diff --git a/backend/pmr_api.py b/backend/pmr_api.py
index 51b410f..fc3e8ec 100644
--- a/backend/pmr_api.py
+++ b/backend/pmr_api.py
@@ -38,6 +38,21 @@ def get_mssql_connection(database='PM_PRES'):
     return pyodbc.connect(conn_str, timeout=10)
 
 
+def warmup_db_connection():
+    """앱 시작 시 DB 연결 미리 생성 (첫 요청 속도 개선)"""
+    try:
+        conn = get_mssql_connection('PM_PRES')
+        conn.cursor().execute("SELECT 1")
+        conn.close()
+        logging.info("[PMR] DB 연결 warmup 완료")
+    except Exception as e:
+        logging.warning(f"[PMR] DB warmup 실패: {e}")
+
+
+# 앱 로드 시 warmup 실행
+warmup_db_connection()
+
+
 # ─────────────────────────────────────────────────────────────
 # 조제관리 페이지
 # ─────────────────────────────────────────────────────────────
@@ -726,36 +741,69 @@ def get_patient_otc_history(cus_code):
         conn = get_mssql_connection('PM_PRES')
         cursor = conn.cursor()
         
-        # OTC 거래 목록 조회 (PRESERIAL = 'V' = OTC 판매)
+        # ✅ 최적화: 한번의 쿼리로 거래 + 품목 모두 조회 (JOIN)
         cursor.execute("""
             SELECT 
                 m.SL_NO_order,
                 m.SL_DT_appl,
                 m.InsertTime,
                 m.SL_MY_sale,
-                m.SL_NM_custom
-            FROM SALE_MAIN m
-            WHERE m.SL_CD_custom = ?
-              AND m.PRESERIAL = 'V'
-            ORDER BY m.InsertTime DESC
-        """, (cus_code,))
+                m.SL_NM_custom,
+                s.DrugCode,
+                g.GoodsName,
+                s.SL_NM_item,
+                s.SL_TOTAL_PRICE,
+                mc.PRINT_TYPE
+            FROM (
+                SELECT TOP (?) *
+                FROM SALE_MAIN
+                WHERE SL_CD_custom = ? AND PRESERIAL = 'V'
+                ORDER BY InsertTime DESC
+            ) m
+            LEFT JOIN SALE_SUB s ON m.SL_NO_order = s.SL_NO_order
+            LEFT JOIN PM_DRUG.dbo.CD_GOODS g ON s.DrugCode = g.DrugCode
+            LEFT JOIN PM_DRUG.dbo.CD_MC mc ON s.DrugCode = mc.DRUGCODE
+            ORDER BY m.InsertTime DESC, s.DrugCode
+        """, (limit, cus_code))
+        
+        # 결과를 order_no별로 그룹핑
+        orders_dict = {}
+        all_drug_codes = []
         
-        # 먼저 거래 목록 수집
-        orders = []
         for row in cursor.fetchall():
-            orders.append({
-                'order_no': row.SL_NO_order,
-                'date': row.SL_DT_appl,
-                'datetime': row.InsertTime.strftime('%Y-%m-%d %H:%M') if row.InsertTime else '',
-                'amount': int(row.SL_MY_sale or 0),
-                'customer_name': row.SL_NM_custom or ''
-            })
+            order_no = row.SL_NO_order
+            
+            if order_no not in orders_dict:
+                orders_dict[order_no] = {
+                    'order_no': order_no,
+                    'date': row.SL_DT_appl,
+                    'datetime': row.InsertTime.strftime('%Y-%m-%d %H:%M') if row.InsertTime else '',
+                    'amount': int(row.SL_MY_sale or 0),
+                    'customer_name': row.SL_NM_custom or '',
+                    'items': []
+                }
+            
+            # 품목 추가 (DrugCode가 있는 경우만)
+            if row.DrugCode:
+                drug_code = row.DrugCode
+                all_drug_codes.append(drug_code)
+                orders_dict[order_no]['items'].append({
+                    'drug_code': drug_code,
+                    'name': row.GoodsName or drug_code,
+                    'quantity': int(row.SL_NM_item or 0),
+                    'price': int(row.SL_TOTAL_PRICE or 0),
+                    'category': row.PRINT_TYPE or '',
+                    'image': None
+                })
         
-        # 최근 limit개만
-        orders = orders[:limit]
+        conn.close()
         
-        if not orders:
-            conn.close()
+        # dict → list 변환
+        purchases = list(orders_dict.values())
+        for p in purchases:
+            p['item_count'] = len(p['items'])
+        
+        if not purchases:
             return jsonify({
                 'success': True,
                 'cus_code': cus_code,
@@ -763,46 +811,6 @@ def get_patient_otc_history(cus_code):
                 'purchases': []
             })
         
-        # 각 거래의 품목 조회
-        purchases = []
-        all_drug_codes = []
-        
-        for order in orders:
-            cursor.execute("""
-                SELECT 
-                    s.DrugCode,
-                    g.GoodsName,
-                    s.SL_NM_item,
-                    s.SL_TOTAL_PRICE,
-                    mc.PRINT_TYPE
-                FROM SALE_SUB s
-                LEFT JOIN PM_DRUG.dbo.CD_GOODS g ON s.DrugCode = g.DrugCode
-                LEFT JOIN PM_DRUG.dbo.CD_MC mc ON s.DrugCode = mc.DRUGCODE
-                WHERE s.SL_NO_order = ?
-                ORDER BY s.DrugCode
-            """, (order['order_no'],))
-            
-            items = []
-            for item_row in cursor.fetchall():
-                drug_code = item_row.DrugCode or ''
-                all_drug_codes.append(drug_code)
-                items.append({
-                    'drug_code': drug_code,
-                    'name': item_row.GoodsName or drug_code,
-                    'quantity': int(item_row.SL_NM_item or 0),
-                    'price': int(item_row.SL_TOTAL_PRICE or 0),
-                    'category': item_row.PRINT_TYPE or '',
-                    'image': None
-                })
-            
-            purchases.append({
-                **order,
-                'items': items,
-                'item_count': len(items)
-            })
-        
-        conn.close()
-        
         # 제품 이미지 조회 (product_images.db)
         image_map = {}
         try:
diff --git a/backend/templates/pmr.html b/backend/templates/pmr.html
index 1202763..3413106 100644
--- a/backend/templates/pmr.html
+++ b/backend/templates/pmr.html
@@ -1880,10 +1880,15 @@
                 
                 if (data.success && data.count > 0) {
                     otcData = data;
-                    // OTC 뱃지 추가 (질병 뱃지 앞에)
+                    // OTC 뱃지 추가 (맨 앞에)
                     const rxInfo = document.getElementById('rxInfo');
-                    const otcBadge = `<span class="otc-badge" onclick="showOtcModal()">💊 OTC ${data.count}건</span>`;
-                    rxInfo.innerHTML = otcBadge + rxInfo.innerHTML;
+                    if (rxInfo && !rxInfo.querySelector('.otc-badge')) {
+                        const otcBadge = document.createElement('span');
+                        otcBadge.className = 'otc-badge';
+                        otcBadge.onclick = showOtcModal;
+                        otcBadge.innerHTML = `💊 OTC ${data.count}건`;
+                        rxInfo.insertBefore(otcBadge, rxInfo.firstChild);
+                    }
                 } else {
                     otcData = null;
                 }