• Title/Summary/Keyword: Korean Pharmacist

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The Role of Pharmacists' Interventions in Increasing Medication Adherence of Patients With Epilepsy: A Scoping Review

  • Iin Ernawati;Nanang Munif Yasin;Ismail Setyopranoto;Zullies Ikawati
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.3
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    • pp.212-222
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    • 2024
  • Objectives: Epilepsy is a chronic disease that requires long-term treatment and intervention from health workers. Medication adherence is a factor that influences the success of therapy for patients with epilepsy. Therefore, this study aimed to analyze the role of pharmacists in improving the clinical outcomes of epilepsy patients, focusing on medication adherence. Methods: A scoping literature search was conducted through the ScienceDirect, PubMed, and Google Scholar databases. The literature search included all original articles published in English until August 2023 for which the full text was available. This scoping review was carried out by a team consisting of pharmacists and neurologists following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and the Joanna Briggs Institute guidelines, including 5 steps: identifying research questions, finding relevant articles, selecting articles, presenting data, and compiling the results. Results: The literature search yielded 10 studies that discussed pharmacist interventions for patients with epilepsy. Five articles described educational interventions involving drug-related counseling with pharmacists. Two articles focused on similar pharmacist interventions through patient education, both verbal and written. Three articles discussed an epilepsy review service, a multidisciplinary intervention program involving pharmacists and other health workers, and a mixed intervention combining education and training with therapy-based behavioral interventions. Conclusions: Pharmacist interventions have been shown to be effective in improving medication adherence in patients with epilepsy. Furthermore, these interventions play a crucial role in improving other therapeutic outcomes, including patients' knowledge of self-management, perceptions of illness, the efficacy of antiepileptic drugs in controlling seizures, and overall quality of life.

Guideline of Improvement and Evaluation of Prescribing Errors in Colorectal Chemotherapy (대장암 항암 화학요법의 처방 오류 평가 및 개선안 제시)

  • Lim, Hyun-Soo;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.2
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    • pp.158-166
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    • 2013
  • Background: Colorectal cancer shows a significant increase in South Korea due to westernization of diet, lack of dietary fiber, drinking and smoking, irregular defecation. There are surgery, chemotherapy, radiation therapy in treatment of colorectal cancer. There may be a medication errors in the process of chemotherapy because of its high toxicity, narrow therapeutic index and the health status of cancer patients. Consequently medication errors can cause increasing the risk of death, prolonging hospital stay and increasing the cost. Among medication errors on medication use process, prescribing errors are of particular concern due to higher risk of serious consequences. It is important for pharmacist to prevent the prescribing errors before reaching patient. Therefore we analyzed the prescriptions of colorectal cancer, classified prescribing errors, suggested guideline to reduce prescribing errors and verified the importance of pharmacist's role in prevention of medication errors activity. Methods: We collected the numbers of prescriptions of colorectal cancer(n=2,373) through anti cancer management program and EMR and analyzed the errors of prescriptions by categories from Oct 1st 2011 to Sep 30th 2012 at Chungbuk National University Hospital. We reviewed the prescriptions as follows - patients' characteristics, the result of test, previous prescriptions, characteristics of antineoplastic agents and patients' allergy, drug sensitivity, adverse events. Prescriptions are classified into inpatient and outpatient and analyzed the errors of prescriptions by categories (dosage form, dose, input, diluents, regimen, product). Results: Total prescription number of inpatient and outpatient of colorectal cancer was 1,193 and 1,180 and that of errors was 107(9%) and 22(1.9%), respectively. In case of errors of categories, the number of errors of dosage form is 69 and 8, errors of dose is 15 and 5, errors of input is 9 and 9 in inpatient and outpatient prescriptions, respectively. Errors of diluents is 8, errors of regimen is 3, errors of product is 3 in only inpatient prescriptions. In case of errors of categories by inpatient department, the number of errors of dosage form is 34 and 35, errors of dose is 7 and 8, errors of input is 6 and 3, errors of diluents is 4 and 4, errors of regimen is 2 and 1, errors of product is 2 and 1 in SG and HO, respectively. In case of outpatient department, the number of errors of dosage form is 8 in HO, errors of dose is 5 in HO, errors of input is 5 and 4 in SG and HO, respectively. Conclusions: The rate of errors of inpatient is higher than that of outpatient. Junior doctors are engaged in prescriptions of inpatient and pharmacist need to pay attention to review all prescriptions. If prescribing errors are discovered, pharmacist should contact the prescriber and correct the errors without delay. The guideline to reduce prescribing errors might be upgrading software of anti cancer management program, education for physicians as well as pharmacists and calling prescriber's attention to preventing recurrence of errors.

Current Status of the Reimbursement for Pharmacist-provided Health Care Services in Japan, the United States, and the United Kingdom (국외 약사서비스 지불보상체계 현황 : 일본, 미국, 영국을 중심으로)

  • Park, Ji Hyun
    • The Journal of the Korea Contents Association
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    • v.22 no.6
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    • pp.712-728
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    • 2022
  • World-widely, there has never been a greater need for people to access high-quality expertise about the effective and safe use of medications. Therefore, the profession of pharmacy should meet these needs of the times, as the demographic shifts have led to a situation where older adults now outnumber children, and polypharmacy is also a commonplace. However, the reimbursement system covered by the National Health Insurance (NHI) in Korea is still limited to the traditional dispensing and compounding role of pharmacist. To provide a take-home message to Korean pharmacy reimbursement system, we aimed to review and analyze the international trends in pharmacy remuneration systems. This is a comparative study between Korea, Japan, the United Kingdom, and the United States. Comparison was conducted by reviewing each country's policy and enforcement programs, as well as the related literature. Japan, the UK and the US systems remunerate diverse patient-centered pharmaceutical care services. The Korean pharmacy service fee is, however, narrowly focused on the traditional product-oriented pharmacy services. This study discussed the future direction of improving pharmacist reimbursement systems in Korea, by expanding professional pharmacy service coverage and diversifying fee schedule.

