PURPOSE: This study was conducted to examine activities of daily living (ADL) of older adults admitted to Korean long-term care hospitals (LTCHs), and to explore the patient and organizational factors that have an impact on the ADL of this population. METHODS: A secondary analysis of the Korean minimum data set (K-MDS) of patients (N=14,369) and of the profiles of LTCHs (N=358) from the Health Insurance Review and Assessment Service was done between January and July 2008. The outcome variable was ADL score 6 months after baseline assessment. Multi-level linear regression was employed to explore the patient and organizational factors that affected ADL scores. RESULTS: Of the patients, 45.4% had a baseline ADL score of between 31 and 40, with a score of 40 indicating that the patient was entirely dependent for all items. None of the organizational characteristics were significantly associated with effects on the ADLs of older adults who had been in a LTHC for at least 6 months. However, patient characteristics, such as age, baseline ADL, frequency of physical therapy, urinary incontinence, fecal incontinence, pressure ulcers, and having a tube or catheter, were significantly associated with ADL 6 months after baseline. CONCLUSION: In order to maintain and improve the ADL of older adults in LTCHs, we should develop strategies to prevent urinary and fecal incontinence, pressure ulcers, unnecessary tubes or catheters, providing adequate physical therapy. Additional studies should include more detailed information regarding nursing staff, including RN hours for direct care, education level and turnover.
*Activities of Daily Living ; Age Factors ; Aged ; Aged, 80 and over ; Catheterization ; Fecal Incontinence ; Female ; Hospitals/*statistics & numerical data ; Humans ; Long-Term Care ; Male ; Pressure Ulcer ; Republic of Korea ; Urinary Incontinence

BACKGROUND: The current educational goals and missions of pharmacy schools in Korea were analyzed to examine the current orientation and future direction of pharmaceutical education. METHODS: Educational mission statements were obtained from the homepages of 35 pharmacy schools and subjected to convert into codes. Themes and categories were induced using qualitative content-analysis from the codes and compared according to location of school (capital area versus province), public versus private, and date of initial enrollment (before versus in 2011). The themes and categories were compared with “the eight-star pharmacist” suggested by World Health Organization (WHO) and International Pharmaceutical Federation (FIP). RESULTS: Twelve themes, 44 categories, and 496 codes were identified. Themes included pharmaceutical expertise, professionalism, contribution to society, basic educational ideology, sphere of activity, leadership, research, dealing with future change, problem-solving ability, self-management and development, cooperation, and respect for life. Mission statements of schools that initially enrolled in 2011 cited humankind level contribution (p=0.011), patient-centered care (p=0.026), and globalization (p=0.018) more frequently than those enrolled before 2011. Most schools mentioned about care-giver, researcher, and decision-maker which were stated in “the eight-star pharmacist”. CONCLUSION: To meet the growing social requirements of a pharmacist's roles, wide-ranging active discussion on establishing educational goals should be made.
Education, Pharmacy ; Humans ; Internationality ; Korea* ; Leadership ; Patient-Centered Care ; Pharmacy* ; Professionalism ; Religious Missions ; Schools, Pharmacy* ; Self Care ; Value of Life ; World Health Organization

BACKGROUND/AIMS: An updated chronic kidney disease (CKD) definition and classification were proposed by Kidney Disease: Improving Global Outcomes (KDIGO), with adoption of a new equation to estimate glomerular filtration rate (GFR) and albuminuria to evaluate kidney structural damage. This study was performed to estimate the prevalence of CKD in the Korean adult population as defined and classified by the KDIGO guidelines. METHODS: Cross-sectional samples of the fifth Korean National Health and Nutrition Examination Survey for 2011 to 2012 were examined for adults aged ≥ 19 years. CKD prevalence was determined based on decreased GFR and albuminuria. The GFR was estimated using the CKD Epidemiology Collaboration creatinine equation, and albuminuria was evaluated using the albumin-to-creatinine ratio (ACR) in spot urine. RESULTS: Of the 16,576 subjects participating in the survey, 10,636 (4,758 men, 5,878 women) were included in the present study. The prevalence of CKD was estimated as 7.9% (7.8% in 2011 and 8.0% in 2012, p = 0.770). The prevalence of low, moderately increased, high, and very high CKD risk prognosis was 92.0%, 6.3%, 1.1%, and 0.6%, respectively. The prevalence of albuminuria (ACR ≥ 30 mg/g) in individuals with GFR ≥ 60 mL/min/1.73 m² has reached 5.7%. The odds ratios of hypertension and diabetes to CKD were 3.4 and 3.1 in men, and 2.9 and 2.0 in women (all p < 0.001), respectively. CONCLUSIONS: A large percentage of CKD patients had albuminuria prior to a decrease in GFR. Regular laboratory tests for albuminuria for the high-risk group, and especially for hypertensive or diabetic patients, might improve detection of CKD at an early stage.
Adult* ; Albuminuria ; Classification ; Cooperative Behavior ; Creatinine ; Epidemiology ; Female ; Glomerular Filtration Rate ; Humans ; Hypertension ; Kidney ; Kidney Diseases ; Korea ; Male ; Nutrition Surveys ; Odds Ratio ; Prevalence* ; Prognosis ; Renal Insufficiency, Chronic*

