• 한국임상약학회지
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• 제24권2호
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• pp.80-89
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• 2014

The study objectives were to investigate the attitude of Ajou University pharmacy students toward pharmaceutical care and to identify their perceived barriers to its provision. Secondarily, their career choices and influential factors for career decision were assessed. Method: A cross-sectional survey of Ajou University pharmacy students in all professional years was conducted in May 2014. Results: Over 2 weeks, a total of 123 students participated in the study (100% response rate). All respondents agreed that pharmaceutical care is the right direction for the provision to be headed and that pharmaceutical care will improve patient health. However, professional year was inversely associated with the degree of positive attitude toward pharmaceutical care. Highly perceived barriers to pharmaceutical care included poor image of pharmacist's role in society (67%) and lack of access to the patient medical record in the pharmacy (65%). Work environment, benefits, and salary were top three influential factors for career plans, and $6^{th}$ year students considered salary most important. Patient-oriented practices (hospital and community pharmacy) were the most preferred career choices among $6^{th}$ year students. Conclusion: Pharmacy clerkships appeared to have a positive influence on career choices of those students. Efforts should be exerted to improve pharmacy clerkships and to promote pharmaceutical care.

• 한국임상약학회지
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• 제27권1호
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• pp.1-8
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• 2017

The prevalence of diabetes and its related morbidity and mortality are being increased. Despite the advancement of evidence-based pharmacotherapy in the management of diabetes, many patients in our country do not achieve satisfied therapeutic outcomes. Pharmaceutical care service can be defined as a patient-centered clinical service provided by pharmacists to improve therapeutic outcomes and quality of life of patients, by identifying, and preventing or resolving drug-related problems (DRPs). Pharmaceutical care service is interdisciplinary team-based practice, and is provided through collaborative practice agreement (CPA) between one or more physicians and pharmacists. This article describes a model of pharmaceutical care service which can be adopted in our country for patients with diabetes in the ambulatory care settings. With the successful implementation of this service, clinical, economic, and humanistic outcomes of patients will be improved. Therefore, by actively implementing pharmaceutical care service, pharmacist should contribute to the promotion of patients' health and to the advancement of health care delivery system.

• 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.

• 약학회지
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• 제51권5호
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• pp.327-335
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• 2007

This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.

• 한국임상약학회지
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• 제29권1호
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• pp.45-55
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• 2019

Background: Although the importance of pharmaceutical care service has been growing to meet the needs of customers with the improvement of clinical and humanistic outcomes, there was not a systematic strategy to promote research in Korea. The aim of this study was to suggest the core agendas for pharmaceutical care services research and development (R&D) considering priorities. Methods: Based on desk researches, we developed R&D agendas for the needs of improving pharmaceutical care services in the area of institution, community, and public health. To determine the priority of agendas in developing pharmaceutical care service, analytic hierarchy process (AHP) analysis was performed by the 14 experts. Criteria and subcriteria were assessed for significance by pairwise comparisons. Then, agendas were evaluated for importance according to each subcriteria, and rank ordered considering the weight calculated by multiplying the importance scores of the criteria and the subcriteria. Results: We derived 25 agendas including 13 for institutional pharmaceutical care service, 8 for community pharmaceutical care service, and 4 for public-health related pharmaceutical care service. AHP model was constructed based on 4 criteria and 8 subcriteria by a hierarchical structure. From the AHP survey, the 'Development of pharmaceutical care service for metabolic and chronic disease' agenda accounted for the highest priority. Conclusion: We have developed the R&D agendas of the pharmaceutical care service which should be promoted. The results should be utilized by the government to nationally support the development of the standards and relevant regulations related to pharmaceutical care services in Korea.

• 한국임상약학회지
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• 제24권4호
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• pp.272-281
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• 2014

Objective: The provision of pharmaceutical care service in compliance with good pharmacy practice (GPP) standards is important, but there is lack of studies to investigate the barriers that significantly hinder community pharmacies in Korea from adhering to the standards. This study was aimed to identify the major barriers to provision of pharmaceutical care service in compliance with the proposed pharmacy practice standards which have been developed based on the GPP standards recommended jointly by WHO and FIP. Methods: Questionnaires reviewed by the expert committee were posted for 32 days on the website which is most frequently accessed by community pharmacists. The respondents completed them by checking the scores (Max=5, Min=1) for major barriers to provision of pharmaceutical care service focusing on patient information management and drug use review process in prescription fillings. The answered scores were automatically collected using online data processing. Mean differences between scored data were assessed by ANOVA. Results: Total 321 pharmacists participated in the survey. Results indicated that 'difficulty of diagnosis identification' (m=3.92, SD=1.21), 'lack of time' (m=3.48, SD=1.22) and 'lack of updated clinical information' (m=3.17, SD=1.10) were the major barriers to provision of pharmaceutical care service in patient information management. The main barriers to drug utilization review were 'lack of time' (m=3.32, SD=1.21), 'lack of updated clinical information' (m=3.11, SD=1.17), and 'negative feedbacks or refusals from prescribers' (m=3.00, SD=1.38). There were significant differences among the groups by location, employed number of pharmacists and acceptability to the proposed GPP standards. Conclusion: Difficulties in managing patient clinical information and lack of time were found to be the major barriers in providing pharmaceutical care services in community pharmacies in Korea. Further research is recommended to determine ways to reduce these barriers in order to provide quality pharmaceutical care service that is in compliance with the internationally recognized GPP guidelines.