Clinical pharmacist services in general wards and perception and expectation of healthcare providers towards the services at a tertiary healthcare center (상급종합병원 병동담당약사 업무 현황 및 의료인의 인식과 기대 분석)

  • Kim, Jeongun;Baek, Sijin;Choi, Nayae;Jeon, Sujeong;Namgung, Hyung Wook;Lee, Junghwa;Lee, Euni;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.1
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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.

Effects of Medication Reconciliation and Cost Avoidance Analysis by Clinical Pharmacists in a Neurocritical Care Unit (뇌신경계 중환자실 전담 약사의 활동에 따른 약물 조정 효과 및 회피비용 분석)

  • Cho, Ui Sang;Song, Young Joo;Jung, Young Mi;Choi, Kyung Suk;Lee, Eunsook;Lee, Euni;Han, Moon-Ku
    • Journal of Neurocritical Care
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    • v.11 no.2
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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.

Pharmaceutical Care for Medication Safety in Critically Ill Neonates (신생아중환자의 안전한 약물사용을 위한 약료서비스)

  • An, Sook Hee
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.3
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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.

Effects of an Integrated Case Management Program on Medication Adherence, Pain, Physical Function and Depression among Korean Medical Aid Beneficiaries with Osteoarthritis (의료급여 관절염환자의 복약순응향상을 위한 통합중재프로그램의 효과)

  • Ahn, Yang Heui
    • Journal of Korean Public Health Nursing
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    • v.28 no.1
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    • pp.32-45
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    • 2014
  • Purpose: The purpose of this study was to test the effectiveness of an eight session integrated case management program for improvement of medication adherence, physical function, pain, and depression among medical aid beneficiaries with osteoarthritis. Method: A nonequivalent control group pre-posttest design was employed. Participants were 55 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=28) or control group (n=27). The framework of this research derived from Cox's Interaction Model of Client Health Behavior guided the overall intervention and the components. The program led by a case manager with a medication calendar, motivating interviewing and coaching strategies and collaboration with a pharmacist. Analysis included change in scores, ${\chi}^2$-test, and t-test. Result: The results showed significant increase in medication adherence, physical function and decrease joint pain, joint stiffness and depression in the experimental group compared to the control group. Conclusion: The eight session integrated case management program indicated an effect on medication adherence, pain, physical function, and depression. Partnership with a pharmacist is recommended for medication adherence and conduct of further studies will be needed in order to determine the long-term effect of an extended integrated program on health outcomes.

Evaluation of Scopolamine Patch Pharmacotherapy for Motion Sickness in S. Korean

  • Lim, Sung-Cil;Lee, Myung-Koo;Lee, Chong-Kil;Lee, Bo-Reum
    • Biomolecules & Therapeutics
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    • v.16 no.2
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    • pp.161-167
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    • 2008
  • Scopolamine patch is an effective anticholinergic and antiemetic agent for motion sickness in S. Korea. Since this medication is Over The Counter (OTC) medication and may cause serious side effects when misused. Therefore, we evaluate the safety and efficacy for scopolamine patch in this study. We selected and surveyed total 43 patients who purchased scopolamine patch from three different pharmacies located at S and C Express Bus terminals and P Port at Seoul, Cheongju, and Busan. In the result, 11 patients (8${\sim}$15 year old:25.6%) were correctly used scopolamine patch with a children dose and 2 patients were misused. 26 (15${\sim}$60 year old: 60.4%) and 4 (over 6o year old: 9.3%) patients were correctly used with a adult dose. 33 patients (69.9%)answered that they knew the directions well how to use scopolamine patch correctly. Only 24.2% (n=8) patients learned the directions by pharmacist's consultation. Most patients (45 frequencies with duplicate counts) had some experienced side effects and among those drowsiness is the most common one. In conclusion, scopolamine patch as a non-prescription drug (OTC) should be monitored by pharmacist with correct drug consultation.

Study of the UK Pharmacy Education and the Pharmacy Registration Assessment: In England and Wales (영국의 약사교육체계와 국가면허 시험제도 연구: England 와 Wales지역을 중심으로)

  • Kim, Yun Jung
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.2
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    • pp.61-67
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    • 2015
  • Pharmacy education and training is continuously evolving to meet the requirement from the society in the UK. Most pharmacy schools offer the Master of pharmacy degree which is a four year undergraduate programme followed by a year of pre-registration placement spanning a year supervised by a professional pharmacist who has at least 3 years' post-registration experience; however, some universities provide either a 5-year sandwich course where the pre-registration training is split up into two periods of 6 months or a 2-year OSPAP programme for those who are already qualified as a pharmacist outside of the UK. The GPhC has announced that the format of the registration assessment is set to change in 2016. The exam questions from 2016 will be more clinical, practical and based around a patient in a real-life scenario. This article addresses important aspects of UK pharmacy education such as university curriculum, training programme, and licence exam, therefore, could potentially offer a significant contribution to the debate about raising academic standards of pharmacy education in South Korea.