The emergence of phosphodiesterase (PDE) 5 inhibitors gave rise to the solution for erectile dysfunction, starting with the development of sildenafil. Although their efficacy in treating erectile dysfunction has been shown, the side effects of PDE5 inhibitors, especially sildenafil, must be taken into consideration. A 64-year-old man received 100 mg of sildenafil and experienced blue vision in both eyes; however, after a day or so, his symptoms improved. The symptoms disappeared when he stopped administering sildenafil, but reappeared when the medication was re-administered. Therefore, he discontinued sildenafil treatment and was prescribed udenafil instead. After that, visual adverse events no longer occurred. Causality assessment showed that in this case, sildenafil-induced cyanopsia was “certain” under the World Health Organization-Uppsala Monitoring Center (WHO-UMC) criteria and Korean causality assessment algorithm (Ver.2), and was “probable” according to the Naranjo scale. In addition, sildenafil also led to abnormal visual reactions in other cases. Sildenafil can also inhibit PDE6, which is present in retinal cells, unlike other PDE5 inhibitors. Thus, visual adverse reactions, such as blue vision, are the unique results of sildenafil, and other PDE5 inhibitors may be used to prevent them.

The emergence of phosphodiesterase (PDE) 5 inhibitors gave rise to the solution for erectile dysfunction, starting with the development of sildenafil. Although their efficacy in treating erectile dysfunction has been shown, the side effects of PDE5 inhibitors, especially sildenafil, must be taken into consideration. A 64-year-old man received 100 mg of sildenafil and experienced blue vision in both eyes; however, after a day or so, his symptoms improved. The symptoms disappeared when he stopped administering sildenafil, but reappeared when the medication was re-administered. Therefore, he discontinued sildenafil treatment and was prescribed udenafil instead. After that, visual adverse events no longer occurred. Causality assessment showed that in this case, sildenafil-induced cyanopsia was “certain” under the World Health Organization-Uppsala Monitoring Center (WHO-UMC) criteria and Korean causality assessment algorithm (Ver.2), and was “probable” according to the Naranjo scale. In addition, sildenafil also led to abnormal visual reactions in other cases. Sildenafil can also inhibit PDE6, which is present in retinal cells, unlike other PDE5 inhibitors. Thus, visual adverse reactions, such as blue vision, are the unique results of sildenafil, and other PDE5 inhibitors may be used to prevent them.

BACKGROUND: With the development of information and communication technology, there is a growing number of people looking for health information on the internet. This pilot study was performed to analyze the pattern of pharmacist consultation on the internet portal site. METHODS: Questions and answers posted on the portal site “Naver Jisik-iN” from March 1st to 31th in 2016 were collected. Medications asked were categorized into prescription drugs, nonprescription drugs, sanitary aids, emergency drugs, functional health foods, and others. Medications were subcategorized into 14 according to the anatomical therapeutic chemical classification system. Questions were divided into 10 categories based on Hepler's drug-related problems. RESULTS: Of the 955 cases, females accounted for 59.5% and inquirers from 11 to 40 years old, 89.4%. The number of prescription drugs, nonprescription drugs, sanitary aids, emergency drugs, functional health foods, and others were 428 (44.8%), 328 (34.3%), 31 (3.3%), 2 (0.2%), 122 (12.8%), and 44 (4.6%), respectively. Questions for drugs acting on alimentary tract and metabolism took up 27.4% followed by those on nervous system, 13.6% and anti-infectives for systemic use, 12.2%. Pharmacist consultation regarding drug information, drug interaction, and adverse reaction occupied 47.9%, 15.2%, and 12.3%, respectively. CONCLUSION: Health counseling through online is predicted to increase steadily, so pharmacists should broaden their boundaries beyond off-line pharmacies to meet social needs.
Classification ; Counseling* ; Drug Interactions ; Emergencies ; Female ; Humans ; Information Services ; Internet* ; Metabolism ; Nervous System ; Nonprescription Drugs ; Pharmacies ; Pharmacists* ; Pilot Projects* ; Prescription Drugs