• 한국임상약학회지
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• 제24권4호
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• pp.282-287
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• 2014

Objective: Objective of this study was to investigate community pharmacy-based pharmaceutical care accessibility in Korea. Survey on the current pharmaceutical care service provision was performed by PM2000 XE, a real-time pharmacy manager program, operated by Korea Pharmaceutical Information Center beginning November 4, 2013 until December 6, 2013 towards all community pharmacies throughout the nation which use the program. Method: The survey questionnaire consisted of four sections: pharmacy type, time-based accessibility, item-based accessibility, and spatial accessibility for non-prescription drugs. Results: Number of pharmacy responded to the survey was 331, and size of the responding pharmacy was mostly medium-scale (66.47%) with 30-99 prescription fillings a day. Proportion of pharmacy with opening hour of 12 hours or longer was only 53.77% and it was less than 25% during saturdays and holidays. Item-based accessibility was generally acceptable for prescription and non-prescription drugs, medical devices, and health supplements. However, spatial accessibility for non-prescription drugs was problematic because only one quarter of the drugs was displayed over the counter, and most of the drugs were behind the counter so that customers could not reach out. Conclusion: Based on the survey result, current situation for accessibility of pharmaceutical care service in Korea is concluded inadequate and therefore needs multidimensional efforts to improve accessibility of the service at national level such as Korea Pharmaceutical Association and Ministry of Health and Welfare.

• 한국임상약학회지
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• 제31권1호
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• pp.12-20
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• 2021

The World Anti-Doping Agency has made efforts to promote the safe use of medications and prevent doping in sports globally. International standards have been established and experts have advocate anti-doping education to athletes and healthcare professionals. Pharmacists are expected to participate in the pharmaceutical care activity of sports medicine in protecting the athletes while providing the spirits of clean sports. In this review, we described the pharmacists' roles and functions in six areas of sports pharmaceutical care: awareness, treatment, prevention, optimization, abuse, and monitoring. Sports pharmacists should be able to prevent inappropriate drug use and manage athletes' illness and injury using pharmacotherapy. Further pharmacists should actively involve to educate and counsel athletes, trainers, and healthcare teams. In conclusion, pharmacists are expected to play important roles in sports pharmacy, which is the emerging area of specialized pharmaceutical care services.

• 한국임상약학회지
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• 제25권3호
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• pp.138-144
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• 2015

Objective: It is to evaluate the drug interaction monitoring program as a pilot project to develop a pharmaceutical care model in a medical intensive care unit and to analyze the influencing factors of drug interactions. Method: Electronic medical records were retrospectively investigated for 116 patients who had been hospitalized in a medical intensive care unit from October to December in 2014. The prevalence of adverse reaction with risk rating higher than 'D' was investigated by Lexi-$Comp^{(R)}$ Online database. The factors related with potential drug interaction and with treatment outcomes were analyzed. Results: The number of patients with a potential interaction of drug combination was 92 (79.3%). Average ages, the length of stay in the intensive care unit and the numbers of prescription drugs showed significant differences between drug interaction group and non-drug interaction group. Opioids (14.4%), antibiotics (7.2%), and diuretics (7.2%) were most responsible drug classes for drug interactions and the individual medications included furosemide (6.4%), tramadol (4.9%), and remifentanil (4.5%). There were 950 cases with a risk rating of 'C' (84.6%), 142 cases with a risk rating of 'D' (12.6%), and 31 cases with a risk rating of 'X' (avoid combination) (2.8%). The factors affecting drug interactions were the number of drugs prescribed (p < 0.0001) and the length of stay at intensive care unit (p < 0.01). The patients in intensive care unit showed a high incidence of adverse reactions related to potential drug interaction. Therefore, drug interaction monitoring program as a one of pharmaceutical care services was successfully piloted and it showed to prevent adverse reaction and to improve therapeutic outcomes. Conclusion: Active participation of a pharmacist in the drug management at the intensive care unit should be considered.

• 한국임상약학회지
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• 제24권3호
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• pp.169-182
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• 2014

Background: There exist some different perceptions on clinical pharmacy between Korean and western societies. Since the pharmacists who received the 6-year pharmacy education join the pharmacy profession soon, it appears imperative to know whether the western-style clinical pharmacy is adaptable to Korean-style pharmacy education and profession. Methods: The authors surveyed 54 professors in the membership directory of the Korean College of Clinical Pharmacy (KCCP) on their perceptions on clinical pharmacy and clinical pharmacists, and their willingness for adapting clinical pharmaceutical care (CPC) and clinical pharmaceutical sciences (CPS) into clinical pharmacy education. The survey consists of 47 questions including dichotomized and Likert scale questionnaires in the areas of respondent demographics, clinical pharmacy, clinical pharmacists, CPC and CPS. Results: Of the 54 KCCP members surveyed, 29 completed the questionnaires in full and one in part. It appears that most KCCP members acknowledge the existence and importance of the two major fields of clinical pharmacy, CPC and CPS. Twenty-eight (96.6%) and seventeen members (68.0%) agreed to introduce CPC and CPS into the clinical pharmacy education in Korea, respectively. Seventeen (63.0%) answered CPC would be successfully adapted in Korea. Twenty (74.1%) agreed that it is desirable for clinical pharmacists to perform CPC and CPS simultaneously. Conclusion: Based on this survey, the authors suggest that pharmacy schools provide their students with the education opportunities on CPC to nurture clinical pharmacists through a master's program and CPS to foster clinical pharmaceutical scientists through a Ph.D. program.