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bkleesnubh 031-787-2214

?? ?? . ????? ??, noncompliance ??, ??, ????, compliance? ??? ?? ????? ?? ??, ???? ??, ???? ??, ???? ??, ???? ???????? ???? ?? ??/?? ???? ?? ? ???? ??????? ?? ????? ?? ??. . ???? ???? ?? - ??? ????? ?? - ???? ??(drug-related problem)? ?? ???? ??- ??? ?? ?(QOL) ?? ?? . ???? ?? :

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bkleesnubh 031-787-2214

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    1. ? ? ? ????????? ??? bklee@snubh.org 031-787-2214

    2. ?? ?? ????? ??, noncompliance ??, ??, ????, compliance? ??? ?? ????? ?? ??, ???? ??, ???? ??, ???? ??, ???? ?? ?????? ???? ?? ??/?? ???? ?? ? ???? ?? ????? ?? ? ???? ?? ??

    3. ???? ???? ?? - ??? ????? ?? - ???? ??(drug-related problem)? ?? ???? ?? - ??? ?? ?(QOL) ?? ??

    5. ???? ???? -1

    6. ???? ???? -2

    7. ???? ???? -3

    8. ? ? ??????(%) ? ? 20 ??? 55~71 ? ? 8 ??? 40~50 ? ? 30~50 ??? 40

    9. ??????? ?? ?? ?????? ?? ? ? ???? 250 ??? ?? 500+ Nursing home?? 50 ???? ? ???? ? ? 1000

    12. ?? ??? ?? ? ?? ?? ?? ??

    13. Factors related to treatment adherence Characteristics of the patients Characteristics of the treatment regimen Features of the disease Relationship between health care provider and patient Organizational factors

    18. ?? ???? ???, ???? ? ? ?? ?? ? ???? ?? ??, ???? ?? ???? ??? ???? ??? ??? ??/??? : ??? ???? ???? ??? ??? *??? ???, Interpreter ????? : ?? ????, ??, ?? ??

    19. ???? Polypharmacy ??? ??? ??? ??? ?? ?? ? ??? ??? ?? ???? ?? ?? ??? ?? ??(??? ??). ??? ?? ??? ???

    20. ??? ???? : ???? ???, ???? ??, ???? Theophylline : ??, ??, ??, ???? ? ???, ????, ?? ???(?????:?? ???, ?-agonist : ??, ??) ????? : ??? ??, TDM ???, ???, ???? ??? ????????: ?? ?? ???, ???(??, ??, ??), ????? : ????, ???? ? ?? ?????, ??? ???(?-blocker : ?? ??? ?? ??, ACEI : ?? ??) ???? ??????? : ?? ?? ??? ??,?? ?? ??? : ?? ??? ??? Isosorbide : ?? ????

    21. Others

    22. Example Managing Hypertension : Stratigies for Improving Patients Compliances

    27. Estimated Efficacy of Antihypertensive Monotherapy

    30. Change in Mean Sitting Diastolic Blood Pressure and Response Rates with a Fixed-dose Combination Formulation Versus its Components

    31. Interacting With Patients ???? ?? ?? : ??? ??(not ??), face to face interaction ?? : ???? ??? ??, ?? ???? ?? ??, ?? ??? ??, compliane ??? ???? ????, ?? ??

    32. The Personal Barriers in the Consultation Process ??? ???? ?? ?? : ??, ?? ???, ???, ??? ??, ??? ?? 1. Responding understandingly I can't really understand how you feel. The illness of yours was a total surprise to you 2. Responding empathetically I would feel just as much at a loss as you.... I know how frustrated and exhausted you must be. 3. Responding through active listening You seem very nervous about taking this medication. Can you tell me why?

    33. ??? ??? ??

    34. ?? ????? ?? – IHS model 1 OBRA ‘90 ???? ???? ???? ??? ?? ?? ??? ??? ????? ?? ???? ?? (? : ??? , ??? ????? ?, ?? ??? ??? ?, ???? ?) ????, ??, ??, ???? ??? ??? ??? ???? ??, ??? ???? ?? ?? ??? ?? ?? ???? ????? ?? ?? ?? ? ???? OTC? ????, ? ??? ? ?? ?? ?? ??? ? ?? ??? ???, ????, ??? ????? ???? ? ?? ? ????

