DOI QR코드

DOI QR Code

A Systematic Review of Outcomes Research in the Hospital Pharmacists' Interventions in South Korea

국내 병원약사의 중재활동과 성과에 대한 체계적 문헌고찰

  • Lee, So Young (College of Pharmacy, Sookmyung Women's University) ;
  • Cho, Eun (College of Pharmacy, Sookmyung Women's University)
  • 이소영 (숙명여자대학교 약학대학) ;
  • 조은 (숙명여자대학교 약학대학)
  • Received : 2019.05.17
  • Accepted : 2019.09.05
  • Published : 2019.09.30

Abstract

Background and Objective: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. Methods: A literature search of the following databases was performed: Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were "hospital pharmacist", "clinical pharmacist", and "Korea". Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. Results: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians' prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). Conclusion: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists' professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.

Keywords

References

  1. American Journal of Health-System Pharmacy. ASHP statement on pharmaceutical care. American Journal of Health-System Pharmacy 1993;50(8):1720-3. https://doi.org/10.1093/ajhp/50.8.1720
  2. Park SY, Choi HY, Nagaya-Sriraman S, et al. Management and curricular components of pharmacy residency programs in Korean hospitals. Yakhak Hoeji 2009;53(4):165-72.
  3. Oh SY. Study on the direction of improvement of the system of pharmacy specialties in Korea. M.S. Thesis for Graduate School of Public health Yonsei University; 2016.
  4. Kwon KH. A study on the pharmacy manpower project 'vision 2030'. 2013.
  5. The Korean Society of Health-system Pharmacists. Board Certified Pharmacist 2004. Available from http://www.kshp.or.kr/. Accessed June 19, 2018.
  6. American Pharmacists Association. BPS Specialties. Available from https://www.bpsweb.org/bps-specialties/. Accessed April 4, 2019.
  7. Seon CJ. The introduction of BPS(Board of Pharmaceutical Specialties). J Kor Soc Health-Syst Pharm 2008;25(1):1-4.
  8. Kang JE, Han NY, Oh JM, et al. Pharmacist-involved care for patients with heart failure and acute coronary syndrome: a systematic review with qualitative and quantitative meta-analysis. Journal of clinical pharmacy and therapeutics 2016;41(2):145-57. https://doi.org/10.1111/jcpt.12367
  9. Gallagher J, McCarthy S, Byrne S. Economic evaluations of clinical pharmacist interventions on hospital inpatients: a systematic review of recent literature. International journal of clinical pharmacy 2014;36(6):1101-14. https://doi.org/10.1007/s11096-014-0008-9
  10. Carmen CG, Fernandez LF, Rotta I, et al. Characterization of pharmacists' interventions in asthma management: A systematic review. Journal of the American Pharmacists Association 2018;58(2):210-9. https://doi.org/10.1016/j.japh.2017.12.009
  11. Omran D, Guirguis LM, Simpson SH. Systematic review of pharmacist interventions to improve adherence to oral antidiabetic medications in people with type 2 diabetes. Canadian Journal of Diabetes 2012;36(5):292-9. https://doi.org/10.1016/j.jcjd.2012.07.002
  12. Al Aqeel S, Abanmy N, AlShaya H, et al. Interventions for improving pharmacist-led patient counselling in the community setting: a systematic review. Systematic reviews 2018;7(1):71. https://doi.org/10.1186/s13643-018-0727-4
  13. Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic reviews 2015;4:1. https://doi.org/10.1186/2046-4053-4-1
  14. Lee JY. Meta-analysis. Journal of Korean society of endocrinology 2008;23(6):361-78. https://doi.org/10.3803/jkes.2008.23.6.361
  15. Ah YM, Lee JY, Moon MR. Clinical and economic evaluation of pharmacists' contribution to patient care on a multi-disciplinary liver transplant team. International journal of clinical pharmacology and therapeutics 2016;54(2):102-9. https://doi.org/10.5414/CP202501
