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4,800원
Objective: Bipolar disorder displays a spectrum of manifestations, including manic, hypomanic, depressive, mixed, psychotic, and atypical episodes, contributing to its chronic nature and association with heightened suicide risk. Creating effective pharmacotherapy guidelines is crucial for managing bipolar disorder and reducing its prevalence. Treatment algorithms grounded in science have improved symptom management, but variations in recommended medications arise from research differences, healthcare policies, and cultural nuances globally. Methods: This study compares Korea’s bipolar disorder treatment algorithm with guidelines from the UK, Australia, and an international association. The aim is to uncover disparities in key recommended medications and their underlying factors. Differences in CYP450 genotypes affecting drug metabolism contribute to distinct recommended medications. Variances also stem from diverse guideline development approaches—expert consensus versus metaanalysis results—forming the primary differences between Korea and other countries. Results: Discrepancies remain in international guidelines relying on meta-analyses due to timing and utilized studies. Drug approval speeds further impact medication selection. However, limited high-quality research results are the main cause of guideline variations, hampering consistent treatment conclusions. Conclusion: Korea’s unique Delphi-based treatment algorithm stands out. To improve evidence-based recommendations, large-scale studies assessing bipolar disorder treatments for the Korean population are necessary. This foundation will ensure future recommendations are rooted in scientific evidence.
4,000원
Background & Objectives: Fixed-dose combinations (FDCs) offer advantages in adherence and cost-effectiveness compared to free combinations (FCs), but they can also complicate the prescribing process, potentially leading to therapeutic duplication (TD). This study aimed to identify the prescribing patterns of FDCs for dyslipidemia and investigate their associated risk of TD. Methods: This was a retrospective cohort study involving drugs that included statins, using Health Insurance Review & Assessment Service- National Patient Sample (HIRA-NPS) data from 2018. The unit of analysis was a prescription claim. The primary outcome was TD. The risk ratio of TD was calculated and adjusted for patient, prescriber, and the number of cardiovascular drugs prescribed using a multivariable Poisson model. Results: Our study included 252,797 FDC prescriptions and 515,666 FC prescriptions. Of the FDC group, 46.52% were male patients and 56.21% were aged 41 to 65. Ezetimibe was included in 71.61% of the FDC group, but only 0.25% of the FC group. TD occurred in 0.18% of the FDC group, and the adjusted risk ratio of TD in FDC prescriptions compared to FC was 6 . 44 (95% CI 5 . 30-7. 82). Conclusions: Prescribing FDCs for dyslipidemia was associated with a higher risk of TD compared to free combinations. Despite the relatively low absolute prevalence of TD, the findings underline the necessity for strategies to mitigate this risk when prescribing FDCs for dyslipidemia. Our study suggests the potential utility of Clinical Decision Support Systems and standardizing nomenclature in reducing medication errors, providing valuable insights for clinical practice and future research.
4,000원
Objective: Atopic dermatitis (AD) is a chronic, recurrent inflammatory skin disease. Both tralokinumab and dupilumab have been recommended in the European Guideline for the treatment of adult patients with severe AD. In Korea, dupilumab has been approved for patients with moderate to severe AD, and reimbursed for those with severe AD. Since there is no clinical trial directly comparing tralokinumab and dupilumab, we conducted indirect comparison to assess the clinical usefulness in patients with AD. Methods: We selected clinical trials for indirect comparison through a systematic literature review. Individual patient data were available for the tralokinumab clinical trial, and aggregated data were available for the dupilumab clinical trial. Therefore, we employed the Matching-Adjusted Indirect Comparison (MAIC) method. The treatment efficacy was assessed based on whether patients achieved a 75% reduction on the Eczema Area and Severity Index (EASI 75) after drug administration. Results: The difference in the proportion of patients achieving EASI 75 between tralokinumab and dupilumab was 4.7% (95% CI: −7.9 to 17.3). Considering the non-inferiority margin for the EASI 75 achievement rate is −10%, tralokinumab is deemed non-inferior to dupilumab as the lower bound of the CI for the difference in the EASI 75 achievement rate between tralokinumab and dupilumab was within −10%. Conclusion: We conducted a MAIC analysis comparing tralokinumab and dupilumab based on EASI 75 achievement. The findings of this study show that tralokinumab is non-inferior to dupilumab and can be implemented in Korean clinical settings with a therapeutic position comparable to dupilumab.
