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이혜연,홍경란,신미정,손현경,진현정,홍경자,나현오 한국병원약사회 1999 병원약사회지 Vol.16 No.3
In relation to medication teaching and patient counselling, a survey on adverse drug reaction(ADRs) of antitubercular drug was conducted in Kangnam St. Mary's Hospital, from April, 1997 to July, 1998. We reviewed medical records(MR) of 231 patients who had taken antitubercular drug and collected data, randomly, through telephone-call from 60 patients. According to the MR, 50.4% of patients experienced and kinds of ADRs and 70.8% of the telephone-call group. In general, most of the ADRs were shown from the MR group within 1∼2 months after starting to take medication and 1 week∼1 month from the telephone-call group, the symptoms were similar in both group. Only 19.3% of the telephone-call group heard an explanation about ADRs, the necessity of good compliance from the doctor. In 13.5% of the MR group stopped taking medications without doctor's permission and 35% of the telephone-call group did not follow the doctor's order for medication in one way or another. The reasons were the lack of understanding about the Anti-tuberculosis medications or occurrence of the ADRs. Also it was fount that 19% of telephone-call group had re-treatment and the period of re-treatment was longer than the first. In conclusion, we have to raise the rate of compliance in order to prevent from the occurrence of drug resistance and treatment failure. Therefore we recommend an introduction of the Directly Observed Therapy(DOT) program, through which the medical doctors and pharmacist can work together to plan and educate the patients to follow the medication orders properly, and activation of the Adverse Drug Reaction Monitoring System in the Hospital.