  16. Han JM, Ah YM, Suh SY, et al. Clinical and economic impact of pharmacists' intervention in a large volume chemotherapy preparation unit. International journal of clinical pharmacy 2016; 38(5):1124-32. https://doi.org/10.1007/s11096-016-0339-9
  17. Park SJ, Suh GY, Lee YM, et al. Evaluation of a clinical pharmacist dosage-adjustment intervention in a teaching hospital medical intensive care unit. Latin America J of Pharmacy 2014;33(4):579-86.
  18. Song YJ, Kim M, Huh S, et al. Impact of an antimicrobial stewardship program on unnecessary double anaerobic coverage prescription. Infection & chemotherapy 2015;47(2):111-6. https://doi.org/10.3947/ic.2015.47.2.111
  19. Choe HM, Kim J, Choi KE, et al. Implementation of the first pharmacist-managed ambulatory care anticoagulation clinic in South Korea. American journal of health-system pharmacy: AJHP: official journal of the American Society of Health-System Pharmacists 2002;59(9):872-4. https://doi.org/10.1093/ajhp/59.9.872
  20. Park TY, Lee SM, Kim SE, et al. Pharmacotherapeutic problems and pharmacist interventions in a medical intensive care unit. Korean Journal of Critical Care Medicine 2015;30(2):82-8. https://doi.org/10.4266/kjccm.2015.30.2.82
  21. Han YH, Park AR, Kim SJ, et al. Effects of the improved method in patient education on rituximab chemotherapy by pharmacists. J Kor Soc Health-Syst Pharm 2014;31(2):724-34. https://doi.org/10.32429/JKSHP.2014.31.2.004
  22. Lee JH, Roh JH, Suh YW, et al. Assessment of medications for geriatric inpatients based on revised inappropriate medication criteria and cost avoidance by intervention of pharmacists J Kor Soc Health-Syst Pharm 2014;31(1):629-37. https://doi.org/10.32429/jkshp.2014.31.1.004
  23. Ryuo JE, Suh YW, Lee BK, et al. Rational intervention of pharmacists during the prescription alteration by comprehensive geriatric assessment. J Kor Soc Health-Syst Pharm 2008;25(2):121-32.
  24. Park TY, Kim YH, Jung YM, et al. The comparison analysis of the prevention of adverse drug events through order interventions by designated-pharmacists. J Kor Soc Health-Syst Pharm 2014;31(1):638-43. https://doi.org/10.32429/JKSHP.2014.31.1.005
  25. Lee Yh, Lee YJ, Hwang EJ, et al. Colon cancer patients'incidence rate of peripheral neuropathy by treated with oxaliplatin and examing change of adverse effects by consultation. J Kor Soc Health-Syst Pharm 2011;28(2):118-26. https://doi.org/10.32429/JKSHP.2011.28.2.005
  26. Lee SY, Nam JY, Lee JY, et al. Evaluation of medication knowledge before and after the education program by pharmacists in patients with rheumatoid arthritis. J Kr Soc Hosp Pharm 2009;26(3):244-51.
  27. Lee JE, Cho YJ, Han HJ, et al. Ca and P levels in ESRD patients and the evaluation of a patient education. J Kr Soc Hosp Pharm 1999;16(4):489-94.
  28. Choi SI, Shin HT, Choi HM, et al. Development and evaluation of anticoagulation clinical pharmacy service for ambulatory patients in a community hospital. Kor J Clin Pharm 1995;5(2):17-31.
  29. Kim SR, Oh JM, Joe YH, et al. Development and evaluation of pharmacists' medication management guideline in pediatric intensive care unit. JKrSocHospPharm 2004;21(4):389-403.
  30. Oh YK, Lee GS, Rhie S. Neonatal total nutritional pharmacy service at intensive care unit at a university hospital in Korea. Kor J Clin Pharm 2013;23(2):167-74.
  31. Yang HR, Choi CW, Kim BI, et al. Clinical significance of the nutritional support team for preterm infants in a neonatal intensive care unit. Pediatric gastroenterology, hepatology & nutrition 2009;12(1):39-45. https://doi.org/10.5223/kjpgn.2009.12.1.39
  32. Yoo SH, Ko YJ, Park AR, et al. Analysis of intervention in chemotherapy prescription and improvement in prevention of prescribing errors by the pharmacist. J Kor Soc Health-Syst Pharm 2012;29(2):131-8.