국내 약학대학 학생들의 보건의료전문직간 교육에 대한 인식
한국임상약학회 한국임상약학회지 제33권 제3호 2023.08 pp.186-194
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4,000원
Background: Interprofessional education (IPE) is important for collaboration between professionals in the team-based practices of the healthcare field. Objectives: This study aimed to examine pharmacy students across in Korea on the experience of IPE and the perceptions of the importance of interprofessional collaboration (IPC) and the need of IPE. Methods: A cross-sectional survey using a 20 questionnaire to pharmacy students nationwide was conducted from March to May 2019. Results: A total of 555 students from 32 pharmacy schools participated. They recognized that the importance of close pharmacist-medical doctor collaboration was an average of 5.38 points (out of 6 points), but the current level of pharmacist-to-medical doctor collaboration was an average of 2.51 points (out of 6 points), and the reasons for the insufficient IPC were the lack of an environment encouraging mutual cooperation (79.5%) and the psychological distance to the other professional (35.3%). They perceived the necessity of IPE between pharmacistmedical doctor was 4.95 points (out of 6 points), with the curriculum including how to cooperate with medical doctors (78.2%), communication skills (51.0%), and understanding of medical doctors’ functions (44.5%), etc. Only 52 respondents (9.4%) had experience in IPE. Respondents who recognized the importance of IPC (≥5 points) showed 4.44-fold higher agreement on the need for IPE than those who did not (≤4 points) (OR 4.44, 95% CI 2.56, 7.68). Conclusions: Further attention and discussion to add IPE program in the pharmacy school curriculum is necessary in order to cultivate pharmacists with sufficient professional collaboration capabilities.
4,000원
Background: Hematocrit is usually measured from venous blood collected by invasive venipuncture. This study was performed to determine hematocrit accurately and precisely using minimally invasive volumetric absorptive microsampling (VAMS) technique. Such technique is to be applied to determining hematocrit in various clinical settings for the care, including therapeutic drug monitoring, of neonatal or epileptic patients, or patients with high risk of infection or bleeding. Methods: The study was performed using 31 VAMS samples obtained from 21 pancreatic cancer patients. Hematocrit was determined using the values of potassium concentrations obtained from blood in VAMS tips (HctVAMS). HctVAMS was compared with hematocrit measured from blood collected by venipuncture (HctVP). The accuracy and precision of HctVAMS in comparison to HctVP were evaluated using Bland- Altman plot, Deming regression and mountain plot. Results: Bland-Altman plot displayed a random scattering pattern of the differences between HctVAMS and HctVP with the mean bias of −0.010 and the 95% limit of agreement ranging from −0.063 to 0.044. Deming regression for HctVAMS and HctVP line demonstrated very small proportional and constant biases of 1.04 and −0.003, respectively. Mountain plot exhibited a narrow and symmetrical distribution of the differences with their median of −0.011 and central 95% range from −0.049 to 0.033. Conclusion: Hematocrit was accurately and precisely determined using less invasive VAMS technique. Such technique appears to be applicable to determining hematocrit in situations that venipuncture is not favorable or possible.
블렌디드 러닝을 활용한 팀 기반 학습 실습 수업에서 약학대학 학생의 학습만족도와 플랫폼 선호도 : 예비 연구
한국임상약학회 한국임상약학회지 제33권 제3호 2023.08 pp.202-209
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4,000원
Background: With the emergent transition of online learning during the COVID-19 pandemic, the need for online/offline blended learning that can effectively be utilized in a team-based learning (TBL) course has emerged. Methods: We used the online metaverse platforms, Gather and Zoom, along with face-to-face teaching methods in a team-based Introductory Pharmacy Practice Experience (IPPE) course and examined students’ learning satisfaction and achievement, as well as their preferences to the learning platforms. A survey questionnaire was distributed to the students after the IPPE course completion. All data were analyzed using Excel and SPSS. Results: Students had high levels of course satisfaction (4.61±0.57 out of 5) and achievement of course learning objectives (4.49±0.70 out of 5), and these were positively correlated with self-directed learning ability. While students believed that the face-toface platform was the most effective method for many of the class activities, they responded that Gather was the most effective platform for team presentations. The majority of students (64.3%) indicated that blended learning was the most preferred method for a TBL course. Conclusion: Students in a blended TBL IPPE course had high satisfaction and achievements with the use of various online/offline platforms, and indicated that blended learning was the most preferred learning method. In the post-COVID-19 era, it is important to utilize the blended learning approach in a TBL setting that effectively applies online/offline platforms according to the learning contents and activities to maximize students’ learning satisfaction and achievement.
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