• 한국의료질향상학회지
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• 제9권2호
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• pp.230-240
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• 2002

Background : The purpose of this study was to develop, implement and evaluate the pharmacist intervention program designed to identify and correctly adjust the dosage of $H_2$-receptor antagonists ($H_2RA$) in renally impaired patients and promote timely conversion of $H_2RA$ from IV to PO therapy. Methods : The study population consisted of renally impaired patients who received $H_2RA$ therapy from April 9 to May 8, 2001 at Hallym Medical Center. Each morning a specifically developed software program identified patients with serum creatinine (Scr) greater than 1.2 mg/dl or age greater than 65 years. The pharmacist, then screened the pharmacy profiles of the identified patients to determine if the patient was on $H_2RA$. For these patients on $H_2RA$ with renal impairement the creatinine clearance (CrCl) was calculated using Cockroft & Gault equation. The pharmacist determined the proper dosage for each identified patients based on the calculated CrCl and the oral dosage that would be appropriate for whom IV therapy was no longer indicated. Result : A total of 149 cases (101 patients) were monitored during the study period. The dosage was inappropriately prescribed for renal function in 61 of 149 cases (41%), and of those, pharmacist made recommendations for 58 cases of which 33 cases (57%) were accepted by the physicians. The administration route of H2RA was inappropriately used as IV in 22 of 53 cases (42%), and pharmacist made recommendations for those 22 cases of which 15 cases (68%) were accepted. Conclusion : Monitoring of patients with renal dysfunction by a pharmacist improved the dosing of $H_2RA$ and a dosing program of patients with renal impairment would be of benefit to other clinicians and institutions seeking to optimize patient care.

• 대한약학회:학술대회논문집
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• 대한약학회 2001년도 Proceedings of International Convention of the Pharmaceutical Society of Korea
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• pp.321.1-321.1
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• 2001

• 대한신경집중치료학회지
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• 제11권2호
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• pp.110-118
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• 2018

Background: The role of clinical pharmacists in medication therapy to improve clinical and economic outcomes has been reported in the literature. This study was conducted to analyze the changes in details of medication interventions before and after the introduction of clinical pharmacists into the care of neurocritical care unit (NCU) patients, and to evaluate the economic effects of clinical pharmacists by calculating the avoidance cost. Methods: A retrospective study was conducted reviewing the electronic medical records from June 2013 to May 2014 (before), and from June 2016 to May 2017 (after). We calculated the number and rates of intervention, the acceptance rates of it, and also reviewed the list of interventions. We calculated avoidance cost if there was no intervention. Results: The monthly mean number of interventions increased from 8.0 (${\pm}5.7$) to 31.7 (${\pm}12.8$) (P<0.001) and the frequency of intervention also increased from 0.8% to 1.6% (P=0.003). The most frequently provided pharmacist intervention was nutritional support before introduction of clinical pharmacists and discussions on the medication plan after. The number of classified interventions was 14 before introduction of clinical pharmacist services and 33 after. The calculated cost avoidance associated with a clinical pharmacists' integration was 77,990,615 won per year. Conclusion: Introduction of clinicals pharmacist into the NCU was associated with increased intervention rates and expanded types of clinical interventions. The cost avoidance achieved by the pharmacists' interventions can be further explored to evaluate if similar expansions of pharmacists' services achieve similar results in other settings.

• 한국임상약학회지
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• 제9권2호
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• pp.97-102
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• 1999

The effects of pharmacist's intervention for asthma patients using self-monitoring of peak expiratory flow rate in medication teaching model was evaluated for 3 months in improving clinical outcomes including emergency visits, hospitalizations, antibiotics use, symptoms and sleep disturbance. Twenty seven patients were enrolled in study and twenty three patients completed the follow-up schedules. The selected patients were given the pre-designed instruction for medication including appropriate use of medication, metered-dose inhaler(MDI) technique, identifying and controling asthma triggers and recognizing early signs of deterioration. There were significant improvements in clinical outcomes, in terms of emergency visits, hopitalizations, antibiotics use, symptoms and sleep disturbance. There were also significant improvements in the MDI use, environmental control, and medication knowledges. There was a progressive increase in peak expiratory flow rate during the three-month intervention. In conclusion, pharmacist's intervention using self-monitoring of peak expiratory flow rate has a significant impact on improving clinical outcomes in asthma patients.

• 한국임상약학회지
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• 제32권1호
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• pp.20-26
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• 2022

Background and objective: The Seoul National University Bundang Hospital (SNUBH) implemented ward-based clinical pharmacy system with designated pharmacists in 10 general wards. Designated pharmacists conduct inpatient medication review, medication intervention, and medication consultation, and provide drug information for health care providers. This study aimed to evaluate the clinical pharmacy services and to examine the perception and expectations of health care providers on the services provided by the designated pharmacists in general wards. Methods: A survey was constructed to include questions on the health care providers' recognition, satisfaction, and perceived needs of designated pharmacists. We determined the frequency and type of interventions of ward pharmacist and their acceptance rate through a retrospective observational study using electronic medical records. Results: A total of 59 health care providers responded the questionnaire and 79.7% of the respondents reported moderate to high levels of satisfaction. Satisfaction with the services was positively associated with clinical interventions and nutrition support team (81.4%). Of 59 respondents, 88.1% agreed that preventing drug-related problems by designated pharmacists' activities were effective. The most common interventions included inadequate dosage (27.4%), omission and additional prescription (14.6%) and inadequate drug form (9.6%). The acceptance rate of intervention was 91.5%, and 151 potentially serious risks and 523 significant risks were prevented by the intervention. Conclusion: Positive results were confirmed in the awareness, satisfaction, and perceived needs of the health care providers for designated pharmacists. Expansion of the ward-based clinical pharmacy system with designated pharmacists to other wards may be considered.