  33. Park JA, Kim JH, Son YM, et al. Cost-effectiveness analysis of pharmacist's clinical pharmacokinetics-Vancomycin. J Kor Soc Health-Syst Pharm 2012;29(2):107-20.
  34. Ahn IY, Kim HS, Jeong YM, et al. A strategy for pharmacists' participation in an antimicrobial stewardship program and its effect. J Kr Soc Hosp Pharm 2016;33(4):341-8.
  35. Kang MK, Yoon SH, Heo YS, et al. Prevention of medication errors by pharmacists' intervention of chemotherapy. J Kor Soc Health-Syst Pharm 2011;28(3):288-95. https://doi.org/10.32429/jkshp.2011.28.3.005
  36. Choe I, Kim KJ, Moon HS, et al. Evaluation of a nutritional support team's impact on treating ,malnourished patients. J Kor Soc Health-Syst Pharm 2011;28(4):390-5. https://doi.org/10.32429/jkshp.2011.28.4.006
  37. Jung JW, Sohn YM, Park HJ, et al. Effects of pharmacist interventions in a surgical intensive care unit. J Kor Soc Health-Syst Pharm 2014;31(4):908-18.
  38. Kim SE, Shin HT, Yoo TW. The effect of medication teaching activities of clinical pharmacist on drug compliance in patients with hypertension in an ambulatory setting. J Kr Soc Hosp Pharm 1992;9(1):44-8.
  39. Kim JH, Cho NC, Han HK. Change of patient recognition degree for patient consultation for the end-stage renal disease in hemodialysis room. J Kor Soc Health-Syst Pharm 2005;22(2):112-7.
  40. Chung JW, Kang YJ, Moon MY, et al. Preliminary study for Economic evaluation of clinical pharmacist intervention. J Kor Soc Health-Syst Pharm 2011;28(4):327-36.
  41. Shin MH, Oh JM, Jeong KJ, et al. Evaluation of pharmacists medication teaching service for hospitalized cancer patients. Kor J Clin Pharm 2002;12(2).
  42. Jung YJ, Ahn Jh, Seock HJ, et al. Studies on the roles of transplant pharmacists: pescription intervention for solid organ transplant inpatients. J Kor Soc Health-Syst Pharm 2014;31(6):1099-109. https://doi.org/10.32429/jkshp.2014.31.6.004
  43. Ahn SS, Kim EH, Kim SJ, et al. The cost-effectiveness evaluation for the pharmacist's therapeutic intervention in type-2 diabetes patients. J Kor Soc Health-Syst Pharm 2011;28(4):317-26.
  44. Kwon SY, Bae HJ, Kwon MS, et al. The preoperative nutritional assessment and the effect of TPN in major abdominal surgery. J Kr Soc Hosp Pharm 2008;25(3):1-9.
  45. Kwak EJ, Sin HJ, Chun PS. The effects of follow-up telephone calls combined with face-to-face meetings on clinical and humanistic outcomes in patients with type 2 diabetes mellitus. Yakhak Hoeji 2015;59(6):270-7. https://doi.org/10.17480/psk.2015.59.6.270
  46. Lee MB, Shin HT, Kim SY. Clinical outcome of educational program using self-monitoring of peak expiratory flow rate for asthma patients. Kor J Clin Pharm 1999;9(2):97-102.
  47. Kim SJ, Kim SM, Choi B-C, et al. The analysis of the outcome of standardized hospital pharmacist training and repeated asthma patient education. Yakhak hoeji 2010;54(6):507-21.
  48. Park IK, Lee SY, Yun JY, et al. The necessity of pharmacist in specialty for the diabetic pharmacotherapy. Yakhak hoeji 2009;53(4):217-21.
  49. Han EA, Yang BM, K LE. Cost-benefit analysis of clinical pharmacokinetic consultation service of theophylline. Quality Improvement in Health Care 2000;7(2):168-79.
  50. Sohn KH. Adverse drug reaction profile in patients with cancer chemotherapy and pharmacist's intervention in the ambulatory care unit. J Kr Soc Hosp Pharm 2012;29(2):149-60.
  51. Cho E, Yoo JH, Lee EK, et al. The effect of anticoagulation service on patient satisfaction and hospital profit. J Kor Soc Health-Syst Pharm 1999;16(2):214-24.
  52. Ye KN, Kim JY, Kim HS, et al. Effect of anticoagulation service on patients treated with warfarin. J Kr Soc Hosp Pharm 2005;22(1):46-53.
  53. Mun Y and Oh JM. The factors influencing the health-related QOL in hemodialysis patients. J Kor Soc Health-Syst Pharm 2002;19(3):269-82.
