• Title/Summary/Keyword: Pharmaceutical Care

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Clinical Outcomes of Multidisciplinary Team Care on the Regulation of Chronic Kidney Disease - Mineral and Bone Disorder (CKD-MBD) in Patients Undergoing Dialysis (미네랄 골질환 합병증을 가진 투석환자에서 다학제 팀 서비스의 임상적 성과)

  • Han, Nayoung;Lee, Sang-Min;Hong, Jin Yi;Noh, Hye Jin;Ji, Eunhee;Song, Yun-Kyoung;Song, Jeeyoun;Kim, In-Wha;Kim, Yon Su;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.4
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    • pp.318-323
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    • 2016
  • Background: Multidisciplinary team care (MTC) is a collaborative approach to treatment plan and ongoing care. We aimed to evaluate the clinical effect of MTC on the regulation of chronic kidney disease-mineral and bone disorder (CKD-MBD) complications in dialysis patients. Methods: This retrospective observational study was approved by the institutional review board. Among patients who have undergone dialysis at admission, the patients admitted to the nephrology ward were allocated to MTC group, and the others to usual care (UC) group. The MTC group had collaborative care by nephrologists, nurses, pharmacists, and nutritionists. The endpoints were the regulation of corrected calcium (cCa) and phosphate (P), the percent of patients in target level of cCa-P product ($cCa{\times}P$), and the prescription rate of non-calcium based P-binders. Results: A total of 163 patients were included from January to December 2009. A significant difference was shown in the percentage of patients in target $cCa{\times}P$ level at admission (MTC vs. UC, 81.40% vs. 91.67%; P = 0.038), but there was no significant difference at discharge. During admission, the cCa and P levels of patients in only UC group were significantly changed. In addition, compared with UC group, patients in MTC group were more likely prescribed appropriate P-binders, when they had higher $cCa{\times}P$ levels than $55mg^2/dL^2$ (P <0.001). Conclusion: It was found that MTC had beneficial effect on improving the regulation of CKD-MBD and the appropriate phosphate binder uses. Therefore, application of the MTC is anticipated to enhance quality of clinical care in chronic diseases.

Efficacy and Safety of Sorafenib for Advanced Non-Small Cell Lung Cancer: a Meta-analysis of Randomized Controlled Trials

  • Wang, Wei-Lan;Tang, Zhi-Hui;Xie, Ting-Ting;Xiao, Bing-Kun;Zhang, Xin-Yu;Guo, Dai-Hong;Wang, Dong-Xiao;Pei, Fei;Si, Hai-Yan;Zhu, Man
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5691-5696
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    • 2014
  • Background: Many clinical trials have been conducted to evaluate sorafenib for the treatment of advanced NSCLC, but the results for efficacy have been inconsistent. The aim of this study was to evaluate the efficacy and safety of sorafenib in patients with advanced NSCLC in more detail by meta-analysis. Methods: This meta-analysis of randomized controlled trials (RCTs) was performed after searching PubMed, EMBASE, ASCO Abstracts, ESMO Abstracts, and the proceedings of major conferences for relevant clinical trials. Two reviewers independently assessed the quality of the trials. Outcomes analysis were disease control rate (DCR), progression- free survival (PFS), overall survival (OS) with 95% confidence intervals (CI) and major toxicity. Subgroup analysis was conducted according to sorafenib monotherapy, in combination with chemotherapy or EGFR-TKI to investigate the preferred therapy strategy. Results: Results reported from 6 RCTs involving 2, 748 patients were included in the analysis. Compared to sorafenib-free group, SBT was not associated with higher DCR (RR 1.31 (0.96- 1.79), p=0.09), PFS (HR 0.82 (0.66-1.02), p=0.07) and OS (HR 1.01 (0.92-1.12), p=0.77). In terms of subgroup results, sorafenib monotherapy was associated with significant superior DCR and longer PFS, but failed to show advantage with regard to OS. Grade 3 or greater sorafenib-related adverse events included fatigue, hypertension, diarrhea, oral mucositis, rash and HFSR. Conclusions: SBT was revealed to yield no improvement in DCR, PFS and OS. However, sorafenib as monotherapy showed some activity in NSCLC. Further evaluation may be considered in subsets of patients who may benefit from this treatment. Sorafenib combined inhibition therapy should be limited unless the choice of platinum-doublet regimen, administration sequence or identification of predictive biomarkers are considered to receive better anti-tumor activity and prevention of resistance mechanisms.

Transitional care for high-risk elderly patients pre/post discharge by collaboration between general hospital and community pharmacy: a pilot study

  • Park, Mi Seon;Lee, Ji Hee;Lee, Heung Bum;Kim, Ju Sin;Choi, Eun Joo
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.1
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    • pp.27-36
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    • 2022
  • Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.

Analysis of Pediatric Drug Dispensing Practice at Hospital Pharmacies (병원약국의 소아약 조제업무 분석)

  • Jung, Sung A;Lee, Eui-Kyoung
    • Korean Journal of Clinical Pharmacy
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    • v.8 no.1
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    • pp.47-53
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    • 1998
  • This study intended to investigate the pediatric drug dispensing practice at hospital pharmacies in order to provide the children with proper pharmaceutical care services. According to the study results, the most significant problem in dispensing pediatric drugs was that only a few pediatric drugs were supplied by the pharmaceutical companies in Korea. It was found that pediatric drugs like rifampicin, phenobarbital and theophylline should be produced in the form of syrup or powder, for the children to swallow drugs with ease. The study results also showed that only $35.5\%$ of the hospital pharmacists reviewed all the prescriptions issued by doctors. In most cases $(65.3\%)$ drug information was only provided when the patients asked to the pharmacists. The lack of working time and clinical information on the patients were found as major barriers. Thus in order to provide better pharmaceutical care services for the children, not only the pharmaceutical companies should pay attention to the production of pediatric drugs, but pharmacists should make every efforts on playing patient-oriented roles.