• 한국임상약학회:학술대회논문집
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• 한국임상약학회 2003년도 추계학술대회
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• pp.97-111
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• 2003

• 한국임상약학회:학술대회논문집
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• 한국임상약학회 2004년도 The 4th Conference on Clinical Pharmacy
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• pp.51-59
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• 2004

• 한국임상약학회지
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• 제30권3호
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• pp.143-148
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• 2020

Objective: This study aimed to investigate pharmaceutical care for critically ill neonates and suggest targeted strategies compatible with the Korean health-system pharmacy. Methods: Articles that reported pharmacy practices for critically ill neonates were reviewed. Pharmaceutical care practices and roles of neonatal pharmacists were identified, and criteria were developed for neonates in need of specialized care by clinical pharmacists. Results: Neonatal pharmacists play many roles in the overall medication management pathway. For clinical decision support, multidisciplinary ward rounds, clinical pharmacokinetic services, and consultation for pharmacotherapy and nutrition support were conducted. Prevention and resolution of drug-related problems through review of medication charts contributed to medication safety. Pharmaceutical optimization of intravenous medication played an important role in safe and effective therapy. Information on the use of off-label medicine, recommended dosage and dosing schedules, and stability of intravenous medicine was provided to other health professionals. Most clinical practices for neonates in Korea included therapeutic drug monitoring and nutrition support services. Reduction in medication errors and adverse drug reactions, shortening the duration of weaning medicines, decreasing the use and cost of antimicrobials, and improvement in nutrition status were reported as the outcomes of pharmacist-led interventions. The essential criteria of pharmaceutical care, including for patients with potential high-risk factors for drug-related problems, was developed. Conclusion: Pharmaceutical care for critically ill neonates varies widely. Development and provision of standardized pharmaceutical care for Korean neonates and a stepwise strategy for the expansion of clinical pharmacy services are required.

• 한국임상약학회지
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• 제26권4호
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• pp.291-297
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• 2016

Background: The current educational goals and missions of pharmacy schools in Korea were analyzed to examine the current orientation and future direction of pharmaceutical education. Methods: Educational mission statements were obtained from the homepages of 35 pharmacy schools and subjected to convert into codes. Themes and categories were induced using qualitative content-analysis from the codes and compared according to location of school (capital area versus province), public versus private, and date of initial enrollment (before versus in 2011). The themes and categories were compared with "the eight-star pharmacist" suggested by World Health Organization (WHO) and International Pharmaceutical Federation (FIP). Results: Twelve themes, 44 categories, and 496 codes were identified. Themes included pharmaceutical expertise, professionalism, contribution to society, basic educational ideology, sphere of activity, leadership, research, dealing with future change, problem-solving ability, self-management and development, cooperation, and respect for life. Mission statements of schools that initially enrolled in 2011 cited humankind level contribution (p=0.011), patient-centered care (p=0.026), and globalization (p=0.018) more frequently than those enrolled before 2011. Most schools mentioned about care-giver, researcher, and decision-maker which were stated in "the eight-star pharmacist". Conclusion: To meet the growing social requirements of a pharmacist's roles, wide-ranging active discussion on establishing educational goals should be made.

• 한국임상약학회지
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• 제25권4호
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• pp.231-237
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• 2015

Backgrounds: Patient counseling has been forced since June. 19, 2014. Prior to this, there was no study to try to standardize medication counseling to improve quality. Purpose: This study was to investigate satisfaction level and comprehension level between the pharmacist group and the patient group about standardized medication counseling sheet. Methods: Questionnaires to assess standardized patient counseling sheet were posted at online survey software (Qualtrics) to pharmacists who worked at community pharmacy and patients who had visited community pharmacy before. Results: Three hundred thirty five patients and three hundred nineteen pharmacists were responded to the questionnaire (Response rate: 72.9%). More than half of each group were satisfied with standardized medication counseling sheets 'for the general public', 'for the pregnant women and nursing mothers', 'for the chronic patient', and 'for the aged' and patient group were more satisfied than pharmacist group. Similarly, more than half of each group comprehended with the medication counseling sheets 'for the general public', 'for the pregnant women and nursing mothers', 'for the chronic patient', and 'for the aged'. Patient group tended to expect longer patient counseling time per one drug than pharmacist group. Also, the majority of both groups wanted to provide standardized medication counseling sheets constantly and extend for all drugs. Conclusion: Both groups were satisfied and comprehended standardized medication counseling sheets, and agreed to expand standardized medication counseling sheets to all drugs. So, it is necessary to build the standardized medication counseling of all drugs.