Purpose: This study is to develop an interprofessional education (IPE) program for medical, nursing, and pharmacy students and to analyze the effectiveness. Methods: Subjects consisted of 116 students (41 medical, 46 nursing, and 29 pharmacy students) enrolled in their final year. Subjects were randomly assigned to either the intervention group or the control group, with 58 in each group. A pretest-posttest control group design was used. The program was operated for a single day, and consisted of small-group activities and role-play. We utilized the following tools: Perceptions towards Interprofessional Education (PIPE), Self-Efficacy for Interprofessional Experiential Learning (SEIEL), and Perception towards Interprofessional Competency (PIC). We used t-test and analysis of covariance for analysis. Results: The PIPE tool revealed that the scores of the intervention group were significantly higher than those of the control group (p=0.000). The result was the same when the scores were categorized into the groups medical students (p=0.001), nursing students (p=0.000), and pharmacy students (p=0.005). The SEIEL study also indicated the intervention group scored significantly higher than the control group (p=0.000). However, pharmacy students did not reveal significant (p=0.983). The intervention group scored significantly higher than the control group in the PIC. A concluding survey of the intervention group indicated that most students were satisfied with the IPE program. Conclusion We hope this study will provide useful information for designing and improving IPE programs in other universities.

Levosulpiride is one of the most frequently prescribed medicines in Korea. An adverse drug reaction (ADR) after taking levosulpiride was reported at a community pharmacy in Korea. A 31-year-old woman reported the symptoms of lactation and amenorrhea after taking levosulpiride; an evaluation of whether these symptoms were caused by the medication was therefore necessary. Several tools can be used to determine if the ADR resulted from the administered drug or other factors, including the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) criteria, the Naranjo scale, and the Korean causality assessment algorithm (Ver. 2). The causality was evaluated as “possible” by the WHO-UMC and Naranjo scales, but as “probable” by the Korean causality assessment algorithm (Ver. 2). In conclusion, the information provided did not indicate definite causality and there were slight differences in the results obtained from each assessment method.
Adult ; Amenorrhea ; Drug-Related Side Effects and Adverse Reactions ; Female ; Global Health ; Humans ; Hyperprolactinemia* ; Korea ; Lactation ; Methods ; Pharmacies* ; Weights and Measures

OBJECTIVE: This study aimed to provide efficacy and safety information on the use of erenumab for prevention of episodic and chronic migraines. METHODS: The keywords “Erenumab and migraine” were used to search the PubMed database to then compile efficacy and safety data for erenumab. Data from relevant Phase 2 and Phase 3 clinical trials were analyzed, using RevMan for statistical analysis. RESULTS: Three clinical trials (one Phase 2 and two Phase 3 studies) were retrieved. All three trials used the same primary endpoint (change from baseline in monthly migraine days (CBMD)) to evaluate efficacy and safety of erenumab use for prevention of episodic and chronic migraines. Subcutaneous doses of erenumab (70 or 140 mg) were administered monthly in each trial, for 3 months (Studies 2, and 3) or 6 months (Study 1). The mean differences in CBMD in the 70 mg and 140 mg erenumab arms were −1.36 and −1.98, respectively, compared to that in the placebo arm. Some adverse events, such as nasopharyngitis and upper respiratory tract infection, were reported, but no differences in safety between erenumab and placebo were found to be significant. CONCLUSIONS: Erenumab showed superior efficacy in prevention of migraines compared to placebo. However, additional information regarding the long-term safety of erenumab should be collected. Therefore, post-marketing surveillance for adverse events is needed.
Arm ; Migraine Disorders ; Nasopharyngitis ; Respiratory Tract Infections

Purpose: Exposure to heat and cold stress can negatively affect pregnant women. However, studies on the association between ambient temperature exposure and pregnant women, especially those with diabetes mellitus, are limited. The presence of this disease is likely to affect the woman’s capacity to adapt to the demands of pregnancy, consequently affecting fetal development. We examined the association between exposure to the mean temperature and diabetes mellitus during pregnancy. Methods: Health Insurance Reviews and Assessment Service was used to obtain data on patients hospitalized between January 2015 and August 2022. The association between the number of pregnant patients with diabetes mellitus according to monthly mean temperature and seasonal differences was analyzed using a generalized additive model. The model was adjusted for the treatment date, mean humidity, and mean age of the women. Results: The total number of patients with diabetes mellitus in pregnancy was 651,655 and the mean temperature was 12.87℃±9.89℃. The association between the mean temperature and diabetes mellitus during pregnancy showed a U-shaped nonlinear association. During the entire period, the number of patients with diabetes mellitus in pregnancy significantly increased by 2.82 per 1℃ increase in mean temperature (estimate, 2.82; 95% confidence interval [CI], -2.06 to 7.71). The number of patients significantly increased by 72.12 per 1℃ increase in mean temperature in the summer (estimate, 72.12; 95% CI, 50.36–93.89), but the increase was not statistically significant in the winter. Conclusion Our findings suggest that maternal exposure to mean temperature during pregnancy is associated with diabetes mellitus.