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The Impact of Wisdom and Pharmaceutical Care on the Corporate Identity of Thai Pharmacy Retail Stores

  • THAVORN, Jakkrit;KLONGTHONG, Worasak;WATCHARADAMRONGKUN, Suntaree;NGAMKROECKJOTI, Chittipa
    • The Journal of Asian Finance, Economics and Business
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    • v.8 no.1
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    • pp.317-326
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    • 2021
  • This study examines factors influencing the corporate identity (CI) of pharmacy retail stores (PRSs) in Thailand as a means to construct a unique corporate identity to represent their strengths and image abroad. An exploratory sequential design was applied. A pilot study involving interviews with four pharmacists was conducted to obtain the variables, and then a questionnaire was designed and administered to 392 respondents. The collected data was analyzed to examine correlations via descriptive analysis, Pearson's correlation, and multiple linear regression (MLR). The results show that wisdom and pharmaceutical care explain 44% of the variance in defining Thai PRSs identity. There is a 61% chance that Thai PRSs should consider wisdom as the most important factor. These findings provide useful insights for pharmacists, pharmaceutical entrepreneurs, and owners of PRSs to enhance competitiveness by devising strategies to create their corporate identity. For the qualitative analysis, Thai PRSs should encourage pharmacists to gain real working experience to develop their wisdom, experience, and skills. Besides, PRSs that build identities as knowledgeable, sincere, and compassionate health providers can successfully expand their operations to other ASEAN countries, as end-consumers will be confident in the reliability of their services.

An Analysis of the Change in Job Contents and Personnel Structure of Hospital Pharmacy Services after the Implementation of the Separation of Prescription and Drug Dispensing Policy (의약분업 이후 병원 약제부서의 업무내용 및 인력구조 변화 분석)

  • Youn, Kyung-Il;Ryu, See-Won
    • Korea Journal of Hospital Management
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    • v.7 no.2
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    • pp.37-51
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    • 2002
  • It has been 2 years since the implementation of the separation of prescription and drug dispensing policy. This study analyzes the effects of the policy on the job contents and personnel structure of hospital pharmacy. The main purposes of the analysis are to determine if the policy has causes the increase of professional activities of pharmacists in hospital and to investigate whether the hospital pharmacy is equipped with enough manpower to provide high quality pharmaceutical service as intended by the policy. The level of professionality of pharmacists' activities is measured by the number of activities of direct involvement in inpatient care such as participation in patient rounding, medication consultation, the number of hospital committee the pharmacists involved and the number of continuous education pharmacists took. The adequacy of personnel structure to provide high quality pharmaceutical care is measured by the level of compliance to the governmental standard of hospital pharmacy personnel. In order to collect the data, surveys were performed for two periods: year 1999 (before the implementation of the policy) and year 2001 (after the implementation of the policy). The results show that the pharmacists' participation in inpatient rounding decreased and that the inpatient medication history management activities, operation of ward pharmacy, participation in hospital committee increased. In personnel structure, the average number of pharmacist per hospital decreased and the number of prescription processing per pharmacist increased. Based on the results this study concludes that the professional activities of hospital pharmacists has increased a little and there were structural changes in hospital pharmacy service activities to increase the professionalism in providing care. However, the pharmacy departments were understaffed hampering the strive to increase the provision of professional pharmaceutical service in hospitals.

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Pharmaceutical Care Services of Community Pharmacies in Korea Through the Review of Literature (문헌자료 고찰을 통한 우리나라 약국서비스 시행 현황)

  • Sohn, Hyun Soon;Kim, Hyojung;Park, Hyekyung;Han, Nayoung;Oh, Jung Mi;Ji, Eunhee
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.1
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    • pp.18-26
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    • 2015
  • Background: The recent change in pharmaceutical education system following the paradigm shift to patient-oriented pharmacy service requires an in-depth discussion to reorganize a future direction and establish a basis for maximizing social values of community pharmacy service. Objective: This study was conducted to review the current status of community pharmacy service provision in Korea based on published literatures. Methods: The electronic databases of National Digital Science Library and Electronic National Assembly Library were used to search the journal articles and dissertation papers. A search term "community pharmacy" was used and the published period was limited to papers published after year 2001, when the legal separation of prescribing and dispensing was implemented. Relevant study reports were also searched manually. Information about pharmacy service provision and study outcomes were retrieved from the selected papers, and classified by predefined individual service scope. Results: A total 33 papers reporting services provided by community pharmacies were selected (journal article 11, dissertation paper 17, and study report 5). Pharmacy services identified in these papers could be classified into prescription dispensing service, pharmaceutical care service, self medication service, other products service, and health promotion service. Twenty papers reported prescription dispensing services, three papers reported pharmaceutical care service, and only two papers reported health promotion service. Current community pharmacy services are highly dependent on prescription drugs while expanded services such as pharmaceutical care and health promotion are peripheral. Most prevalent research topic was medication counseling service (18 papers), reflecting that community pharmacists generally consider it to be the most important and fundamental service. Overall, current pharmacy services are very limited and focus on prescription dispensing service. Conclusion: At this point of time requiring expansion and quality improvement of community pharmacy services, we suggest further lively discussion to strengthen pharmacist's functional identity and set conditions for providing socially expected services.