  54. Kwon MG, Jung HM, Jin YD. The approaches to enhance the efficiency of patient education for chronic respiratory diseases. J Kor Soc Health-Syst Pharm 2005;22(1):19-22.
  55. Yun EH, Shin KM, Lee ST. The effect of patient counseling at the respiratory clinic in eulji general hospital. J Kor Soc Health-Syst Pharm 1999;16(2):209-13.
  56. Son HY, Kim MG, Kwon MG, et al. The assessment of the levels of patient satisfaction and the strategy for improvement of education program for patients with respiratory disease in Paik Hospital. J Kor Soc Health-Syst Pharm 2007;24(2):124-30.
  57. Lim JK, Yang SH, Shin MJ, et al. Assessment of the inhalation technique after medication counseling using the request form for inhaler. J Kor Soc Health-Syst Pharm 2000;17(1):127-34.
  58. Kang MK, Kim AJ, Cho YS, et al. Effect of clinical pharmacist interventions on prevention of adverse drug events in surgical intensive care unit. Korean J Crit Care Med 2013;28(1):17-24. https://doi.org/10.4266/kjccm.2013.28.1.17
  59. Yu SK, Park SI, Park SY, et al. The effect of repeated education using a computerized scoring system for the proper use of inhalation medicine. Tuberculosis and Respiratory Diseases 2007;63(6):491-6. https://doi.org/10.4046/trd.2007.63.6.491
  60. Newman SP, Weisz A, Talaee N, et al. Improvement of drug delivery with a breath actuated pressurised aerosol for patients with poor inhaler technique. Thorax 1991;46(10):712-6. https://doi.org/10.1136/thx.46.10.712
  61. Prasanna D, Rajesh V, Satish K, et al. Assessment of clinical pharmacist intervention in tertiary care teaching hospital of Southern India. Asian Journal of Pharmaceutical and Clinical Research. 2013;6(Suppl 2):258-61.
  62. Shareef J, Fernandes J, Samaga LN. Clinical pharmacist interventions in drug therapy in patients with diabetes mellitus and hypertension in a university teaching hospital. International Journal of Pharmaceutical Sciences and Research 2015;6(10):4424-32.
  63. Leape LL, Cullen DJ, Clapp MD, et al. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA 1999;282(3):267-70. https://doi.org/10.1001/jama.282.3.267
  64. Claudia L and Heile H. Clinical pharmacists' interventions in a German university hospital. Pharm World Sci 2010;32(2):194-9. https://doi.org/10.1007/s11096-010-9367-z
  65. Somers A, Robays H, De PP, et al. Evaluation of clinical pharmacist recommendations in the geriatric ward of a Belgian university hospital. Clinical interventions in aging 2013;8:703-9. https://doi.org/10.2147/CIA.S42162
  66. Suzan N K, Michael P, Mark M, et al. Pharmacists on rounding teams reduce preventable adverse drug events in hospital general medicine units. Arch Intern Med 2003;163(17):2014-8. https://doi.org/10.1001/archinte.163.17.2014
  67. Lee ES. Safe and secure handling of medicine strengthening pharmaceutical care systems. 2017.
  68. Hammick M, Freeth D, Koppel I, et al. A best evidence systematic review of interprofessional education. Medical teacher 2007;29(8):735-51. https://doi.org/10.1080/01421590701682576
  69. Revision of Pharmaceutical Affairs Law 'Order-Hospital pharmacist should participate in Drug intervention work. Multidisciplinary care service'. Available from http://www.dailymedipharm.com/news/articleView.html?idxno=39838. Accessed June 18, 2018.
  70. Kim MJ, Kim YK, Shin SJ. Job performance by advanced practice nurses in Korea. Korean Journal of Adult Nursing 2014;26(6):630-41. https://doi.org/10.7475/kjan.2014.26.6.630
  71. Sung YH, Lee YH, Lim KC, et al. The development of outcome indicators for advanced practice nurses Journal of Korean Clinical Nursing Research 2010;16(3):157-74.
  72. Difficulty of Institutionalization of Advanced Practice Nursing. Available from http://www.monews.co.kr/news/articleView.html?idxno=108480. Accessed June 19, 2018.

Cited by

  1. 제4차 산업혁명과 미래 약사 직능의 변화 vol.30, pp.4, 2019, https://doi.org/10.24304/kjcp.2020.30.4.217