    35. ?? ????? ?? – IHS model 2 ????? ??? ??? ? ? ?? ?? ??? ??? ???? ???(refill) ?? ?? ??? ?? ?? ?? 24?? ?? ??? ???? ?? ? ? ?? ?? *Open ended questions (do, did, can, will ? who, what, why, when)

    36. ?? ????? ?? -Health Communication Model ??? ???? (??? ?? ? ?? ???? ??) ??? ??? ??? ?? ????? ?? ??? ?? ??? ?? ??? ??? ?? ??? ???? ??? advice ?? (??? ?? ??, ??? ?? ??)

    37. ???? - ???, ?? Q : Enalapril ??? ???, ??? ??????…

    38. ???? – ???? Q : ??? ??? ?? ?? ??? ….

    39. ??? ??(nitroglycerin???, cafergot ) ? 1? ?? ???? ?? ? ?? ? ? ??? ? ?? ?? ?? ?? ??? ?? ?? ???? ?? (prednisolone, carbamazepine, sulfasalazine) ?? ?? ?? ??? ???? ?? (prednisolone, warfarin, amiodarone, calcitriol, digoxin) Methotrexate 1-2?/?, Bactrim 2? /? ?,? ?? ???? - ??

    40. ????-SE/ADE

    41. ? ? ?? ?? ??

    42. ????? : Tetracycline, Sulfonamide, Phenothiazine ? ??? ?? ???, ??? ????? ??? ???? ??: Nitrates, Nifedipine, Indomethacin, Dipyridamole, Cilostazole, Ticlopidine * ??? ?? ??? ??,??,?? : ??? ?? ? ???? ??? ? ??? ?? : Spironolactone, Cimetidine, Phenothiazine… ?? : Risperidone, Methylphenidate, Theophylline,,, ?? : ? ???(Propranolol), ?????(Amantadine) ?? ?? : ACE ??? Impotence? ??? ??? : Clonidine, Methyldopa, ?- ???(Propranolol 2-43% >> Timolol, Atenolol, Labetalol, Nadolol) ???? – SE/ADE ? ???

    45. ???? ??-??? ?? ?

    46. ???? – ??? ??? ???? ??? ???(?? ?? ? 3??) Risk/ Benefit ?? ????: ?? 20? ?? ?? (???? ???? 1/3~1/2? ???) ??? : ????? ??? Vit. A, D ?? ??? : ???? ??(??, ?? ??, ?? ??) ??? : acetaminophen(FDA: B) ???: Penicillin, Cephalosporin, Erythromycin, Lincomycin (FDA: B)

    48. ???? – ??? ????

    49. ???? -?? ???? ?? ?? - ???? ?? ?? ?? : Captopril, Dipyridamole, Isoniazid, Rifampicin - ??? ?? ?? : ??, ?? ?? ??(Bromocriptin, Lisuride) ?? ??? ?? ??( Itraconazole, Lovastatin) ??, ??, ??? - Theophylline : ??? ?? ?? - Chlorpropamide : ??? ??? ?? (Disulfiram like reaction)

    50. ???? - ?? ???? ???? ??? ?? ?? ????(Diazepam, Vit C ?? ?) : ??? ??? ?? ??? ?? ?? ??? ?? ? ???? : ??? ?? ???? ????? ?? ?(? : Chlorambucil ??, dry syrup ??? ??, ??? ?) Nitroglycerin ??? : ??, ???? ??

    51. ????? ?? ?? ? ????

    52. ?? ?? ?? ???

    55. ??? ???? ??

    56. Compliances Aids

    57. ??? ??

    68. ?? Interview Medication Intervention ????

    69. ?? Interview Self Medication (????,?????) ?? Drug allergy ? ADE ?? ?? Drug compliance ?? ???? ?? ?? -> CGA ? ???? ?? -> ??? ???? conference?? ??

    70. Medication Intervention ?? ??/?? (???/???) ???? ?? ?? ??? ??? ?????? ?????? monitoring ???? ???? ?? TDM (Therapeutic Drug Monitoring) TPN (Total Parenteral Nutrition)

    71. ???? ??? ?? ? ?? ??? ?? ??? ?? ?? ??? ?? ?? ? ????? ???? ?? : ?? ??/??,??????, ?? ??? ????, ????, ????? ?? ?

    72. ?????? ??? ????? ??? ?????? ?? ???? ?? ?? ?? Warfarin ? aspirin, ??? ? ?? ???? ????? ??? ????? ???? ??? ?? ? ????, ACS ??, ???? ??

    73. ???? ?? ???? 24?? ??? ??, ???? ?? ??? ??

    74. ????? ???, ??? ??? ?????? ?? ???? ????? ?? 24?? ??? ?? ?? ?? ???? ????-??? ?? ??

    75. ???? ?????? ??? ??

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