caution will be needed in prescribing these drugs in patients who have prognostic factors for PD.
Correspondence to:
Sunmee Jang, PhD
College of Pharmacy and Gachon Institute
of Pharmaceutical Sciences
Gachon University
191 Hambakmoero, Yeonsu-gu, Incheon, 13120, South Korea
Email: [email protected]
Original Research
Provider factors influencing prescriptions of recommended antihypertensive medications among patients with diabetes and hypertension
Hee-Jin Kang, Inmyung Song, Yeon-Yong Kim, Jong Heon Park, Seongjun Ha, and Sunmee Jang
Price
42.00 $
Volume 57 (2019) p. 393 - 401
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 57 – No. 8/2019 (393-401)
Provider factors influencing prescriptions of recommended antihypertensive medications among patients with diabetes and hypertension
Hee-Jin Kang1#2, Inmyung Song3, Yeon-Yong Kim1, Jong Heon Park1, Seongjun Ha1, and Sunmee Jang4
1Department of Big Data, Health Insurance Pollicy Reseach Institute, Health Insurance Service, Wonju, 2Real World Insights, IQVIA, Seoul, 3School of Pharmacy, Sungkyunkwan University, Suwon, and 4College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea
Objective: Managing hypertension to prevent complications in patients with diabetes requires appropriate pharmacotherapy. This study aimed to analyze healthcare provider factors influencing prescriptions of angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) as the first-line therapy in managing hypertension among patients with diabetes in primary care. Materials: This study used National Health Insurance Claims Data in Korea. Methods: We calculated the prescription rate of angiotensin-converting enzyme inhibitors (ACE inhibitors) or ARBs by dividing the number of patients prescribed an ACE inhibitor or an ARB by the number of patients with diabetes prescribed hypoglycemic agents and antihypertensive agents. We performed a logistic regression to investigate the factors influencing the prescription rate of ACE inhibitors or ARBs. Results: The mean prescription rate of ACE inhibitors or ARBs was 69.8%. The prescription rate of ACE inhibitors or ARBs decreased with increasing physician and patient age. The rate was higher for male patients than for females. The rate was higher in institutions with a greater number of physicians and among internists than among general practitioners, surgery-related and internal medicine-related specialists. The rate was significantly influenced by the mean monthly number of patients with hypertension per medical institution, the number of physicians per medical institution, and the physician’s age and specialty. Conclusion: The age and specialty of the prescribing physician influenced the use of ACE inhibitors or ARBs in patients with diabetes and hypertension in primary care. Efforts are needed to promote information exchange among physicians and the appropriate prescriptions of antihypertensive agents in patients with diabetes and hypertension in primary care.Correspondence to:
Sunmee Jang, PhD
College of Pharmacy
and Gachon Institute
of Pharmaceutical Sciences
Gachon University, Incheon, Korea
191 Hambakmoero, Yeonsu-gu, Incheon, 21936,
Republic of Korea
Email: [email protected]
